Author's introductionThis review of recent feminist analyses and theorizing of labor markets uses a global lens to reveal the forces shaping gender inequality. The first section introduces the key words of globalization, gender and work organization. Next, I examine gender as embodied labor activity in globalized worksites, and the effects of globalization on gendered patterns of work and life. Putting gender at the center of globalization discourses highlights the historical and cultural variability of gender relations intersecting with class, race and nationality, and highlights the impact of restructuring on workers, organizations and institutions at the local, national and regional as well as transnational levels. Then I turn to look at labor market restructuring through commodification of care, outsourcing of household tasks and informalization of employment to show how these processes shape the complexity of relationships between and the interconnectedness of social inequalities transnationally and in global cities. Place matters when analyzing how service employment alters divisions of labor and how these labor market changes are gendered. Global restructuring not only poses new challenges but also creates new opportunities for mobilization around a more robust notion of equality. The final section explores the development of spaces for collective action and the rise of new women's and feminist movements (e.g., transnational networks, non‐governmental agencies). The study of globalization, gender and employment has broad importance for understanding not only the social causes but also the social consequences of the shift to a post‐industrial society.Author recommendsAcker, Joan 2004. 'Gender, Capitalism and Globalization.'Critical Sociology 30, 1: 17–41.Feminist scholarship both critiques gender‐blind globalization discourses and an older generation of women and development theories. By tracing the lineage of current feminist literature on globalization to women and development research, Joan Acker shows both the continuities and distance traveled from the previous terrain of debate. New feminist scholarship on globalization owes a debt to these important, albeit limited, studies of women at work in Latin America, Africa and Asia, but acknowledges the need to go beyond the category of women to analyze specific forms and cultural expressions of gendered power in relationship to class and other hierarchies. One of the major advances in feminist theory comes under the microscope of Acker's keen analysis when she excavates how gender is both embodied and embedded in the logic and structuring of globalizing capitalism. This extends the case she made in her earlier pioneering research on gender relations being embedded in the organization of major institutions. For the study of globalization, Acker posits that the gendered construction (and cultural coding) of capitalist production separated from human reproduction has resulted in subordination of women in both domains. Acker uncovers the historical legacy of a masculine‐form of dominance associated with production in the money economy that was exported to and embedded in colonialist installation of large‐scale institutions. By the late 20th Century large‐scale institutions promoted images and emotions that expressed economic and political power in terms of new articulations of hegemonic masculinity. As an article outlining debates on the nature of globalization and of gender, it serves as a good introduction to the topic.Chow, Esther Ngan‐Ling 2003. 'Gender Matters: Studying Globalization and Social Change in the 21st Century.'International Sociology 18, 3: 443–460.Chow's introduction to the special issue on 'Gender, Globalization and Social Change in the 21st Century' in International Sociology (2003) reviews the literature on gender and globalization and provides an excellent overview of 'gender matters.' Her definition of globalization captures salient features of the current era. This definition encompasses the economic, political cultural and social dimensions of globalization. Further, she offers a framework for studying the 'dialectics of globalization', as 'results of conflicting interaction between the global and local political economies and socio‐cultural conditions…' A dialectics of globalization is a fruitful approach for studying transformative possibilities. This article could serve as background reading or as part of an introductory section.Arlie Russell Hochschild, Arlie Russell. 2003. 'Love and Gold.' Pp. 15–30 in Global Women: Nannies, Maids and Sex Workers in the New Economy, edited by Barbara Ehrenreich and Arlie Russell Hochschild. Metropolitan Books.Hochschild's chapter in Global Women examines the transfer of traditional women's work to migrant women. Women in rich countries are turning over care work (nannies, maids, elder care) to female migrant workers who can be paid lower wages with few or no benefits and minimal legal protections. This global transfer of services associated with a wife's traditional role extracts a different kind of labor than in prior migrations based on agricultural and industrial production. Emotional, sexual as well as physical labor is extracted in this current phase of globalization; in particular, emotional labor and 'love is the new gold'. Women migrate not only to escape poverty, but also to escape patriarchy in their home countries by earning an independent income and by physical autonomy from patriarchal obligations and expectations. Many female migrants who leave poor countries can earn more money as nannies and maids in the First World than in occupations (nurses, teachers, clerical workers) if they remained in their own country. Thus, migration can be seen as having contradictory effects on women's well‐being and autonomy. This chapter can be used in a section dealing with the specific topic of globalization and care work or in a section introducing the topic of gendered labor activities.McDowell, Linda, Diane Perrons, Colette Fagan, Kath Ray and Kevin Ward. 2005. 'The Contradictions and Intersections of Class and Gender in a Global City: Placing Working Women's Lives on the Research Agenda.'Environment and Planning A 37, 441–461.This group of prominent social geographers from the UK collaborates to great effect in a welcome addition to the literature theorizing the complex articulations of gender and class in global cities. Their detailed research comparing three localities in Greater London is a corrective to the oft‐cited multi‐site study of global cities by Saskia Sassen. They find that Sassen underestimates gains and losses for both men and women in the 'new' economy. Place makes a difference when assessing the impact of women's increased rates of labor market participation on income inequality and patterns of childcare. The article outlines a new research agenda by 'placing' working women's lives at the center of analysis.Parrenas, Rhacel Salazar 2008. The Force of Domesticity: Filipina Migrants and Globalization. New York: New York University Press.Rhacel Salazar Parrenas brings together her influential research on Filipina migrants and extends her path‐breaking ethnographic analysis to include Filipina domestic workers in Rome and Los Angeles and entertainers in Tokyo. David Eng incisively captures the importance of Parrenas's analysis when he states, 'Extracted from home and homeland only to be reinserted into the domestic spaces of the global north, these servants of globalization exemplify an ever‐increasing international gendered division of labor, one compelling us to reexamine the neo‐liberal coupling of freedom and opportunity with mobility and migration'. The book is well suited to illuminate discussions of domesticity and migration, transnational migrant families, the impact of migration laws in 'home' and 'host' countries, and transnational movements among migrant women.Walby, Sylvia. 2009. Globalization and Inequalities: Complexity and Contested Modernities. London: Sage.This book introduces new theoretical concepts and tests alternative hypotheses to explain variation in trajectories of gender relations cross‐nationally. It synthesizes and reviews a vast literature, ranging from the social sciences to the natural sciences to construct a new approach to theorizing the development of gender regimes in comparative perspective. Sylvia Walby seeks to explain the different patterns of inequalities across a large number of countries. The analysis differentiates between neo‐liberal and social democratic varieties of political economy, and makes explicit the gender component of institutions and their consequences. The project builds on Walby's pioneering work on comparative gender regimes, and extends the research by operationalizing empirical indicators for a range of key concepts, and by analyzing links between a wide set of institutions (including economy, polity, education and violence) and how these are gendered in specific ways. As in the past, Walby is not afraid to tackle big questions and to offer new answers. Throughout the book, like in her previous body of research, Walby takes on the question of social inclusion/exclusion and critically interrogates concepts of democracy, political participation, equality and rights. Walby uses a comparative lens to examine the democratic 'deficit' in liberal and social democratic countries, and how migration restructures patterns of inequality and the consequent reconstitution of national and ethnic relations within countries. There is more to the book than abstract theoretical debates. Walby poses and assesses alternative political projects for achieving equality. The book is an original contribution that will likely influence sociology in general and theories of social change in particular.Online resourcesStatus of women in the world: United Nations Development Fund for Women (UNIFEM) http://www.unifem.orgUNIFEM was established at the United Nations in order to foster women's empowerment through innovative programs and strategies. Its mission statement summarizes UNIFEM's goals as follows: 'Placing the advancement of women's human rights at the center of all of its efforts, UNIFEM focuses on reducing feminized poverty, ending violence against women; reversing the spread of HIV/AIDS among women and girls; and achieving gender equality in democratic governance in times of peace as well as war'. The website includes information on global initiatives such as zero tolerance of violence against women, the impact of the economic crisis on women migrant workers, and strategizing for gender proportionate representation in Nigeria. Primary documents relevant to women's advancement appear on the website; these include the Convention on the Elimination of all Forms of Discrimination Against Women (CEDAW) and the UN Security Council Resolution 1325 on Women, Peace and Security. UNIFEM publishes monographs assessing the progress of women around the world. One notable example is the 2005 publication on Women, Work & Poverty by Martha Chen, Joann Vanek, Francie Lund, James Heintz with Renana Jhabvala and Christine Bonner. http://www.unifem.org/attachments/products/PoWW2005_eng.pdf Gender equity index http://www.socialwatch.org/en/avancesyRetrocesos/IEG_2008/tablas/valoresdelIEG2008.htm Social Watch produces an up‐to‐date gender equity index composed of three dimensions and indicators: empowerment (% of women in technical positions, % of women in management and government positions, % of women in parliaments, % of women in ministerial posts); economic activity (income gap, activity rate gap); and education (literacy rate gap, primary school enrollment rate gap, secondary school enrollment gap, and tertiary education enrollment gap). These separate indicators in addition to the gender equity index are arrayed by country. There are 157 countries, representing 94% of the world's population, in the sample. Mapping these indicators across countries presents a comparative picture of the absolute and relative standing of women and gender equity in the world.Focus QuestionsKey words: Globalization1. What is meant by globalization?
a. To what extent is globalization new? Or is globalization another phase of a long historical process? b. Can we differentiate inter‐national (connections between) from the global (inter‐penetrations)?
Feminism and globalization
How do feminist interventions challenge globalization theories (for example the presumed relationship between globalization and homogenization and individualization)? How do different feminisms frame and assess the conditions of globalization around the world?
Gender and globalization
What role do women, and different women, play in the global economy? Are patriarchal arrangements changing as a result of greater economic integration at the world level?
Migration and mobilities
What does Parrenas mean by partial citizenship?
How does it relate to the case of Philippine migrant workers? What is the relationship between 'home' and 'host' nations? How important is a vehicle like the Tinig Filipino in forging 'imagined communities' and new realities?
What is the mix of choice and compulsion in the different migrations mobilities of men and women?
Globalization and politics
Are women subject to the same kinds of legal protections (and regulations) that evolved in earlier periods? Do new flexible production processes and flexible work arrangements undercut such legal protections?
Globalization and collective mobilization
Does globalization open spaces for new women's movements, new solidarities, new subjectivities and new forms of organizing?
Sample syllabusCourse outline and reading assignments Conceptualizing the 'Global' and 'Globalization' Dicken, Peter, Jamie Peck and Adam Tickell. 1997. 'Unpacking the Global.' Pp. 158–166 in Geographies of Economies, edited by Roger Lee and Jane Willis. London: Arnold.Amin, Ash and Nigel Thrift. 1996. 'Holding Down the Global.' Pp. 257–260 in Globalization, Institutions, and Regional Development in Europe, edited by Ash Amin and Nigel Thrift. Oxford: Oxford University Press.Acker, Joan. 2004. 'Feminism, Gender and Globalization.'Critical Sociology 30: 17–42.Background Reading:Gottfried, Heidi. 2006. 'Feminist Theories of Work.' Pp. 121–154 in Social Theory at Work, edited by Marek Korczynski, Randy Hodson, Paul Edwards. Oxford: Oxford University Press.Peterson, V. Spike. 2008. 'Intersectional Analytics in Global Political Economy.' in UberKeruszungen, edited Cornelia Klinger and Gudrun‐Axeli Knapp. Munster: Wesfalisches Dmpfboot.Chow, Esther Ngan‐Ling. 2003. 'Gender Matters: Studying Globalization and Social change in the 21st Century.'International Sociology 18 (3): 443–460.Walby, Sylvia. 2009. Globalization and Inequalities: Complexity and Contested Modemities. London: Sage. Gender and Globalization Gottfried, Heidi. Forthcoming. 'Gender and Employment: A Global Lens on Feminist Analyses and Theorizing of Labor Markets.'Sociology CompassFernandez‐Kelly, Patricia and Diane Wolf. 2001. 'Dialogue on Globalization.'Signs 26: 1243–1249.Bergeron, Suzanne. 2001. 'Political Economy Discourses of Globalization and Feminist Politics.'Signs 26: 983–1006.Freeman, Carla. 2001. 'Is Local: Global as Feminine: Masculine? Rethinking the Gender of Globalization.'Signs 26:1007–1037. Theorizing Politics and Globalization Sassen, Saskia. 1996. 'Toward a Feminist Analytics of the Global Economy.'Indiana Journal of Global Legal Studies 4: 7–41.Parrenas, Rhacel Salazer. 2001. 'Transgressing the Nation‐State: The Partial Citizenship and 'Imagined (Global) Community' of Migrant Filipina Domestic Workers.'Signs 26:1129–1154.Bosniak, Linda. 2009. 'Citizenship, Noncitizenship, and the Transnationalization of Domestic Work.' Pp. 127–156 in Migrations and Mobilities: Citizenship, Borders, and Gender, edited by Seyla Benhabib and Judith Resnik. New York: New York University Press.Background Reading:Benhabib, Seyla and Judith Resnik. 2009. 'Introduction: Citizenship and Migration Theory Engendered.' Pp. 1–46 in Migrations and Mobilities: Citizenship, Borders, and Gender, edited by Seyla Benhabib and Judith Resnik. New York: New York University Press. Migrations, Mobilities and Care Hochschild, Arlie Russell. 2003. 'Love and Gold.' Pp. 15–30 in Global Women: Nannies, Maids and Sex Workers in the New Economy, edited by Barbara Ehrenreich and Arlie Russell Hochschild. Metropolitan Books.Hondagneu‐Sotelo, Pierrette. 2001. Domestica: Immigrant Workers Cleaning and Caring the Shadows of Affluence. Berkeley: University of California Press.Parrenas, Richard Salazar. 2008. The Force of Domesticity: Filipina Migrants and Globalization. New York: New York University Press.Pyle, Jean 2006. 'Globalizations, Transnational Migration, and Gendered Care Work.'Globalizations 3(3): 283–295.Qayum, Seemin and Raka Ray. 2003. 'Grappling with Modernity: India's Respectable Classes and the Culture of Domestic Servitude.'Ethnography 4: 520–555. Restructuring and Gender Inequality in Global Cities McDowell, Linda, Diane Perrons, Colette Fagan, Kath Ray and Kevin Ward. 2005. 'The Contradictions and Intersections of Class and Gender in a Global City: Placing Working Women's Lives on the Research Agenda.'Environment and Planning A 37: 441–461.McDowell, Linda. 1997. 'A Tale of Two Cities? Embedded Organizations and Embodied Workers in the City of London.' Pp. 118–129 in Geographies of Economies, edited by Roger Lee and Jane Willis. London: Arnold.Bruegel, Irene. 1999. 'Globalization, Feminization and Pay Inequalities in London and the UK.' Pp. 73–93 in Women, Work and Inequality, edited by Jeanne Gregory, Rosemary Sales and Ariane Hegewisch. New York: St. Martin's Press. Embodiment and Restructuring Halford, Susan and Mike Savage. 1997. 'Rethinking Restructuring: Embodiment, Agency and Identity in Organizational Change.' Pp. 108–117 in Geographies of Economies, edited by Roger Lee and Jane Willis. London: Arnold.Gottfried, Heidi. 2003 'Temp(t)ing Bodies: Shaping Bodies at Work in Japan.'Sociology 37: 257–276. Gender in the Global Economy: Post‐Socialist and Emerging Economies Salzinger, Leslie. 2004. 'Trope Chasing: Engendering Global Labor Markets.'Critical Sociology 30: 43–62.Kathryn Ward, Fahmida Rahman, AKM Saiful Islam, Rifat Akhter and Nashid Kama. 2004. 'The Nari Jibon Project: Effects on Global Structuring on University Women's Work and Empowerment In Bangladesh.'Critical Sociology 30: 63–102Otis, Eileen. 2007. 'Virtual Personalism in Beijing: Learning Deference and Femininity at a Global Luxury Hotel. Pp. 101–123 in Working in China: Ethnographies of Labor and Workplace Transformation, edited by Ching Kwan Lee. Routledge.Background Reading:Ferguson and Monique Mironesco (eds.). 2008. Gender and Globalization in Asia and the Pactific: Method, Practice, Theory. Honolulu: University of Hawaii Press. Globalization and Policy Developments Lenz, Ilse. 2004. 'Globalization, Gender and Work: Perspectives on Global Regulation.' Pp. 29–52 in Equity in the Workplace: Gendering Workplace Policy Analysis, edited by Heidi Gottfried and Laura Reese. Lexington Press.Woodward, Alison. 2004. 'European Gender Mainstreaming: Promises and Pitfalls of Transformative Policy.' Pp. 77–100 in Equity in the Workplace: Gendering Workplace Policy Analysis, edited by Heidi Gottfried and Laura Reese, Lexington Press.Fraser, Nancy. 2007. 'Reframing Justice in a Globalizing World.' in Global Inequality, edited by David Held and Ayse Kaya. Polity. Gender and the New Economy Walby, Sylvia, Heidi Gottfried, Karin Gottschall and Mari Osawa. 2006. Gendering and the Knowledge Economy: Comparative Perspectives, Palgrave, See chapters by Sylvia Walby, Mari Osawa, and Diane Perrons.Ng, Cecelia. 2004. 'Globalization and Regulation: The New Economy, Gender and Labor Regimes.'Critical Sociology 30: 103–108. Globalization and Transnational Organizing Ferree, Myra Marx. 2006. 'Globalization and Feminism: Opportunities and Obstacles for Activism in the Global Area.' Pp. 3–23 in Global Feminism: Transnational Women's Activism, Organizing, and Human Rights, edited by Myra Marx Ferree and Aili Mari Tripp. New York: New York University Press.Yuval‐Davis, Nira. 2006. 'Human/Women's Rights and Feminist Transversal Politics.' Pp. 275–295 in Global Feminism: Transnational Women's Activism, Organizing, and Human Rights, Myra Marx Ferree and Aili Mari Tripp. New York: New York University Press.Mohanty, Chandra Talpade. 2006. "Under Western Eyes" Revisited: Feminist Solidarity Through Anti‐Capitalist Struggles.' Pp. 17–42 in Feminism without Borders: Decolonizing Theory, Practicing Solidarity, edited by Durham, N.C.: Duke University Press.
Background: Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (>= 65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0-100 based on the 2.5th and 97.5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target-1 billion more people benefiting from UHC by 2023-we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings: Globally, performance on the UHC effective coverage index improved from 45.8 (95% uncertainty interval 44.2-47.5) in 1990 to 60.3 (58.7-61.9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2.6% [1.9-3.3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010-2019 relative to 1990-2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0.79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388.9 million (358.6-421.3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3.1 billion (3.0-3.2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968.1 million [903.5-1040.3]) residing in south Asia. Interpretation: The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people-the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close-or how far-all populations are in benefiting from UHC.
The Situation In The Middle East This Record Contains The Text Of Speeches Delivered In English And Of The Translation Of Speeches Delivered In Other Languages. ; United Nations S/PV.8195 Security Council Seventy-third year 8195th meeting Wednesday, 28 February 2018, 10.35 a.m. New York Provisional President: Mr. Alotaibi. . (Kuwait) Members: Bolivia (Plurinational State of). . Mr. Inchauste Jordán China. . Mr. Wu Haitao Côte d'Ivoire. . Mr. Tanoh-Boutchoue Equatorial Guinea. . Mr. Ndong Mba Ethiopia. . Ms. Guadey France. . Mr. Delattre Kazakhstan. . Mr. Tumysh Netherlands. . Mr. Van Oosterom Peru. . Mr. Meza-Cuadra Poland. . Ms. Wronecka Russian Federation. . Mr. Nebenzia Sweden . Mr. Orrenius Skau United Kingdom of Great Britain and Northern Ireland . Mr. Allen United States of America. . Ms. Eckels-Currie Agenda The situation in the Middle East Report of the Secretary-General on the implementation of Security Council resolutions 2139 (2014), 2165 (2014), 2191 (2014), 2258 (2015), 2332 (2016) and 2393 (2017) (S/2018/138) This record contains the text of speeches delivered in English and of the translation of speeches delivered in other languages. The final text will be printed in the Official Records of the Security Council. Corrections should be submitted to the original languages only. They should be incorporated in a copy of the record and sent under the signature of a member of the delegation concerned to the Chief of the Verbatim Reporting Service, room U-0506 (verbatimrecords@un.org). Corrected records will be reissued electronically on the Official Document System of the United Nations (http://documents.un.org). 18-05507 (E) *1805507* S/PV.8195 The situation in the Middle East 28/02/2018 2/22 18-05507 The meeting was called to order at 10.35 a.m. Adoption of the agenda The agenda was adopted. The situation in the Middle East Report of the Secretary-General on the implementation of Security Council resolutions 2139 (2014), 2165 (2014), 2191 (2014), 2258 (2015), 2332 (2016) and 2393 (2017) (S/2018/138) The President (spoke in Arabic): In accordance with rule 39 of the Council's provisional rules of procedure, I invite the following briefers to participate in this meeting: Mr. Mark Lowcock, Under-Secretary- General for Humanitarian Affairs and Emergency Relief Coordinator, and Mr. Jeffrey Feltman, Under- Secretary-General for Political Affairs. The Security Council will now begin its consideration of the item on its agenda. I wish to draw the attention of the members of the Council to document S/2018/138, which contains the report of the Secretary-General on the implementation of Security Council resolutions 2139 (2014), 2165 (2014), 2191 (2014), 2258 (2015), 2332 (2016) and 2393 (2017). I now give the floor to Mr. Lowcock. Mr. Lowcock: We have received a lot of questions about resolution 2401 (2018), which the Security Council adopted on Saturday, 22 February, and its demand for a cessation of hostilities without delay for at least 30 consecutive days throughout Syria. I want to start today by answering the questions we have received. Is the United Nation ready to deliver to people who need humanitarian assistance? Yes. We have convoys ready to go to 10 besieged and hard-to-reach locations, including a 45-truck convoy with aid for 90,000 people to Douma and eastern Ghouta. Are you ready to support medical evacuations from eastern Ghouta? Yes, we are working very closely with the International Committee of the Red Cross (ICRC), the Syrian Arab Red Crescent and other health partners on that. Has resolution 2401 (2018) been implemented? Is there a ceasefire in Syria? No, and no. Have you got any inter-agency cross-line convoys through to hard-to-reach or besieged areas? No. Have you been given permission to access any of those locations? No. Have you received the necessary facilitation letters for convoys? No. Have there been any medical evacuations? No. Have any civilians left eastern Ghouta? No. Is there any actual improvement in the humanitarian situation in eastern Ghouta since the adoption of the resolution demanding, as it did, unimpeded access? No. Can you deliver assistance in eastern Ghouta during a humanitarian pause between 9 a.m. and 2 p.m. local time? To quote the ICRC Middle East Director, who spoke about that yesterday: "It is impossible to bring a humanitarian convoy in five hours." Agencies now have years of experience in that area, and it can take a day simply to pass checkpoints, even when the parties have agreed. The goods then have to be offloaded. If there has been no humanitarian access since the adoption of resolution 2401 (2018) on Saturday, what has happened in the past few days? More bombing, fighting, death, destruction, maiming of women and children, hunger and misery — in other words, more of the same. On 26 February, two days ago, airstrikes, barrel bombs and artillery shelling were reported across eastern Ghouta, including in Harasta, Shafuniyeh, Otaya, Hosh Eldawahreh, Al-Ashari, Jobar, Beit Sawa, Hazerma, Hannnura, Nashabiyeh, Sagba and Douma. Reports indicate that at least 30 civilians, including women and children, were killed. In Shafuniyeh, 14 people, including three women and four children, were reportedly killed and many others injured by airstrikes. Eighteen civilians, including drivers of ambulances, women and children, were reportedly received at health facilities in Shafuniyeh with difficulties breathing, consistent with the use of chlorine. One child reportedly died as a result. On the same day, two workers from local non-governmental organizations (NGOs) were reportedly killed as a result of shelling on the besieged enclave. It was also reported that two health-care facilities in Saqba were taken out of service by airstrikes. In the past few days, shells have also reportedly continued to fall on Damascus city from eastern Ghouta. Since 18 February, more than 580 people are now reported to have been killed due to air and ground strikes in eastern Ghouta, with many more than 1,000 people injured. At the same time, hundreds of rockets fired from eastern Ghouta into Damascus have reportedly killed 15 people and injured more than 200. I now want to update the Security Council on the situation in other parts of the country. 28/02/2018 The situation in the Middle East S/PV.8195 18-05507 3/22 In Idlib, fighting continues to kill and injure civilians, destroy civilian infrastructure and result in large population movements. Since December, an estimated 385,000 people have been displaced, with many civilians moving north. Half of Idlib's population was already displaced. People are being forced to move yet again, with each disruption increasing their vulnerability. Civilians are concentrated in an ever-smaller area. Many are forced to live in makeshift camps or in the open air. Formal camps are overwhelmed, operating at up to 400 per cent of their capacity. The response is being stretched to its limits. We are receiving reports of civilian deaths and injuries and of restriction on the movement of many civilians as a result of military operations in Afrin. Those who risk moving continue to be stopped at exit points by the local authorities in Afrin, preventing them from accessing safer areas. We believe that, so far, approximately 5,000 people have reached the surrounding villages and Aleppo city. Tens of thousands are believed to be displaced within Afrin. The Turkish authorities have emphasized to us their willingness to facilitate humanitarian access. We would like to see aid convoys operated from Damascus. However, to date that has not been agreed by the Syrian side. In Raqqa city, conditions remain unsafe for the return of internally displaced persons (IDPs). Among those trying to return home, 637 people have been injured and more than 125 killed by unexploded ordinance since last October. Medical and other essential services are absent and access for humanitarian workers to the city remains precariously limited because the conditions are so dangerous. As I have said before, demining activities need to be accelerated as a matter of urgency. Humanitarian access for the United Nations and its implementing partners in Hasakah was limited for much of January due to the increased restrictions placed by the local authorities. United Nations convoys were blocked from travelling to the northeast from elsewhere within the country. The delivery of aid already in local warehouses was also blocked. While an agreement to resume humanitarian deliveries was reached on 30 January, that agreement will end in March. NGO partners continue to deliver goods and services across the north-east. However, sustainable access for the United Nations is critical. Any protracted interruption of humanitarian assistance and services in the IDP sites may drive the displaced people back to areas where they are not safe. Earlier this month, the United Nations received clearance for the first assessment visit to Deir ez-Zor after it had been under the control of the Islamic State in Iraq and the Levant (ISIL) for three and a half years. More than 100,000 people live in the town despite that fact that it is estimated to be 80 per cent destroyed. The infrastructure is almost completely destroyed, particularly in the central and the eastern areas, where ISIL was in control. In coordination with the Syrian Arab Red Crescent, the United Nations has dispatched 78 trucks carrying food, health, nutrition, protection, shelter, education, water and sanitation items since last September, when ISIL was driven out. Finally, we remain concerned about the tens of thousands of people stranded in Rukban, in south-eastern Syria. We continue to seek the necessary agreements for convoys of life-saving assistance to them. As I said last week (see S/PV. 8186), there was a severe reduction, of nearly 40 per cent, in cross-line access to besieged and hard-to-reach areas in 2017 as compared to 2016. On average in 2017, over the entire 12-month period, we reached 165,000 people a month with cross-line convoys. That was completely inadequate. So far this year, we have reached a total of only 7,200 people through a single small convoy earlier this month. In other words, we were reaching more than 50 times as many people in besieged and hard-to-reach areas last year as to date this year. The main reason for the reduction in the number of convoys has been the consistent refusal by the Government of Syria to provide the necessary approvals and facilitation letters to support delivery. As the Secretary-General's report (S/2018/138) details, while we continue to reach millions of people in urgent need in areas controlled by the Government of Syria and through the cross-border programmes mandated in resolution 2393 (2017), assistance across conflict lines to millions of people in hard-to-reach and besieged areas has completely collapsed in recent months. Unless that changes, we will soon see even more people dying from starvation and disease than from the bombing and shelling. The United Nations remains focused on reaching those most in need throughout the country, including the 5.6 million people considered to be in acute need. The needs-based approach means that the United Nations will continue to seek to deliver aid and to S/PV.8195 The situation in the Middle East 28/02/2018 4/22 18-05507 provide services to millions of people in a principled manner regardless of where they are located. More than half of those in need are in Government-controlled areas. However, millions more people are not. What the Syrian people need has been made abundantly clear — protection, access to basic goods and services, an end to sieges and respect for international humanitarian law and international human rights law. The Security Council has unanimously supported all such needs in adopting resolution 2401 (2018). I started today by answering questions that we have received regarding resolution 2401 (2018). I would like to end with a question for the Security Council. When will the resolution be implemented? The President (spoke in Arabic): I thank Mr. Lowcock for his briefing. I now give the floor to Mr. Feltman. Mr. Feltman: I am grateful for this opportunity to brief the Security Council following the comprehensive briefing by Under-Secretary-General Mark Lowcock. In two weeks, we will mark the beginning of the eighth year of the Syrian conflict. There are no words to express our frustration over the collective failure of the international community to end this war, but that frustration is nothing compared to the suffering and destruction visited ceaselessly upon the Syrian people. We are here again today because the brief respite that the Council unanimously demanded only days ago in resolution 2401 (2018) has not materialized, as Mr. Lowcock just described. The air strikes, shelling and ground offensives continue. There are even reports of yet another chlorine gas attack. What we need is the implementation of resolution 2401 (2018), and that is not happening. Nearly seven years since the peaceful protests in Dar'a and the reaction that set in motion what would eventually become all-out war, we are still grasping for a political solution, which is the only way to end the bloodletting. The Secretary-General has called eastern Ghouta a hell on Earth. The United Nations will continue to work with Syrians and the international community to help bring about a durable political solution. We will also continue to demand that all the parties involved in the conflict respect international humanitarian law — the rules of war — and protect civilians. We will continue to demand the release of those who have been arbitrarily detained and the end of enforced disappearances. We will continue to forcefully call for justice and accountability. Those responsible for the catalogue of horrors that mark daily life in Syria, including chemical and terrorist attacks, torture and sexual violence, sieges and attacks on hospitals, schools and other civilian infrastructure, must be held accountable. Those outrages continue in large part because the perpetrators have so far enjoyed impunity. As the Secretary-General said earlier this week, "Security Council resolutions are only meaningful if they are effectively implemented". The United Nations acknowledges Russia's announcement of a daily five-hour pause for eastern Ghouta. In addition to Mr. Lowcock's briefing and what the International Committee of the Red Cross has stated, we respectfully remind all parties that resolution 2401 (2018) demands the sustained delivery of humanitarian aid for a minimum of 30 consecutive days. The Secretariat and relevant agencies are united and pulling in one direction towards the immediate and continuous cessation of hostilities that can be sustained beyond 30 days for unimpeded aid delivery. We also urgently need to get humanitarian aid and services in and the sick and critically wounded evacuated from besieged eastern Ghouta and other locations. We are ready to deliver. The Secretary-General has repeatedly reminded parties of their absolute obligation under international humanitarian law and human rights law to protect civilians and civilian infrastructure. Earlier this month, Emergency Relief Coordinator Lowcock told the Council (see S/PV.8186) in no uncertain terms that that is an obligation, not a favour. He has just updated us all on the humanitarian situation and provided an update on the United Nations readiness to deliver aid and services, and the tireless efforts of humanitarians to reach all in need, wherever they are. But right now we must address the particular needs of those in besieged eastern Ghouta. Resolution 2401 (2018) affirms that the cessation of hostilities shall not apply to military operations against the Islamic State in Iraq and the Levant (ISIL), Al Qaida, the Al-Nusra Front, and "all other individuals, groups, undertakings and entities associated with Al-Qaida or ISIL, and other terrorist groups, as designated by the Security Council". (resolution 2401 (2018), para. 2). In our view, that rightly maintains the parameters set out in resolution 2254 (2015), but there must be 28/02/2018 The situation in the Middle East S/PV.8195 18-05507 5/22 a frank assessment of what that means in relation to the humanitarian tragedy that we are witnessing in eastern Ghouta. First, we condemn all violations of international law by all parties, including shelling from eastern Ghouta, which has injured or killed civilians in Damascus. The scale of the Government's indiscriminate military attacks against eastern Ghouta — an area with a civilian population of 400,000 — cannot be justified based on targeting Jabhat Al-Nusra fighters. Efforts to combat terrorism do not supersede obligations under international humanitarian law and human rights law. Secondly, the United Nations has not seen any confirmation by the Government of Syria of its commitment to implement resolution 2401 (2018), although at the resolution's adoption Syria's Permanent Representative to the United Nations said, "As a State, we bear a responsibility towards our citizens and we have a sovereign right to counter terrorism" (S/PV.8188, p. 12). Thirdly, yesterday the Head of the Syrian Negotiations Committee transmitted to the Secretary- General a letter on behalf of the three major non-State armed opposition groups — Jaysh Al-Islam, Faylaq Al-Rahman and Ahrar Al-Sham — and civil groups in eastern Ghouta regarding their full commitment to the implementation of resolution 2401 (2018). Specifically, they committed to ensuring the necessary environment for United Nations humanitarian access as well as, "to expel all elements of Hay'at Tahrir Al-Sham, Jabhat Al-Nusra and Al-Qaida and all who belong to these groups from eastern Ghouta". Fourthly, the United Nations has no independent verified reports that those three non-State armed opposition groups in eastern Ghouta created a coordination centre, as has been alleged regarding Jabhat Al-Nusra, nor has the United Nations seen any public announcement by those groups of such a centre. Jaysh Al-Islam has denied that claim. What the United Nations can verify is that non-State armed opposition groups in eastern Ghouta, over the past 24 hours, have expressed their readiness in writing to evacuate Jabhat Al-Nusra fighters. Previous negotiations on that issue among those groups and key members of the International Syrian Support Group humanitarian task force in Geneva and Damascus have not resulted in success. Alleviating the tragic situation in eastern Ghouta has the Council's full attention. Yet we cannot forget that resolution 2401 (2018) demands a cessation of hostilities throughout Syria. Violence continues in Afrin, Idlib and the eastern part of the country. Council members have heard about the humanitarian challenges and suffering of the people in those areas as well. I would like to take this opportunity to emphasize that developments in those areas will undoubtedly render the situation in Syria even more complex. There will be no sustainable solution if the Council's resolutions are not implemented. That will require that the parties step back from the brink and fulfil their obligations to end the fighting in Syria. All our efforts will be in vain if there is no serious investment in a political solution. As Council members are aware, resolution 2401 (2018) calls on all Member States to use their influence with the parties to ensure the implementation of the cessation of hostilities. The United Nations calls for a renewed commitment by all concerned Member States to work seriously to implement the cessation of hostilities. The United Nations also cautions against drawing the Organization into monitoring exercises. That has been tried in the past without success — not for lack of trying — but in the absence of political will among Member States to underpin United Nations efforts. Member States, especially those working within the Astana and Amman arrangements, should use their resources and clear influence over the parties to ensure the implementation of a sustained cessation of hostilities throughout Syria. The conflict in Syria continues to threaten regional and international stability because the warring parties believe there is a military solution. There is not. The United Nations remains convinced that a political solution is the only way forward. Special Envoy Staffan de Mistura is pressing forward on facilitating the establishment of a constitutional committee in Geneva, as part of the overall intra-Syrian political process towards the full implementation of resolution 2254 (2015), for which the United Nations requires the positive and constructive engagement of both negotiating delegations. Special Envoy De Mistura will need the full support of the Council and the international community as a whole if the United Nations efforts are to have a chance of reinvigorating a serious and meaningful political process. I trust that he will have that support. S/PV.8195 The situation in the Middle East 28/02/2018 6/22 18-05507 The President (spoke in Arabic): I thank Mr. Feltman for his briefing. I shall now give the floor to those members of the Council who wish to make statements. Mr. Orrenius Skau (Sweden): I make my remarks today on behalf of Sweden and Kuwait as co-penholders for the humanitarian track of the Security Council's work on the situation in Syria. I would like to thank Mr. Mark Lowcock once again for a very sobering update. We share his sense of urgency following the adoption of resolution 2401 (2018) last weekend to fully take advantage of the 30- day pause so that the United Nations and its partners can dispatch life-saving aid convoys and begin medical evacuations. Since the resolution's adoption, we have been asked, as penholders, when the resolution would take effect and to whom it would apply. We are very clear: the resolution took effect upon its adoption and applies to all parties across the entire country. The clock is ticking. There is no time to lose. Let me also sincerely thank Mr. Jeffrey Feltman for his briefing today. We share his deep concern concerning reports of the flagrant lack of compliance with the ceasefire in eastern Ghouta. We would like to extend our sincere appreciation to all members of the Council for their constructive cooperation, which enabled the adoption of resolution 2401 (2018). The resolution represents decisive and meaningful action by the Council in response to the calls from the United Nations, the humanitarian community and, above all, the civilian population in Syria. However, the value of a resolution is not in its adoption, but in its implementation. We must now all build on the spirit of cooperation that led to the resolution's adoption and work together to ensure that it is enforced. Compliance with the resolutions of the Security Council is not optional; it is an obligation of all Member States. The humanitarian community stands ready to do its part. Having adopted this resolution, the Council must do its part. For the next few weeks, let us seize the opportunity that this resolution represents and focus on its implementation. We would like to make four concrete recommendations on the way forward. First, existing de-escalation agreements must be complied with most urgently in eastern Ghouta. We call on the three Astana guarantors to spare no effort to achieve this end. Resolution 2401 (2018) clearly demands that all parties cease hostilities; air strikes, the ground offensive and shelling must stop. We take note of the initial positive indications from armed opposition groups in eastern Ghouta that they are ready to comply with the resolution. We also note their commitment to expel the Al-Nusra Front from the area. We must build on this, and we call on those with influence over armed opposition groups to secure their commitment to the cessation of hostilities. Clearly the Council has demanded in resolution 2401 (2018) that the Syrian Government cease all military operations without delay. Secondly, as Mr. Lowcock has told us, the United Nations and its implementing partners in the field are ready to commence life-saving convoys and medical evacuations. We urge the Syrian authorities to immediately issue facilitation letters for the convoy to Duma to proceed this week as a necessary first step. It can no longer be business as usual; the Council has demanded weekly convoys to all areas and populations in need. Thirdly, existing structures to strengthen compliance with and monitoring of the cessation must urgently be activated. We look to the Chairs of the Task Force on the Ceasefire of the International Syria Support Group to undertake more frequent meetings, which are needed at least on a weekly basis. The Amman operations room should also be utilized. We see merit in making a clearer link between monitoring mechanisms and the Security Council. Fourthly, the Council must remain actively seized of this matter. Sweden and Kuwait will request an open briefing from the incoming presidency on the Secretary-General's report on implementation and compliance that is due 15 days after the resolution's adoption. We should also stand ready to meet and take appropriate action at any time necessary so as to ensure implementation of this resolution. Finally, we welcome any efforts to de-escalate violence and to allow and facilitate humanitarian access in Syria, but let us be clear — resolution 2401 (2018) demands a 30-day, nationwide ceasefire, with immediate access for weekly convoys and medical evacuations. A five-hour ceasefire does not meet the requirements of the resolution. The resolution is not primarily about the evacuation of civilians, but demands humanitarian access to civilians and medical evacuations. The 28/02/2018 The situation in the Middle East S/PV.8195 18-05507 7/22 cessation of hostilities must be implemented fully and without delay. It is imperative that all parties uphold their obligations under international humanitarian law and international human rights law at all times. Last Saturday's unanimous action reinforced the legitimacy and credibility of the Security Council (see S/PV.8188). Today's briefings demonstrate that there is no time to rest on the laurels of this achievement. We must now move without delay to ensure our action here last Saturday is translated into the relief and assistance expected by the millions of people affected by this conflict. It is now incumbent on all the parties and all those with influence over the parties to spare no effort and use all channels available in order to advance the full implementation of resolution 2401 (2018). Mr. Delattre (France) (spoke in French): First of all, I want to thank Mark Lowcock and Jeffrey Feltman for their very clear briefings. I would like today to focus my remarks on our shared road map, namely, the full implementation of resolution 2401 (2018), which we adopted unanimously last Saturday (see S/PV. 8188). On behalf of France, I would like to express three main messages today. My first message is that we must not pay lip service. The situation on the ground remains dramatic and has not improved in recent days. Since the adoption of resolution 2401 (2018), the offensive against the eastern Ghouta has continued relentlessly. France, of course, strongly condemns these indiscriminate bombings, which affect inhabited areas and civil infrastructure. In this context, the disastrous humanitarian situation continues to deteriorate. No United Nations convoy has been able to reach the eastern Ghouta or any of the other besieged areas, no emergency medical evacuation has been carried out, no siege has been lifted. The Syrian regime is maintaining its stranglehold on the civilian population and is methodically pursuing its policy of destruction. More than 400,000 people remain under siege in eastern Ghouta, including 130,000 children. The demand sent by the United Nations to authorize a priority convoy for Duma, the main city in eastern Ghouta, has not received any response from the Syrian authorities to date. My second message is this. The resolution adopted by the Security Council on 24 February makes very specific demands on the parties. Hostilities must cease without delay in order to establish a lasting humanitarian truce for at least 30 days, in order to allow both the delivery of humanitarian aid and the evacuation of the wounded and sick. Let me stress this point. These demands are perfectly clear and cannot be distorted or reinterpreted. Contrary to what some would have us believe, the demands made by the resolution are absolutely clear. Our responsibility today is to implement, fully and in their totality, the provisions that we have unanimously adopted. If we do not that, what credibility can be given to our commitments? What credibility can be given to Security Council resolutions? The United Nations and its partners tell us that they are ready to deliver aid to the people of eastern Ghouta and other priority areas. There is therefore not a minute to lose because every minute that passes can turn lives upside down. At the conclusion of difficult negotiations, the Council managed to unite in the face of the gravity of the humanitarian situation and the escalation of the Syrian conflict in recent months. We must now work together, in the same spirit of unity, to effectively implement on the ground the resolution we unanimously adopted. This is my third message. Following yesterday's meeting in Moscow with French Foreign Minister Jean-Yves Le Drian and his Russian counterpart, Sergei Lavrov, France is putting forward four concrete proposals for making progress and for doing so without delay. The first is to ensure that all parties implement the cessation of hostilities that resolution 2401 (2018) demands. I note that the three main opposition groups present in eastern Ghouta as well as Nassar Al Hariri, head of the High Negotiations Committee of the Syrian opposition, have written to the Secretary-General and to the President of the Council to state that they would respect the truce. It is therefore urgent in the extreme — if I can put it that way — that the Damascus regime also unambiguously express its willingness to respect the Council resolution and to formalize it in writing. We have taken note of the Russian proposal of a daily five-hour humanitarian truce. It is a positive first step, but it is insufficient. We must go further. Resolution 2401 (2018) demands of the parties a minimum period of 30 consecutive days of cessation of hostilities. Respecting that demand is non-negotiable. That goal requires more than just symbolic declarations or political posturing. At a minimum, it requires that humanitarian personnel be allowed to do their work. S/PV.8195 The situation in the Middle East 28/02/2018 8/22 18-05507 These workers are used to taking risks on a daily basis, but the parties must allow them to do their work. Given that the opposition groups have formally committed to doing just that, the regime must do so as well, and without delay. To that end, supporters of the regime, beginning with Russia, must bring the necessary pressure to bear. Our second proposal, by way of a demand, pertains to the need to immediately open the relevant, clearly identified checkpoints — beginning with Wafideen — in order to allow the access of priority convoys of the United Nations. We therefore demand that the Syrian authorities submit without delay the necessary letter to facilitate the deployment of humanitarian convoys. Thirdly, it is extremely urgent to allow medical evacuations for the most critical cases, giving priority to children. The Syrian Arab Red Crescent indicates that 1,065 people need emergency medical evacuations. We have not a minute to lose. Finally, France considers it essential to create a monitoring mechanism to ensure the implementation of resolution 2401 (2018) and compliance with the resolution by the parties. We are working diligently to establishing that mechanism now. Those are the French proposals to address the urgent need to put an end to the bombing and protect civilians, who beyond resolution 2401 (2018), are protected under international humanitarian law. It is also crucial to intensify our efforts to reach a political solution in the framework of the Geneva process and resolution 2254 (2015). It is the only way out of the conflict and the only way to prevent a looming escalation of tensions. France will not deviate from that path. The overall credibility of the Security Council and the responsibility of each of its members are crucially at stake today in the context of the Syrian tragedy. Mr. Allen (United Kingdom): I would like to thank Under-Secretary-Generals Lowcock and Feltman for their clear, factual briefings and for reiterating to all of us on the Security Council the ongoing horror of the conflict in Syria — and in particular in eastern Ghouta, because that is where it is clear the situation is most dire by a huge order of magnitude. It was five days ago (see S/PV.8188) that we sat in this Chamber and all of us raised our hands in support of a 30-day ceasefire, which we hoped would provide some relief to Syria's people. That was a desperately needed step, one that came too late for many. In eastern Ghouta alone, Médecins Sans Frontières reported that at least 630 people were killed and 3,000 injured in the week before resolution 2401 (2018) was adopted, with women and children representing nearly 60 per cent of the wounded and 50 per cent of the deceased. We also continue to condemn attacks on Damascus from eastern Ghouta. Let us recall the demands of our resolution. It called for at least a 30-day ceasefire without delay to allow for the delivery of humanitarian aid and medical evacuation. "Without delay" means right now, immediately — that there should be no delay. We all voted for those demands and we committed to using our influence to ensure that. In response, Russia has declared a five-hour daily humanitarian window. That is not what the Council demanded, nor what Russia agreed to use its influence to ensure. A five-hour window has not delivered and cannot deliver any meaningful improvement on the ground. Under-Secretary-General Lowcock has made clear that the United Nations cannot get humanitarian convoys in and out within that time frame, as has the International Committee of the Red Cross. Humanitarian pauses of a few meagre hours are no substitute for a sustained ceasefire, which is vital to ensuring the delivery of life-saving humanitarian assistance and medical evacuations. If Russia is able to deliver a five-hour pause, let it deliver a 24-hour pause, as it agreed on Saturday. Let us now take stock of the situation in Syria, and specifically in eastern Ghouta, where the situation is at its most desperate. Let us review if any real change has occurred in the past five days. Has the resolution been implemented? Has there been a ceasefire? Has there been any delivery of humanitarian aid or any medical evacuations? Has the adoption of the resolution brought any relief to the people of Syria? The fighting has not stopped. All of the main armed opposition groups have committed to the full implementation of resolution 2401 (2018). The Al-Assad regime has not, and has in fact ignored the resolution we adopted. Reports of attacks and air strikes by pro-regime forces continue. Twenty-two air strikes reportedly took place even during Russia's so-called humanitarian pause. And, as if it could not get any worse, there have been disturbing reports of the use of chlorine gas. Doctors in eastern Ghouta reported to the Syrian-American Medical Society that 16 patients, including six children, were suffering from symptoms 28/02/2018 The situation in the Middle East S/PV.8195 18-05507 9/22 indicative of exposure to chemical compounds, following an alleged regime attack on Sunday — only one day after the resolution was adopted. Since Saturday not a single aid convoy has been able to access eastern Ghouta to provide relief to the desperate civilians. The World Health Organization estimates that 1,000 people are now in need of medical evacuation from eastern Ghouta. None have been evacuated since the resolution was adopted. The consequences of the failure to implement the resolution are clear: the casualties continue to rise and the horror continues. The Syrian Observatory for Human Rights reports at least 14 civilians, including three children, were killed on Sunday. In short, in the words of one doctor from eastern Ghouta, "Nothing has changed." It is the responsibility of us all to ensure that resolution 2401 (2018) is enacted in full. In the words of my Foreign Secretary, the Al-Assad regime must allow the United Nations to deliver humanitarian aid, in compliance with resolution 2401 (2018), and we look to Russia and Iran to make sure this happens, in accordance with their own promises. I implore all those with influence over the Syrian regime to act now to ensure that the ceasefire that they supported in the Chamber is implemented in full and immediately. To do anything less is an affront to the Council, the United Nations and the international system that we live by. We will continue to monitor the implementation of resolution 2401 (2018) and commit to returning to the Council regularly until we see it respected. Ms. Eckels-Currie (United States of America): Every time the Security Council attempts to address the humanitarian crisis in Syria, we take a small leap of faith. I say "we" in reference to the Security Council. I speak of faith because all Council members and most States Members of the United Nations still genuinely try to uphold the responsibilities under the Charter of the United Nations, including abiding by and fully implementing Security Council resolutions. Despite the grim updates we heard today, we must maintain the hope that we can help the Syrian people. If we do not have that hope, we are wasting our time here. Just four days ago, the Security Council took another leap of faith. We adopted resolution 2401 (2018), demanding a 30-day ceasefire for all of Syria, unimpeded and sustained humanitarian access to deliver desperately needed food and medical supplies, and immediate and unconditional medical evacuations based on need and emergency. Our goal was clear and simple. The Al-Assad regime and its supporters have been pummelling eastern Ghouta, where 400,000 people live under siege and constant bombardment. Resolution 2401 (2018) demanded that the assault stop. That was the Council speaking in one, clear voice. The opposition groups operating in eastern Ghouta have made clear their commitment to the ceasefire. The Free Syrian Army, Jaysh al-Islam, the Al-Rahman Legion and Ahrar al-Sham all committed to implementing resolution 2401 (2018). Against all odds, we hoped that Mr. Al-Assad might respect the resolution, cease hostilities and allow unfettered humanitarian access to all those who need it. Against all odds, we hoped that Russia would use its influence to ensure Mr. Al-Assad's commitment to resolution 2401 (2018). Once again, that hope has been crushed because so far, for the people of eastern Ghouta, nothing has changed. Despite the unanimous call for a ceasefire, the regime's attacks continue unabated. Hundreds of Syrians have been killed or injured since we adopted the resolution on Saturday. What is worse is that less than 24 hours after we demanded the ceasefire, there were reports that the Al-Assad regime again used chlorine gas as a weapon. Such attacks demonstrate Syria's complete and utter contempt for the Council and the United Nations. On Monday one human rights organization reported 18 attacks that defied the Council's demands. On Tuesday another organization reported at least 23 air strikes and four barrel bombs in eastern Ghouta. Syrians on the ground are reporting that Tuesday was worse than Monday with regard to strikes from the regime. How can that be? On the humanitarian front, as Mark Lowcock stated, the Al-Assad regime has allowed no deliveries of assistance into eastern Ghouta — not one. Opposition groups in the area have expressed their commitment to allowing aid in, but the Al-Assad regime still says no. Since we adopted resolution 2401 (2018), Russia has announced a daily five-hour humanitarian pause in the aerial bombing of civilians in eastern Ghouta, which is cynical, callous and in flagrant defiance of the demands of resolution 2401 (2018). The cessation of hostilities is for at least 30 days — every day, all day. Russia does not get to unilaterally rewrite the terms of the resolution. It negotiated it and voted for it. Russia, S/PV.8195 The situation in the Middle East 28/02/2018 10/22 18-05507 Iran and the Al-Assad regime are not even trying to hide their intentions. They are asking civilians to leave eastern Ghouta on the false premise that they can then attack anyone left in the area as much as they would like. Let us call the actions what they are. Mr. Al-Assad and his allies want the civilians of eastern Ghouta to walk into the arms of a regime that has been attacking and starving them for the past seven years. That is not a humanitarian gesture. They do not care if the 400,000 people of eastern Ghouta suffer, as long as they can continue to pursue their military and political objectives. We know what Iran, Syria and the Al-Assad regime are doing because they have done the same thing in the past. It is the same playbook they used for Aleppo in 2016. Once again, we, including Russia, demanded in the Security Council Chamber that Mr. Al-Assad stop the bombing, and yet Russia, Iran and Mr. Al-Assad continue their attacks, defying the wishes of the Council and of the international community. Because we have been through this before, we know what Russia will say today. It will say that there are terrorists in eastern Ghouta so that the Al-Assad regime can bomb as ferociously and indiscriminately as it wants and kill as many civilians as it wants. That defies the principles governing the laws of war. The Al-Assad regime should not be allowed to bomb and starve its own people into submission under the guise of counter-terrorism. That Russian argument makes a mockery of the Council and of international law. Russia also accuses the United States of somehow being responsible for humanitarian crises in Syria, but such accusations are ludicrous. The United States does not block humanitarian aid in any area. In fact, the United States has provided more than $7 billion in humanitarian aid in response to the crisis. The Council must not fall for Russia's misdirections. When the ceasefire was adopted unanimously on Saturday, including by the Russians, Ambassador Haley stated that our resolve to stand by our demands in the resolution would be tested. It has come to pass. Despite everything that has happened since Saturday, we are not casting aside the ceasefire in Syria; just the opposite. We would like to redouble our efforts in the Security Council to implement it, but the only way to change the situation on the ground is for all of us — every single one of us — around the table and each State Member of the United Nations to speak the truth about what is happening. The past four days should show us that when it comes to demanding a ceasefire, it is not enough to say that all parties should show restraint or commit to the ceasefire because in eastern Ghouta there is only one party dropping barrel bombs, gassing the Syrian people and denying deliveries of food and medical assistance. It is the Al-Assad regime, operating with the full support of Russia and Iran. On Saturday we stated that the only way to restore the credibility of the Council was to make the ceasefire a reality. Russia, Iran and the Al-Assad regime have not complied with the Council's demands and have not silenced their guns. Unless we take action, they will stop at nothing to destroy eastern Ghouta and we will again fail to help the Syrian people. Mr. Van Oosterom (Netherlands): First, let me thank Under-Secretaries-General Lowcock and Feltman for their briefings. In my statement I will address three points: implementation, implementation and implementation. First, I will speak about the implementation of the cessation of hostilities. Since the Council adopted resolution 2401 (2018) on Saturday, civilians are still dying in eastern Ghouta and elsewhere in Syria. The humanitarian disaster continues worsen. We need a full, nationwide cessation of hostilities and we need it now. The Russian proposal for a humanitarian corridor and pauses of five hours per day cannot be a substitute for a humanitarian pause of 30 consecutive days, as demanded in resolution 2401 (2018). Those five hours do not meet the obligations under the resolution and are not enough for the United Nations to be effective in delivering aid to the entire area of Ghouta, as Under- Secretary-General Lowcock just stated. We call upon the parties to the conflict and on those with influence on the parties to show decisive action and stop the violence. As Under-Secretary- General Feltman stated, three armed opposition groups in eastern Ghouta have announced that they are committed to fully implementing resolution 2401 (2018). We expect the regime to do the same. The air strikes, the shelling and the shooting must stop. For the credibility of the Council, it is crucial that its resolutions be fully implemented. That is the obligation of all States Members of the United Nations, under the Charter. 28/02/2018 The situation in the Middle East S/PV.8195 18-05507 11/22 The Kingdom of the Netherlands repeats the call made by the High Representative of the European Union for Foreign Affairs and Security Policy, Federica Mogherini, to the Astana guarantors. She called on the Foreign Ministers of Russia, Iran and Turkey to "take all necessary steps to ensure that the fighting stops, the Syrian people are protected and that urgent humanitarian access and necessary medical evacuations are taking place". My second point is about the implementation of humanitarian access. Resolution 2401 (2018) calls for sieges of populated areas, including eastern Ghouta, to be lifted immediately, and demands safe, unimpeded and sustained access for humanitarian convoys. As Under-Secretary-General Lowcock just explained, the United Nations stands ready with 45 trucks to deliver essential aid to eastern Ghouta. But the necessary facilitation letters are still lacking, and the security conditions do not permit those deliveries. At this point, more than 1,000 people are in urgent need of medical care, but they are still trapped in eastern Ghouta. If they are not given the care they need in hospitals in Damascus or elsewhere, they may die. The United Nations and the Security Council have consistently pleaded for these medical evacuations, and yet there are still no developments with regard to them. We also need to see access to aid for those fleeing the fighting in Afrin. More generally, there should be delivery of humanitarian aid to the areas that are not under Government control. As Mr. Feltman just said, we should reach all who are in need, wherever they are. My third point is about implementing the protection of civilians. The exception on the cessation of hostilities in paragraph 2 of the resolution allows targeted action against terrorists who are designated as such by the Council. However, that does not mean that absolutely anything is allowed. International humanitarian law applies to all military combat operations and counter-terrorism actions. The principles of distinction, proportionality and precaution must be respected in all circumstances. The civilians in the conflict must be protected. There is talk of humanitarian corridors for civilians who want to leave eastern Ghouta, but evacuations should always be voluntary. We are concerned about the possibility that humanitarian corridors will be used for forced population transfers. Civilians cannot be forced to leave, and neither should they be forced to stay. If voluntary evacuations do take place, we will call on the United Nations to monitor them. Currently, the most urgent humanitarian situation is in eastern Ghouta and Idlib, but needs remain high elsewhere in Syria as well. We welcomed the January delivery of aid to Rukban, but we want to stress the importance of sustained access and a durable solution. As others have said today, the demining activities in Raqqa should be increased, and the Kingdom of the Netherlands is doing its part in that regard. The media coverage of the issue of the exploitation of Syrian women in exchange for aid is very disturbing. There should be no tolerance of such behaviour, as the Secretary-General and the Office for the Coordination of Humanitarian Affairs have already said. The probity of any United Nations implementing parties should be beyond any doubt. In conclusion, we must ensure that resolution 2254 (2015) is fully implemented. There can be no military solution to the conflict, and we call on all the parties to engage seriously in the United Nations-led political process as a matter of urgency. The suffering of the people of Syria has lasted for more than seven years. For the sake of the millions of women, children and men trapped in this horrendous war, it is high time that all parties started putting the protection, interests and well-being of the Syrian people on the top of their agenda. Yesterday, my Minister, Ms. Sigrid Kaag, said that humanitarian access and the protection of civilians are cornerstones of international humanitarian law. They are part of our shared values and shared humanity. The Security Council must do justice to those values and to our shared humanity. Mr. Meza-Cuadra (Peru) (spoke in Spanish): We thank you for convening today's meeting, Mr. President, and for the briefings by Mr. Lowcock and Mr. Feltman on the situation in Syria. On Saturday, when we adopted resolution 2401 (2018) after long and complex negotiations, we highlighted the commitment that Council members have shown to achieving a humanitarian ceasefire in Syria. As we said at the time, it will be crucial to closely monitor its proper implementation and to maintain the Council's unity with regard to its responsibility to protect the civilian population, in line with international law and international humanitarian law. Four days in, we are still being forced to lament and condemn the attacks on civilians and to reiterate S/PV.8195 The situation in the Middle East 28/02/2018 12/22 18-05507 our calls for the immediate and comprehensive implementation of resolution 2401 (2018). As the Secretary-General has pointed out, Council resolutions make sense only if they are effectively implemented. The credibility of the Security Council as a whole, and of those of its members with the greatest potential influence on the ground in particular, is at stake. In the light of this, we want to emphasize that the cessation of hostilities that the Council has demanded clearly covers the whole of Syrian territory, including eastern Ghouta and Afrin, and should last for a minimum of 30 days. If we are to ensure that, in our view we should mobilize the International Syria Support Group's Ceasefire Task Force. It is essential to ensure that all the parties to the conflict comply with the ceasefire provided for in resolution 2401 (2018), and that the Council is able to closely monitor that compliance. In that regard, we support the four recommendations outlined by Sweden and Kuwait. We must remind the Syrian authorities of their responsibility to protect their people, and we firmly condemn the military operations in eastern Ghouta and other areas of the country that have continued even after the adoption of resolution 2401 (2018). However, we welcome the strenuous efforts of the Organization, and of the Office for the Coordination of Humanitarian Affairs in particular, to prepare 45 trucks carrying supplies and ready to enter eastern Ghouta as soon as the necessary permits are granted. The first report on the implementation of resolution 2401 (2018) will be presented in less than two weeks, and we hope that it will be able to inform us that the humanitarian crisis caused by the Syrian conflict has been alleviated, because we cannot wait any longer. It is the Security Council's duty to continue working relentlessly to achieve what we have all unanimously agreed on. Ms. Wronecka (Poland): I very much appreciate today's clear and informative briefings by Mr. Lowcock and Mr. Feltman, and I would like to share a few thoughts from Poland's point of view. Since the Council's adoption on Saturday of resolution 2401 (2018), we have been seeing yet more extremely worrying developments on the ground. As I said in my last statement on the subject (see S/PV.8188), the heavy fighting in Syria has unfortunately not only continued but is increasing. In that context, we should persist in our efforts to take every possible action to ensure the resolution's full and safe implementation. We call on all to work to alleviate the suffering of civilians, including children, by giving them free and safe access to humanitarian assistance. That should include voluntary evacuation, which should be strictly overseen by the United Nations and its implementing partners and based solely on medical need, in order to ensure that the process is genuinely voluntary. We would like to stress that all the relevant actors should use all their influence to help to improve the conditions on the ground immediately. We urgently call for a cessation of hostilities throughout all of Syria for 30 days, as stipulated in resolution 2401 (2018). In that context, it is also important to note that the cessation of hostilities may also offer an opportunity for the talks being held under United Nations auspices in Geneva to gain momentum, so that a political solution can finally be reached. For that reason, we call on all parties to fulfil their commitments to the existing ceasefire agreements. It should be emphasized that the implementation of the ceasefire announced by resolution 2401 (2018) should ensure the safe entrance and stay of humanitarian and medical personnel without prejudice to their health or life. When such personnel enter hard-to-reach areas, we should know precisely how long they can stay while delivering assistance under the ceasefire, otherwise their lives could also be in danger. In conclusion, let me stress the importance of maintaining the unity of the Council on the question of the implementation of humanitarian resolutions. The unanimous adoption of the resolution is just the beginning of the process. We call on all actors with influence on the ground to take all steps necessary to ensure that the fighting stops, that the Syrian people are protected and, finally, that urgent humanitarian access is enabled and that the necessary medical evacuations can take place. Mr. Inchauste Jordán (Plurinational State of Bolivia) (spoke in Spanish): We thank Mr. Lowcock, Under-Secretary-General for Humanitarian Affairs, and Mr. Jeffrey Feltman, Under-Secretary-General for Political Affairs, for their respective briefings. Once again, we would like to say how appalled we are at the terrible situation suffered by the Syrian people, as the past two months have been the most violent since the start of the conflict, and civilians, primarily women and children, are the ones that are suffering the gravest consequences of this intensification of the war. We call the attention of the Security Council to the continuing 28/02/2018 The situation in the Middle East S/PV.8195 18-05507 13/22 violations of international law, especially international humanitarian law and international human rights law, as these attacks have targeted civilian infrastructure such as hospitals, schools and homes. My delegation would like to express once again its gratitude to the delegations of Sweden and Kuwait for their work in promoting the unanimous adoption of resolution 2401 (2018), which imposes a cessation of hostilities throughout Syria, which is as urgent as it is necessary. We urge the parties to implement the resolution immediately in order to speed up access of humanitarian assistance without any restrictions, allow urgent medical evacuations and the entry of humanitarian convoys, and ensure the protection of hospitals and medical facilities, especially in eastern Ghouta, Idlib and north of Hama. We wish to underscore once again the need for continued cooperation and coordination among the Syrian Government and the various humanitarian assistance agencies, so that the delivery of humanitarian assistance can be effective, especially in hard-to-reach areas, and to prevent administrative obstacles from derailing or negatively affecting the deployment of the required humanitarian assistance. We also stress the need to begin, as soon as possible, humanitarian mine-clearing in areas that require it, in particular in the city of Raqqa, to allow the return in dignified and safe conditions of people who were forced to flee their homes because of the conflict. As we have stated previously, we believe that if our aim is to alleviate the suffering of the Syrian people in the face of armed violence, the Security Council has the major challenge of maintaining its unity so as to ensure that this organ's decisions are implemented. We reiterate that the solution to this conflict can be found only through an inclusive political process based on dialogue and coordination, led by the Syrian people and for the Syrian people, that will make it possible to reach a peaceful solution among all parties involved. With this in mind, we wish to highlight the various forums for dialogue, specifically the Astana process, at which de-escalation zones were agreed on that must be respected by all parties. We will be closely following the next round of the process. We wish also to highlight the other opportunities for dialogue that could make it possible to reach further compromises to achieve a definitive end to hostilities, such as the Sochi national dialogue, which is aimed at strengthening the Geneva political process, with respect for the unity, sovereignty and territorial integrity of Syria and its right to choose its own political, economic and social system without any external pressure or interference. Mr. Tanoh-Boutchoue (Côte d'Ivoire) (spoke in French): Côte d'Ivoire thanks Mr. Jeffrey Feltman and Mr. Mark Lowcock for their respective briefings on recent developments in the situation in Syria following the adoption by the Security Council of resolution 2401 (2018), on the humanitarian situation in Syria. My delegation commends the Secretary-General for his unstinting efforts as part of the political dialogue among the Syrian parties with the aim of arriving at a lasting solution to the protracted crisis ravaging that country. In that regard, my country welcomes the holding of intra-Syrian peace talks on 25 and 26 January in Vienna in the framework of the Geneva process, followed by the talks held in Sochi on 29 and 30 January. My delegation cherishes the hope that the proposals stemming from the Sochi talks, including the establishment of a committee tasked with drawing up a new constitution, will receive consistent attention from the international community, as part of the concerted quest to find a lasting solution to the crisis in Syria. The situation on the ground is deeply alarming. Military operations that include the use of non-conventional weapons are leading to mass displacements of people, the loss of human lives, injuries and the destruction of public infrastructure, including hospitals and schools. The grave humanitarian crisis spawned by the fighting led to the adoption by the Security Council this past Saturday, 24 February, of resolution 2401 (2018), with a view to the cessation without delay of hostilities for a 30-day period to enable the delivery of humanitarian assistance to people in need as well as medical evacuations. My delegation notes with regret that the adoption of the resolution did not contribute to restoring calm on the ground. The ceasefire proposed was short-lived, despite the numerous appeals for a cessation of hostilities. Even the very minimum one called for by the Russian Federation, an ally of the Damascus Government, on Monday 26 February did not lead to a positive response. Air raids and rocket launches continue on the ground, thereby obstructing the work of humanitarian personnel. S/PV.8195 The situation in the Middle East 28/02/2018 14/22 18-05507 We deplore the ongoing loss of life among humanitarian workers — 22 United Nations personnel and 66 staff members or volunteers of the International Red Cross — and we deplore also the material damage that has been wrought, which includes the destruction of 25 vehicles and 44 facilities, according to the information we have received. Nonetheless, Côte d'Ivoire welcomes the fact that United Nations humanitarian agencies and their partners have managed to assist people in need by conducting 1,567 deliveries. My country reaffirms that a resolution of the crisis in Syria must be part of an inclusive dialogue and political process, as set out in the road map under resolution 2254 (2015). In that regard, my country calls for full compliance with the 30-day ceasefire, in accordance with resolution 2401 (2018), which will not only allow humanitarian actors to respond to critical emergencies but also create the conditions for a return to the negotiating table by all parties to the Syrian crisis. To that end, Côte d'Ivoire urges the members of the Security Council to unite and surmount their differences in order to send a message of hope and solidarity of the international community to the Syrian people. Mr. Ndong Mba (Equatorial Guinea) (spoke in Spanish): As usual, Under-Secretary-General for Humanitarian Affairs Mark Lowcock and Under- Secretary-General for Political Affairs Jeffrey Feltman just gave us detailed briefings on the humanitarian and political situation in Syria. Those were the first briefings to be delivered to the Security Council following the unanimous adoption of resolution 2401 (2018), on 24 February. I take this opportunity to thank both Under-Secretaries-General, as well as to acknowledge the willingness of the United Nations and its partners to send convoys of trucks with the necessary humanitarian aid and begin medical evacuations as soon as conditions on the ground allow. As Secretary-General António Guterres said two days ago in his statement before the Human Rights Council, "Security Council resolutions are only meaningful if they are effectively implemented". The Republic of Equatorial Guinea hopes resolution 2401 (2018) is meaningful in that way in order to relieve the affected population of the suffering it has endured, especially in eastern Ghouta, that is, we hope for it to be immediately implemented. We want to reiterate that the Syrian conflict has no military solution. The opponents therefore must take a seat at the negotiating table to engage in direct and frank dialogue, without exclusions, however complicated it may be to do so. It must be the Syrians who determine the future they want for their country. The international community must redouble its efforts in making sure the opponents engage in negotiations, and the countries that have influence need to wield it to establish trust, with the ultimate goal of achieving lasting and just peace in Syria. We commend the intention expressed by the largest opposition groups — Jaysh Al-Islam, Faylaq Al-Rahman and Ahrar Al-Sham — to respect the ceasefire, and we invite all the other parties involved to take the same decision. The Republic of Equatorial Guinea believes that the only reason that the humanitarian situation remains of concern is because the opponents do not agree on negotiating to reach a peace agreement, which consequently causes more civilian victims, leads to the destruction of hospital facilities and hampers humanitarian aid operations. The conflict has recently intensified around the town of eastern Ghouta and some other parts of Syria, which has resulted in civilian casualties, the destruction of a considerable number of medical and relief facilities and the obstruction of humanitarian relief operations led by the United Nations. Equatorial Guinea is very touched and horrified by the critical situation the Syrian people are experiencing, and we must not show indifference to so much pain and suffering. It is therefore imperative that the parties to the conflict implement and uphold the relevant Security Council resolutions, especially the most recent, resolution 2401 (2018), including allowing access to humanitarian aid, halting hostilities and ultimately, cooperating with the United Nations in its efforts to assuage the conflict and make humanitarian operations effective by ensuring aid deliveries reach the affected populations and evacuating the sick and seriously injured so that they can receive the necessary medical care. The international community, while striving to help Syria, must not forget the neighbouring countries that have welcomed refugees and shown a spirit of solidarity worthy of praise. I would like to conclude my statement by expressing well-deserved tribute to the Office for the Coordination of Humanitarian Affairs and all those who work with it on the ground for their bravery and determination in fulfilling their humanitarian mission to deliver aid to 28/02/2018 The situation in the Middle East S/PV.8195 18-05507 15/22 those in need. We encourage them to persist in their noble efforts. Mr. Tumysh (Kazakhstan): I join others in thanking Under-Secretary-General Lowcock and Under- Secretary-General Feltman for their comprehensive and sobering briefings. Kazakhstan welcomed the unanimous adoption of resolution 2401 (2018). That document should be urgently implemented to ensure a comprehensive ceasefire in Syria. The ceasefire regime should be implemented fully, especially in the areas of eastern Ghouta, southern Idlib and northern Hama, to resolve their long-accumulated acute humanitarian problems, deliver aid to the most difficult regions and evacuate the wounded and sick. Turning to the situation on the ground in the country, according to our humanitarian colleagues, over the past 78 hours and to our deep regret, military operations continued to be reported in besieged eastern Ghouta, resulting in deaths, including women and children. Attacks on Damascus from eastern Ghouta are also continuing. To our great disappointment, a Syrian Arab Red Crescent warehouse in a Damascus suburb was reportedly struck by shelling. During the same period, attacks on the city of Damascus and the governorate resulted in 14 deaths and 214 injured. We are glad to know that the United Nations has mobilized and is ready to immediately support life-saving aid convoys in several areas in eastern Ghouta. We therefore call on the Council members and the wider United Nations membership to assist the Office for the Coordination of Humanitarian Affairs (OCHA) in operationalizing the delivery of humanitarian assistance in eastern Ghouta, as well as in carrying out hundreds of medical evacuations. We echo the United Nations calls on all parties to facilitate unconditional, unimpeded and sustained access to all people in need throughout the country and take all measures to protect civilians and civilian infrastructure, including schools and medical facilities, as required by international law. It is equally important to ensure, in close coordination with OCHA, the protection of medical and humanitarian workers. We must also insist that parties support United Nation agencies in the fulfilment of their mandates. In that context, Kazakhstan proposes that all-round assistance be provided to the inter-Syrian negotiations through the Astana process and that positive developments be taken advantage of to improve the humanitarian situation. My country stands for a solution in Syria based on resolution 2254 (2015), the Geneva communiqué (S/2012/522, annex) and agreements on the de-escalation zones reached through the Astana process. We regret the lack of full agreement and close coordination among the key stakeholders in managing the Syrian crisis. We also attach great importance to strengthening the inter-Syrian political dialogue with greater support from the world community. Lastly, Kazakhstan notes the need to establish closer interaction among the leading stakeholders in Syria, in particular between the Russian Federation and the United States, to improve the political process and ensure positive changes on the humanitarian track. Mr. Wu Haitao (China) (spoke in Chinese): I would like to thank Under-Secretary-General Lowcock and Under-Secretary-General Feltman for their briefings. China commends the United Nations aid agencies for their humanitarian relief efforts in Syria. The security situation in various parts of Syria, including Damascus and eastern Ghouta, has escalated recently, causing significant civilian casualties. We sympathize profoundly with the suffering of the Syrian people and condemn all acts of violence against innocent civilians. The parties concerned should take immediate measures to de-escalate the tensions in line with the relevant Security Council resolutions. The Council's unanimous adoption of resolution 2401 (2018) demonstrates the consensus and unity of its members on the humanitarian issue in Syria. We appreciate the positive efforts of the parties concerned. China welcomed Russia's announcement by Russia that it will implement the ceasefire measures and assist with the evacuation of people from conflict areas. We call on the parties in Syria to put an immediate end to hostilities in accordance with the resolution, actively coordinate with United Nations relief efforts and ensure safe humanitarian corridors in the relevant areas. A political settlement is the only viable solution to the Syrian issue. The Syrian National Dialogue Congress was recently held successfully in Sochi and has had positive results. Special Envoy de Mistura is making ongoing efforts to advance the Syrian political process. The international community should support the Syrian parties in resuming dialogue and negotiations under the auspices of United Nations mediation as soon S/PV.8195 The situation in the Middle East 28/02/2018 16/22 18-05507 as possible and in seeking a solution that is acceptable to all parties through a Syrian-owned and -led political process. That is the only way to fundamentally ease the humanitarian situation in Syria and end the suffering of the Syrian people without delay. Terrorist organizations are still launching attacks in Syria, causing significant civilian casualties and impeding United Nations humanitarian relief efforts. The international community should strengthen its cooperation on counter-terrorism, adopt unified standards and resolutely combat all terrorist organizations that are designated as such by the Security Council. Ms. Guadey (Ethiopia): We thank Under-Secretary- General Mark Lowcock and Under-Secretary-General Jeffrey Feltman for their comprehensive briefings. We would like to express our gratitude to the United Nations and its humanitarian partners for their continuing efforts to provide humanitarian assistance to millions of Syrians. As Mr. Lowcock said, the humanitarian crisis in Syria continues to be a devastating one. Military activities in various parts of the country, including eastern Ghouta, have affected the ability of the United Nations to deliver lifesaving assistance to all in need. As the report of the Secretary- General (S/2018/138) says, the conflict and other obstacles have had a disastrous effect on the level of humanitarian access. In order to address those challenges and to alleviate the Syrians' suffering, the Security Council unanimously adopted resolution 2401 (2018), demanding the institution without delay of a cessation of hostilities for at least 30 consecutive days throughout Syria so as to ensure the safe, unimpeded and sustained delivery of humanitarian aid and services and medical evacuations. As we all emphasized on Saturday after welcoming the resolution's adoption (see S/PV.8186), what is now required is its full and comprehensive implementation with the immediate engagement of all parties and those with influence on them. Of course, we understand and appreciate the fact that the United Nations is ready to provide immediate humanitarian aid across the country. However, as Mr. Lowcock just highlighted, there are still military activities in various areas. In that regard, we call on all the parties to fully implement resolution 2401 (2018) for the sake of the Syrian people, who have continued to bear the brunt of the conflict for almost eight years. We appreciate any measure taken by Member States to facilitate the implementation of the ceasefire, including the humanitarian pause and humanitarian corridor announced by the Russian Federation. At the same time, it is obvious that more needs to be done to fully implement the resolution. It is therefore imperative to take urgent and coordinated action to bring about an immediate ceasefire, thereby ensuring that the United Nations and its humanitarian partners have safe, sustained and needs-based access in order to deliver humanitarian aid to all Syrians in need of assistance. In conclusion, it is ultimately a comprehensive, Syrian-led political solution, facilitated by the United Nations on the basis of resolution 2254 (2015), that can sustainably end the humanitarian tragedy in Syria. Mr. Nebenzia (Russian Federation) (spoke in Russian): We thank Under-Secretary-General Lowcock and Under-Secretary-General Feltman for their briefings. By the way, at the outset I would like to take advantage of this opportunity to ask Mr. Lowcock where the United Nations is getting its evidence and data on deaths in Damascus, for instance. According to the Syrian authorities' information, for example, just since 22 January, 12 people have died in Damascus, while the United Nations figure is 11 for the whole month. Where is he getting his information from? The White Helmets, maybe? Today, as has been usual recently, the United States delegation devoted its statement to Russia. It told us that it knew what we were going to say today, which it does not. And I am pleased about that, because it means that it did not see our statement before the meeting began. On 24 January, the Security Council unanimously adopted resolution 2401 (2018), in an important decision aimed at improving the humanitarian situation in Syria, especially in areas where the danger of military clashes remains or there are obstacles of one kind or another to the civilian population's access to essential assistance. Today many questions have been asked — emphatic questions, rhetorical questions, questions aimed directly at us. We answered the questions asked of us during our discussion at the adoption of resolution 2401 (2018). There are a lot of people here who like to pick citations from the resolution that they like and forget the ones that do not suit them. If I may, I will quote two extracts from it, from paragraph 1 and paragraph 10. 28/02/2018 The situation in the Middle East S/PV.8195 18-05507 17/22 (spoke in English) "Demands that all parties cease hostilities without delay, and engage immediately to ensure full and comprehensive implementation of this demand by all parties, for a durable humanitarian pause for at least 30 consecutive days throughout Syria, to enable the safe, unimpeded and sustained delivery of humanitarian aid and … medical evacuations". "[U]nderscores the need for the parties to agree on humanitarian pauses, days of tranquillity, localized ceasefires and truces to allow humanitarian agencies safe and unhindered access to all affected areas in Syria". (spoke in Russian) Has everyone read the resolution? We have said, and we will say it again, that any sustained pause must be preceded by an agreement between the parties on de-escalation. The demands that military activity end overnight are either the result of a misunderstanding of the realities or a deliberate exploitation of this human tragedy. The statement by the United States delegation simply rewrote resolution 2401 (2018). What sort of joint effort, such as the Permanent Representative of France called for today, can we talk about in these circumstances after what we heard today in the United States delegation's statement? Russia has announced the establishment in eastern Ghouta of daily five-hour humanitarian pauses. Everything possible is being done to ensure that they function successfully. Specifically, medical and temporary accommodation posts have been equipped, ambulance teams organized, motor transport provided. We call on the United Nations, the International Committee of the Red Cross and other recognized humanitarian organizations to join these efforts. However, on the very first day, the militias took advantage of the announcement of the pause to go on the offensive. The same thing happened on the second day. The mortar shelling continued, including in the humanitarian operations corridors. Not a single person was able to leave the danger area. We took note of the relevant letters submitted on behalf of the illegal armed groups. We were told previously that the most convenient way of informing Council members about them was being sought. It has been found and it is indeed highly original — directly through the work e-mail addresses of all the political coordinators, meaning that someone deliberately sent the relevant contact information to dubious individuals from the ranks of the radical Syrian opposition. It is very similar to the situation that occurred when information about the closed negotiations on humanitarian resolutions became available to Western media agencies. However, we hope that the opposition leaders are serious and that their deeds will match their words. We are expecting clear guarantees in that regard from the militias' foreign sponsors, many of whom are seated around this table. The first thing that is needed is a definitive repudiation of the terrorist organizations. It has to be understood that terrorists continue to be a legitimate target of military operations, and we will not stand on ceremony with them. Overall, we have to decide on the most effective way to neutralize Jabhat Al-Nusra in eastern Ghouta. Why can't some members show a willingness to cooperate on that issue? Or do they not want to? The information background to this issue is overheated to the point of no return. If we had not adopted resolution 2401 (2018), it is difficult even to imagine what the Western media outlets would have made of it or how they would have portrayed Russia. But even now, when the resolution has been adopted, our Western partners act as if everything in it pertains solely to Damascus and Russia, and that its successful implementation depends almost entirely on the will of our two countries, while they, the self-styled champions of humanity, somehow imagine that they have an exclusive right to lecture us on the subject. In various media outlets, especially American ones, there have been false allegations that we mock the tragedy of this war and the situation in eastern Ghouta, and that we say that the campaign is exaggerated and fake. I will ask these humanistic gentlemen once again: Where were they when American aircraft blew Raqqa off the face of the Earth? Where were the cries and the hand-wringing? Months have passed since the terrorists were banished from that city and yet it is still uninhabitable. On top of that, there are new reports of 24 civilian casualties from Coalition air strikes in Deir ez-Zor province. Who are they — second-class citizens? Or when innocent people die from democratic bombs, is that somehow immaterial — perhaps even honourable? We urge the United Nations — in fact, we insist — to send an assessment mission to Raqqa as soon as possible, and that the Coalition, which is in de facto control of the area, give it all necessary support. We also expect that instead of establishing quasi- S/PV.8195 The situation in the Middle East 28/02/2018 18/22 18-05507 administrations in areas liberated from the Islamic State in Iraq and the Levant, the Coalition leadership will come up with a plan to turn them over to the central authorities, in consideration of the Security Council's repeated affirmations of Syria's sovereignty and territorial integrity. That would be a great deal more constructive than the relentless quest to find what is a non-existent basis in international law for maintaining its presence on Syrian territory. If Council members have interesting ideas on how to raise the profile of local Government and find effective ways to rebuild the ethnic and religious balance that existed before the war, they should present them to the Syrians in the negotiations in Geneva and let them decide the issues for themselves through the mediation of the United Nations. We also demand that the Coalition open humanitarian access to the territory it is occupying around the Al-Tanf military base in order to bring aid to the residents of the Rukban camp as soon as possible. By the way, that is also a provision of resolution 2401 (2018). It is not for nothing that we keep saying that what is going on is painfully reminiscent of the situation in eastern Aleppo when the West unleashed a wave of monstrous anti-Russian hysteria. We are the only country being asked to implement resolution 2401 (2018). We are being criticized for instituting humanitarian pauses. Some claim that there are not enough of them. Demands, demands, demands. For some reason, someone is always bossily demanding something of Russia. Britain's Foreign Secretary has altogether decided that he is the prosecutor who is threatening to punish our country. Apparently, he called for today's meeting to be convened. He said so himself. The Russian Centre for Reconciliation of Opposing Sides in the Syrian Arab Republic is making daily and hourly efforts to achieve a cessation of hostilities, establish humanitarian pauses and ease the suffering of civilians. May I ask what other members have done to implement resolution 2401 (2018)? Has even one of their countries lifted a finger? Have they brought their influence to bear on those whom they consider the moderate opposition? Have they persuaded them to lay down their weapons and stop taking hostages? The hugely complex issue that the Syrian conflict represents is being used for unscrupulous purposes. The rivers of tears roll down only when the next stronghold where militias and terrorists mingle is threatened, at which point an unheard-of level of action kicks in. The real aim is the regime, as some members like to refer to the lawful Syrian authorities. Any hint of its success in fighting terrorism on its own territory is a thorn in their side. They are ready to use any means to stop it. This is a warning. We know about the chemical evidence being fabricated in order to blame Damascus. We know about the meetings on the subject, where they are being held and who is taking part in them. Today we once again heard unsubstantiated allegations about the Syrian Government's use of chemical weapons. I am tired of asking if members understand the futility of Damascus using chemical weapons from both a military and a political point of view, and the completely believable probability of militias using chemical provocations. I think they do understand it perfectly, but they persist in seeking an excuse for military intervention. United States officials, and the head of the Foreign Office and others, have already talked about military strikes against Syria, and it is obvious where that intellectual activity is heading. We urge everyone to stop the dirty tricks and join the concerted efforts to alleviate the humanitarian situation in Syria by implementing the resolution we have just adopted. We hope that the United Nations generally and Mr. Lowcock personally, as Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, will rise to the occasion. We have circulated a draft presidential statement on the resolution's implementation. We have placed it under the silence procedure until 1 p.m., and we call on the Council to adopt it. We hope that there will be no objections before one o'clock. I will take the liberty of reading it out. (spoke in English) The Security Council, with reference to its resolution 2401 (2018), urges all parties to implement it and, to this end, further urges all armed groups and all Member States with influence on them to ensure the safety of the announced humanitarian corridors for evacuation from eastern Ghouta. The Security Council calls for the establishment of similar humanitarian corridors in Al-Tanf and Rukban. The Security Council requests the Secretary-General to expeditiously send a mission to Raqqa to assess humanitarian needs there. 28/02/2018 The situation in the Middle East S/PV.8195 18-05507 19/22 (spoke in Russian) And by the way, we, like the other members of the Security Council, believe that there can only be a political solution to the Syrian conflict. We are doing everything we can to achieve that, and certainly somewhat more than those who have been spreading fire and fury today. We propose, as we have always proposed, that they join in these efforts, rather than throw up road blocks in an attempt to serve their own geopolitical agendas. The President (spoke in Arabic): I shall now make a statement in my national capacity. First of all, the delegation of Kuwait aligns itself to the statement made by the representative of Sweden on behalf of our two countries as co-penholders on the issue of Syria. We thank Mr. Mark Lowcock, Under- Secretary General for Humanitarian Affairs, and Mr. Jeffrey Feltman, Under-Secretary-General for Political Affairs, for their briefings. Four days after the adoption of resolution 2401 (2018), which demands that all parties cease hostilities throughout Syrian territory for 30 days, I would like to make the following points. We have said from the outset that resolution 2401 (2018) is only the first step towards improving the humanitarian situation in Syria. However, to date we have not seen the implementation of the provisions of the resolution — not even a partial implementation — as we heard from Mr. Lowcock this morning, in particular in eastern Ghouta. The Council demonstrated unity in adopting the resolution and it is up to us now to ensure that all its provisions are implemented in full and immediately in order to alleviate the suffering of our brethren in Syria and to protect civilians. The resolution is binding on all, in accordance with Article 25 of the Charter of the United Nations. Secondly, we welcome the fact that the United Nations is ready to come to eastern Ghouta and other besieged areas so as to deliver all kinds of aid and assistance to those that need them. We call on all the parties to the conflict in Syria to uphold international humanitarian law and abide by the provisions of the resolution, which cover all the various aspects that are causing the daily suffering of the Syrian people. Thirdly, we underscore the importance of members of the Council making their contribution by spurring all the parties to the conflict in Syria to immediately implement the provisions of resolution 2401 (2018), keeping in mind that, as co-penholders, we are committed to closely follow its implementation, including ensuring a briefing by the Secretariat 15 days after the adoption of the resolution. I now resume my functions as President of the Council. In accordance with to rule 37 of the Council's provisional rules of procedure, I invite the representative of the Syrian Arab Republic to participate in this meeting. I now give the floor to the representative of the Syrian Arab Republic. Mr. Ja'afari (Syrian Arab Republic) (spoke in Arabic): The Syrian Government has examined the forty-eighth monthly report of the Under-Secretary-General for Humanitarian Affairs, and, yesterday morning, as usual, we sent a formal letter to the Secretary-General and to the President of the Security Council setting forth the position of the Syrian Government on the report. We are realistic. We know well that the United Nations is not a charitable organization. That is clear given that it has been unable to implement the principles of the Charter and international law since its inception — and the Palestinian question is a case in point. There have been other failures by the United Nations: in Iraq, Libya, the former Yugoslavia, Grenada — for those who have forgotten Grenada — Nicaragua, and the list goes on. However, I hope we can preserve the United Nations as an organization even as it continues to lack charitability. I would now like to make the following points. First, the Syrian Government is fully committed to the principles of international law and international humanitarian law, as well as Syrian law and the Syrian Constitution, all of which stipulate that the Syrian Government has the responsibility to ensure the safety and security of Syrian citizens and protect them from terrorist groups. Secondly, the current report, just like previous reports, has a great flaw, namely, that the authors of the report continue to rely on politicized sources, open sources and unreliable figures. At the same time, the report continues to ignore credible Government sources and even the reports issued by the representatives of the United Nations in Syria. Those representatives, along with the reports they have submitted to the United Nations in New York, acknowledge the efforts S/PV.8195 The situation in the Middle East 28/02/2018 20/22 18-05507 of the Syrian Government and its cooperation on the humanitarian issue. However, none of this information that reaches New York appears to be mentioned in the report, as if by miracle. Thirdly, the Syrian Government condemns the authors of the report — the Office of the United Nations High Commissioner for Human Rights and the Office for the Coordination of Humanitarian Affairs — especially after the adoption of resolution 2401 (2018), for their failure to mention the Turkish aggression against the Syrian city of Afrin. That aggression has claimed the lives of many people, including women and children, destroyed public and private facilities and has led to the displacement of the city's inhabitants and a severe shortage of humanitarian goods. However, Afrin is not eastern Ghouta, eastern Aleppo, Fo'ah or Kefreya. Fourthly, the Syrian Government fully rejects the failure of the authors of the report to mention the catastrophic impact of the so-called International Coalition and its members. The Coalition, which has claimed the lives of hundreds of civilians and members of the Syrian forces who are fighting Da'esh, committed two new massacres yesterday that claimed the lives of 29 civilians and injured dozens, most of them women and children, in the villages of Sha'fa and Thahret Allouni in eastern Deir ez-Zor. It appears that the International Coalition is focused on this part of eastern Deir ez-Zor because it is home to civilians who do not host Da'esh or Al-Nusra Front terrorists. The Coalition has also destroyed the city of Raqqa, as my colleague the representative of the Russian Federation just noted. My Government calls once again for dismantling this illegitimate aggressive Coalition and for an immediately stop to its crimes against the Syrian people. The Russian military issued a communiqué today saying that the areas under the control of the allies and agents of the United States in Syria are witnessing the worst humanitarian crisis currently in the country. Those areas have become black holes, just like the black holes in outer space. With regard to the situation in eastern Ghouta, the Syrian Government believes that the current deterioration in the situation is due to the fact that terrorist groups there have launched attacks against residential zones and military targets. Up until yesterday, they had launched more than 2,180 missiles and mortars against the city of Damascus. Those attacks claimed the lives of 66 civilians and injured 474 others. Government forces have been forced to respond to those attacks and to carry out their constitutional responsibility in guaranteeing security and safety for the citizens. My Government condemns the use, by the authors of the report, of the term "besieged areas" when considering the situation in eastern Ghouta, in rural Damascus. Under pressure from influential countries in and outside of the Council, they continue to deliberately ignore the fact that people in eastern Ghouta are besieged from within by the various armed terrorist organizations operating there. Those terrorist organizations are exploiting civilians and using them as human shields. They are seizing and monopolizing humanitarian assistance, distributing the aid to their supporters or selling it at exorbitant prices, as was the case in eastern Aleppo. Syria regrets the failure of the authors of the report to refer to the suffering of thousands of kidnapped people who are in eastern Ghouta prisons and other places where the terrorist groups are spread. The kidnapped people include women, children and elderly. These people were kidnapped from their homes and places of work and have been subjected to the worst forms of torture. There are civilians, including from city of Adra and from Latakia, who were kidnapped from their homes five years ago. The Syrian Government also condemns the statements by the Secretariat and reports of the Secretary-General, which continue up till now to disregard the suffering of 8 million civilians in the capital Damascus as a result of hundreds of missiles and mortars launched daily from terrorist groups within eastern Ghouta. The accusations by the authors of the report, like those of the Western countries that have influence on them, that the Syrian Government is allegedly besieging Ghouta have been consistently refuted. They have proven to be unfounded, as we have seen in recent reports noting that the Saudi regime provided "aid" to eastern Ghouta in February. That proves, first, that eastern Ghouta is not besieged and, secondly, that it is possible to access it. In particular, the terrorist groups in Ghouta continue to receive arms and munitions from Governments that support terrorism, including Saudi Arabia's so-called humanitarian assistance. The Syrian Government is more committed than anyone to protecting its citizens across Syria. In that 28/02/2018 The situation in the Middle East S/PV.8195 18-05507 21/22 regard, it has taken all necessary measures to protect its citizens and to respond to the attacks of terrorist groups in eastern Ghouta. We have sought to protect these civilians from the terrorists by establishing a humanitarian corridor to ensure their exit from eastern Ghouta. We announced the humanitarian corridor only hours after the adoption of resolution 2401 (2018) in order to ensure the safety of civilians — in cooperation with our Russian friends and allies. We have provided them with shelter, food, medicine and medical care at the expense of the Syrian Government, not the Office for the Coordination of Humanitarian Affairs. The Syrian Government has also called on members of the armed groups to lay down their weapons, cease their terrorist activities inside residential areas and engage in national reconciliation efforts. However, those terrorist groups, including the Al-Nusra Front, Jaysh al-Islam and Faylak ar-Rahman, have forcibly prevented civilians from reaching the corridor, as some members of the Council may know. They also sought to target the humanitarian corridor after it was announced, through the use of mortars. As for the letter sent by the terrorist Mohamed Alloush, it is a clear indication that he rejects the exit of civilians from Ghouta. It is clear that he wants to use them as human shields. There seems to be a new trend in the United Nations to circulate a letter from a terrorist group as an official document. That is an innovation at the United Nations. There is no respect for the Member States concerned. We have followed closely the way resolution 2401 (2018) was adopted and today's statements and briefings. We can clearly say that the main goal behind the adoption of the resolution is neither to reach a clear truce or ceasefire, as some may claim, nor to protect civilians and meet their needs. The main goal was to use the Security Council once again as a means to prevent any progress by the Syrian army and its allies in the fight against the terrorist groups that are targeting the city of Damascus. I say that for the thousandth time. How else to explain the fact that the resolution fails to refer to any Council resolution on counter-terrorism? Who can explain to us the strong resistance of some States during the negotiations on the draft resolution to any text that excludes Da'esh, the Al-Nusra Front and the terrorist groups affiliated with them from the supposed ceasefire? For three days, the Council has continued to negotiate the issue of whether to include or exclude them. The false humanitarian propaganda on the situation in eastern Ghouta coincided with another campaign under the supervision of the United States, claiming the use of chemical weapons again in Syria, in areas under the exclusive control of terrorists or, I should say, the White Helmets. Today, The New York Times published a Tin-Tin style, childish report claiming that there is cooperation on the chemical issue between my country and the Democratic People's Republic of Korea. The article is a full-page report on the front page of The New York Times. It seeks to tarnish the image of the Syrian Government and the Democratic People's Republic of Korea. It ends by saying that this information is not substantiated. "Though experts who viewed the report said the evidence it cited did not prove definitively that there was current, continuing collaboration between North Korea and Syria on chemical weapons." That is a word-for-word quote from The New York Times. It seems that The New York Times is not up to date on what is going on in the world. It seems that the New York Times does not know that the American vessel, the MV Cape Ray, destroyed the chemical arsenal voluntarily submitted by the Syrian Government after joining the Chemical Weapons Convention and the Organization for the Prohibition of Chemical Weapons (OPCW), as a full member. That is old information, déjà vu, as is said in French. However, it seems that The New York Times has decided to address this issue today. I will read a communiqué that we received just now of information that I think should be taken into consideration when addressing the issue of the use of chemical weapons in Syria. And I can tell the Council that terrorists will use chemical weapons in Syria. On the morning of 20 February, four days ago, three Turkish trucks carrying chlorine entered Idlib governorate through the Bab Al-Hawa crossing. I think that The New York Times should verify that information. Two trucks stopped in the village of Qalb Loze in Idlib, and the third continued its way to Al-Habit village in northern Idlib. Information available to the Syrian Government points to the fact that terrorists are currently preparing for a chemical weapon using the substance of chlorine on a large scale and to then accuse the Syrian Arab Army of using such weapons. Those terrorists have clear instructions from Western and Turkish intelligence to fabricate a chemical attack before 13 March, because S/PV.8195 The situation in the Middle East 28/02/2018 22/22 18-05507 it is on that date that the eighty-seventh session of the Executive Council of the OPCW will be held. According to the information I received just now, the two trucks are currently in the school of Qalb Loze village. Other cars and terrorists are also currently in the school, which they have turned into a warehouse for chemical weapons. As for the third truck, it is currently in a centre belonging to the Hay'at Tahrir Al-Sham, which is a Turkish agent, in the north-eastern part of Al-Habit village. A vast number of terrorists are currently unloading the truck there. In providing the Security Council with this information, we affirm that these terrorists, at the instructions of their operators, will use these chemical weapons before 13 March. The main responsibility for ending hostilities lies with those countries that have real influence with terrorist groups in Ghouta and other parts of Syria. They should compel these terrorist groups to stop their terrorist activities and allow civilians to leave those areas, which are used by these groups as a base to launch their terrorist attacks. There is in this Organization a group of five countries that are shedding tears over the humanitarian situation in Syria. Unfortunately, some of them are members of the Council. They have invited Member States to watch a movie about the White Helmets, two days from now in the Economic and Social Council Chamber here at the United Nations. Some members of the Council are advocating for a group that has been designated as a terrorist group by the Council. I hope that the Council will address the information I have provided seriously and appropriately. The President (spoke in Arabic): As this is the last scheduled meeting of the Council for the month of February, I would like to express the sincere appreciation of the delegation of Kuwait to the members of the Security Council, especially my colleagues the Permanent Representatives, their respective staff and to the secretariat of the Council for all the support they have given to us. Indeed, February has been a busy month, and one in which we rallied to consensus on several important issues within our purview. We could not have done it alone or without the hard work, support and positive contributions of all the delegations and the representatives of the Secretariat, as well as all the relevant conference service officers, interpreters, translators and security staff. As we end our presidency, I know I speak on behalf of the Council in wishing the delegation of the Netherlands good luck in the month of March. I now invite Council members to informal consultations to continue our discussion on the subject. The meeting rose at 12.45 p.m.
The rapid growth in Islamic Finance Industry such as in Islamic banking, takaful, waqf, and sukuk gain more awareness and interest from around the world including Islamic countries and non-Islamic countries such as Singapore, South Korea, Japan, Europe, Australia, Brazil, and America Latin. Based on Islamic Financial Services Board (IFSB) and Ernst & Young Report in 2016 it stated that Islamic finance industry had reached a gross value USD 1.88 trillion in 2015. In addition, it also maintained double-digit growth rates despite sustained low energy prices, geopolitical conflicts and economic uncertainty. Meanwhile, Global Islamic Finance Report 2017 reported that in December 2016 global Islamic financial service industry stood at USD2.293 trillion. According to El-Qorchi (2005) that highlights there have three motivation of shifting to Islamic finance because strong demand for Shariah compliant products and services, demand from Gulf region or oil rich nation for Shariah compliant investment and lastly non-muslim investor also attracted with competitiveness of Shariah compliant products and services. Furthermore, there have numerous capital structure modern theories that have been developed since 1958 begin with MM Irrelevance Theory and continue with Trade-off Theory, Pecking Order Theory, Agency Theory and Market Timing Theory. As an example, trade-off theory is encouraging the firms to use debt financing rather than retained earnings and equity financing in order to utilise the tax deduction benefit from interest on debt financing. Each of this theory has different vi approach to manage and oversee the capital structure decision. Unfortunately, not all these theories explain adequately the effect of capital structure on corporate performance for Shariah compliant companies. Therefore, the question that can been arisen which is the most appropriate and suitable capital structure theory under Shariah principles? Firstly, this study intends to determine until to what extent the capital structure of Shariah compliant companies (SCC) can be different from Non Shariah compliant companies (NSCC). Many studies have been done on capital structure. However, most of the studies focused on the capital structure determinants, impacts of capital structure on financial performance, how the tax affected capital structure and short-term debt during financial crisis period. All of these past studies using financial institution, small and medium enterprises (SME) and public listed companies (PLC) as samples in their study. Nevertheless, there are few studies relate to the impact of capital structures on corporate performance during financial crisis. Shariah compliant companies presume to be more resilent during financial crisis based on their characteristic. However, there is no study on how SCC manages their capital structure during financial crisis period. Therefore, in order to fill the research gap, it is necessary to carry out a study on impact of capital structure on corporate performance during financial crisis by using SCC as sample. The main objective of this study is to investigate the impact of capital structure on corporate performance of SCC predominantly during financial crisis period. To the best of our knowledge, there is no such empirical study that has been conducted until nowadays. As information, Shariah compliant companies (SCC) are deemed to comply with Shariah principles, rules, values and restrictions when dealing with the financing activities. In order to ensure SCC comply with all the Shariah principles and free from prohibited elements such as interest (riba), gambling (masyar) and speculation (gharar), Shariah advisory board (SAC) are established to monitor the SCC's activities. Besides, before being listed in Islamic index all the firms must be complying with the qualitative and quantitative criteria for screening process that are set by the index provider. This study will take the sample from FTSE Shariah global index series, therefore under this index provider, Yasaar Ltd is an impartial consultancy and leading authority on handling Shariah matters including the screening process. Under quantitative screening, there have several financial vii benchmarks that the firms need to follow in order to acquire the shariah-compliant status. According to Haron and Ibrahim (2012) due to the benchmark that are set by index provider, it leads SCC to raise capital via equity financing. Empirically, firms that rely more on equity-based financing tend to be more resilient during financial crisis period. Gitman and Zutter (2012, p.508) defines the capital structure as "the mix of debt and equity maintained by the firm". Thus, the main concern is how the firm decision to optimize the capital structures by combining debt and equity financing. There have a number of previous studies that explored how the firms or financial managers determine the optimum capital structure to ensure they can maximize the firm's corporate performance. Based on the empirical results it shows that there has numerous factor that influenced the firms and financial manager in order to make the capital structure financing decision such as profitability, growth, size, tangibility, tax, leverage, liquidity, and industry. Meanwhile, this study will focus on some financial benchmarks in order to achieve the objective of this study. Such example this study uses corporate performance, debt to equity ratio, debt financing ratio (short-term debt ratio and long-term debt ratio), tangibility ratio, cash plus account receivables ratio, growth ratio, and size ratio. Corporate Performance In this study, two proxies will be used to measure the corporate performance of the firm. Firstly, this study decides to use profit before tax and zakat over total asset or it called pre-tax return on assets (Pre-tax ROA) to measure the firm's corporate performance. This ratio is to measures how the efficiency of the firm can earn on its investment in its assets. In other words, how the firm used its assets effectively to generate the income or profit from that assets. Like the previous study that have been used earnings before interest and tax (EBIT) over total assets and profit before interest and tax to measure the firm's corporate performance. Initially, this study intends to show the different significant impact to the firm's corporate performance if the firm paying taxes or zakat or both. It is due to the SCC has special taxes that are called 'zakat' under Shariah term and it viii has fixed-rate 2.5 percent from the net profit or income. However, until nowadays zakat still voluntary basis in most of the Muslim countries. Based on the sample in this study, Malaysia is the only country that implemented zakat system however it based on voluntary basis and none of the samples shows the zakat amount in their financial statement. The second proxy in this study for dependent variables that represents for firm's corporate performance is return on equity ratio (ROE) ratio. Based on the previous studies, there has been used net income after tax over total equity to measure the ROE in their studies. Therefore, this study also decides to use the same measurement as the prior studies. This ratio will measure by the firm's profitability using net profit after interest, tax and preference dividend divided by ordinary share capital plus reserves at the end of the financial year. ROE ratio is one of the main profitability ratios that concentrate on the firm's ordinary shareholders and compares the profit that has been earned and its capital. Some of the investors are using this ratio to measure the firm's ordinary shares desirability. Debt to Equity Ratio Some of the Islamic index provider set the financial benchmark that the total debt must be less than 33 percent from the total equity. Such an example, Dow Jones Global Islamic Index (DJIM) set the debt to equity ratio as one of their financial benchmarks. However, FTSE Global Equity Shariah Index does not include this benchmark under their screening process. Therefore, this study intends to use this benchmark to see whether there have significant differences between SCC and NSCC. This study decides to use total debt divided by total equity as a measurement of debt to equity ratio. It supported by other studies such as Margaritis and Psillaki (2010) and Memon et al., (2012) that also used the same measurement in their studies. This ratio is to evaluate a firm's financial leverage by measuring the degree of firm financing based on debt to equity or wholly-owned funds. In case if the company downturn, it measures the ability of the shareholder equity to cover all the debts in the firms. ix Debt Financing Under FTSE Global Equity Shariah Index quantitative screening, the debt ratio must be less than 33 percent of total assets. Due to this study's objective to determine the impact of capital structure on corporate performance during financial crisis, therefore the debt ratio divided into two categories, which are short-term debt financing and long-term debt financing. Based on Fosberg (2013) conducted a study on public listed companies in US and found that short-term debt financing increased from 1.3 percent in 2006 to 2.2 percent in 2008 which represent $34 million increase due to the financial crisis that are happened in 2008. It supported by numerous studies (see Brealey et al., 2008; Almeida et al., 2011; Federal Reserve, 2012; Fosberg, 2013) that during the stock market collapsed in 2008, the borrowing power of firms becomes fewer than before due to the credit supply was limited. Therefore, firms intend using more STD financing during financial difficulties. Hassan and Samour (2016) added that it highlighted that capital structure financing decision were impact during financial crisis period. Cheema et.al (2017) and Shahar and Shahar (2015) found that SCC using long-term debt (LTD) financing more than short-term debt (STD) financing. It might be due to the restriction for limited interest and risk sharing under Shariah guidelines. However, for NSCC, they are using more STD in order to meet the working capital requirement. On the other hand study by Sahudin, Ismail, Sulaiman, Rahman, and Jaafar (2019) found that SCC using more STD financing compared to LTD financing. STD financing is more widely used compared to LTD financing by the SCC in Malaysia because the majority of Islamic debt instruments issued short-term debt rather than long-term debt (Aggarwal & Yousef, 2000). This also supports agency theory whereby it justifies the function of STD financing as a mechanism to control the debt and mitigate the agency problem. Therefore, this study intends to examine the significant differences in financing patterns particularly before, during and after the financial crisis period. x Tangibility Ratio Tangibility assets become more popular as a measurement for bank viability after the financial crisis occurred. Bank viability means the bank's judgment on the ability of the firms to meet ongoing financial obligation with the additional investment and financing such as from the banks and investors. One of the reasons because tangible assets are liquid compared to intangible assets. It supported by Charalambakis and Garrett (2012) that stated tangible assets are the main point in explaining the capital structure within the firms. As a result, tangible assets have a higher value in the market and even if firms have financial problem or going to bankrupt, the firms can easily and quickly in selling their tangible assets. Scott (1977) and Titman and Wessels (1988) stated that less profitable firm intends to have a high value of tangible assets and the firms will use tangible assets as collateral in order to get more debt financing. Therefore, any firm that has higher tangibility ratio will issue more debt financing. This is in line with trade-off theory that highlight, firms need to enjoy the advantage of tax with issuing more debt financing while having more profit to the firm. Ahmad and Azhar (2015) added that this would give assistance to the firms that have default in their debt to use the tangible asset to avoid being bankrupcy. Cash plus Account Receivables Ratio Most of the previous studies used the liquidity ratio in order to measure the firm's ability to meet the short-term financial obligation. Even Thabet and Hanefah (2014) found in their study that liquidity were one of the factors that have the impact on the corporate performance to the firm. This ratio is important to ensure the firms have cut limit for total cash and account receivables in one time in order to avoid excess or lack of cash in the firms. In addition, it also to reduce the agency cost. To the best of our knowledge, this is the first study that examines the impact on total cash plus account receivables over total assets (CashAR) to the corporate performance. This variable is chosen as an independent variable for this study due to the characteristics for SCC must be following and passed the benchmark in order to be listed in the Islamic index. Farooq xi and Alahkam (2016) also mentioned that the Islamic financial system was more stable and resilient because of the economy based on Islamic guidelines. Growth Ratio This study decides to use the different amount of this year sales minus last year sales divided by this year sales as a proxy of firm growth ratio. It is supported by prior studies (Salim and Yadav, 2012; Bundala, 2012; Proença et al., 2014; Cheema et al., 2017) that are also used the same measurement for growth ratio in their studies. According to Titman & Wessel (1988) and Rajan & Zingales (1995) shows that the firms with high future growth turns out to be used less leverage in the financing decision. It is because the firm will shift from debt financing to equity financing. In addition, growth ratio are influence by the profitability of the firm. This study will be focused on selected countries from Southeast Asia, which are Malaysia, Indonesia, Vietnam, Singapore, and Thailand. The selection sample is justified that Southeast Asia is the most progressive region in the Islamic capital market in the Asia region (Yakcop, 2002). Initially, this study has identified 595 samples of Public Listed Companies under industrial sector in Southeast Asia. Nevertheless, 114 samples have been excluded due to the several reasons such as incomplete financial statement and change of accounting year during the period of study. Thus, the final samples selected are 197 PLC from Shariah-compliant companies and 284 PLC from Non-shariah compliant companies. All the sample are collecting through DataStream that is published by Thomson Reuter Eikon. This study gathers all the financial statements such as balance sheet, income statement and cash flow statement in order to achieve the objective of this study. The unique for this study, the data is analyzed using Python Pandas programming software. This is the first study using Python Pandas to analyze the impact of capital structure on corporate performance during the financial crisis. As information, Pandas are the software library written for the Python programming language for data manipulation and analysis. Undoubtedly, Pandas offer data structures and operations for manipulating numerical tables and time series. Therefore, the first step to do to analyze the data by creating the coding system that is xii required for this study. In order to accomplish the objective in this study, the regression equations have been developed as follows: 1. Y (Pretax ROA) = β0 + β1D/Eit + β2Tangit + β3STDit + β4LTDit + β5CASH/ARit + β6GRWit + β7SIZEit + β8(X) + ε 2. Y (ROE) = β0 + β1D/Eit + β2Tangit + β3STDit + β4LTDit + β5CASH/ARit + β6GRWit + β7SIZEit + β8(X) + ε Whereby: Pre-tax ROA = Return on asset before tax ratio ROE = Return on equity ratio D/E = Debt to equity ratio STD = Short term debt ratio LTD = Long term debt ratio TANG = Tangibility ratio CASHAR = Cash plus account receivable ratio GRW = Growth ratio SIZE = Size ratio ε = Error term X = dummy variable 0: Non-Shariah Compliant Companies (NSCC) 1: Shariah Compliant Companies (SCC) The analysis begins with the multicollinearity test and the purpose of this test to ensure there is no problem of multicollinearity among the variables. Based on the result, none of the tolerances value is less than 0.2 and none of the Variance Inflation Factor (VIF) is greater than 10. As a result, it found that there is no multicollinearity problem in this study. The analyses continue with the descriptive statistic analysis that found the corporate performance of Shariah compliant companies (SCC) is higher than Non Shariah compliant companies (NSCC) during the financial crisis and after the financial crisis for both proxies, pre-tax return on assets (Pre-tax ROA) and return on equity (ROE). However, for independent variables those are debt to equity ratio, short-term debt ratio, long-term debt ratio, cash plus account receivables ratio shows that SCC has lower ratio through out the periods which are before, during and after financial crisis. These results have been expected due to the benchmarks that are set xiii by index providers during the quantitative (financial) screening process. Furthermore, SCC requirements to follow all the time the benchmark in order to be listed in Shariah index and maintain as shariah status. Due to this reason, we can observe that SCC always has a lower leverage ratio compare to NSCC. In addition, firms that have lower ratio are better because high leverage ratio or debt financing ratio contributes to the high risk of solvency and instability of the firms. Tangibility ratio for SCC is higher than NSCC before, during and after the financial crisis period. This ratio becomes more important after the financial crisis period. It is because it uses as a measurement for bank viability and indicate the firm's collateral level. Therefore, SCC with a higher tangibility ratio can issue more debt financing. It becomes more secure in case of bankruptcy; the firm can sales its tangible assets in order to pay their debt financing. Cash plus account receivables ratio is lower than NSCC before, during and after financial crisis period. Even though high liquidity can attract more lender and manager to make investment easily however there have high risk of bankruptcy and high risk of non-payment. Besides, the lower liquidity can contribute to the lower agency problem. Growth ratio shows before and during financial crisis period NSCC have higher ratio than SCC. However, after financial crisis period, SCC demonstrates higher ratio than NSCC. It indicates that SCC's growth better after financial crisis period. In addition, it proved that SCC gets more attention from the investor after financial crisis period. The second major finding are from multiple regression analysis based on pre tax ROA as the first proxy for corporate performance. It found that all the independent variables are significant except for debt to equity ratio before the financial crisis period. However, during the financial crisis period, only long-term debt ratios not significant and after the financial crisis period both short-term debt and long-term debt do not significant. Shariah-compliant companies only have a significant level after the financial crisis period. The impact of capital structure on corporate performance, pre-tax ROA for SCC is 1.6617 times higher than NSCC after financial crisis period. xiv Second proxy of corporate performance is a return on equity (ROE). All the independent variables are significant with the ROE except for debt to equity ratio and cash plus account receivable ratio before the financial crisis period, while long-term debt ratio during and after the financial crisis period. SCC significantly with ROE before the financial crisis and it shows that the impact of capital structure on SCC for corporate performance, ROE is -2.9264 times lower than NSCC. However, after the financial crisis period, the impact of capital structure on corporate performance, ROE for SCC is 4.3171 times higher than NSCC. The findings in this study posed an important implications for academicians, researchers, regulatory bodies as well as the management of the firms particularly Shariah compliant and non-shariah compliant companies, as they pave for further exploration. It offers knowledge to the regulatory bodies and related government agencies to come out with the guidelines and framework regarding shariah compliant status. Therefore, in order to set up with the new regulations and guidelines, these agencies need to understand the needed of investors and the characteristics of SCC itself in order to develop new guidelines to attract more investors. Such cases in Malaysia, the government give incentive to the new shariah compliant companies with five years tax exemption. Other, in UK and France they have amended their tax structure to compatible with Islamic finance guidelines. There have several limitations encountered in conducting this study. This study did not take into consideration the effects of the Asian financial crisis because there have different impact between the countries due to the different level of development in the financial market, the policies of the government and the sensitivity of that country to external incidents. In addition, due to this was the cross country study, therefore the differences are expected due to difference law system and regulation, bureaucracy, dissimilar costs and benefits that the companies face in each country. These limitations have paved the way to future research. Therefore, in the future it hopes to take consideration for these limitations in order to fill the research gap in this area ; slami finans özellikle son zamanlarda, İslami bankacılık, tekaful, vakıf ve sukuk gibi bir çok alanda hızlı bir büyüme göstermektedir. İslami finans İslam ülkelerinin yanında, Singapur, Güney Kore, Japonya, Avrupa, Avustralya, Brezilya ve Amerika Latin gibi İslami olmayan ülkeleri de kapsayacak şekilde dünyanın dört bir yanından, gittikçe daha fazla farkındalık ve ilgi kazanmaktadır. İslami Finansal Hizmetler Kurulu (IFHK) ve 2016'da Ernst & Young raporuna dayanarak, İslami finans sektörünün 2015 yılına kadar brüt 1,88 trilyon ABD doları değerine ulaştığını belirttimektedir. Üstelik bu sektörün büyüme hızı, düşük enerji fiyatlarının sürmesine, jeopolitik çatışmalara ve ekonomik belirsizliğe rağmen, çift haneli büyüme oranlarını korumuştur. Örneğin, 2017 yılına ait Küresel İslami Finans Raporunda, Aralık 2016'da küresel İslami finansal hizmet sektörünün 2,293 trilyon ABD doları bulduğu raporlanmıştır. El-Qorchi'ye (2005) göre İslami finansa geçiş konusunda üç motivasyon bulunduğu vurgulamaktadır: Şeriat uyumlu ürün ve hizmetlere yönelik güçlü talep, Körfez bölgesindeki petrol zengini uluslardan gelen Şeriat uyumlu yatırım için talep ve ve son olarak Şeriat uyumlu ürün ve hizmetlerin rekabet gücünden etkilenen gayrimüslim yatırımcıların ilgisi. Ayrıca, 1958'den bu yana geliştirilen ve MM Teorisi ile başlayan ve Takas Teorisi (Trade-Off Theory), Finansman Hiyerarşisi Kuramı (Pecking Order Theory), Vekâlet Maliyeti Teorisi (Agency Theory) ve Piyasa Zamanlama Teorisi (Market xvi Timing Theory) ile devam eden çok sayıda sermaye yapısı teorisi vardır. Örnek olarak Takas teorisi, firmaları borcun faizinden faydalanmak için birikmiş karlar ve özkaynak finansmanı yerine, borç finansmanı kullanmaya teşvik etmektedir. Bu teorilerinin her birinin sermaye yapısı kararını yönetmek ve denetlemek için farklı bir yaklaşımı vardır. Bu çalışmanın temel amacı, finansal kriz döneminde sermaye yapısının kurumsal performans üzerindeki etkisini incelemektir. İlk olarak, bu çalışma Şeriat uyumlu şirketlerin (ŞUŞ) sermaye yapısının Şeriat uyumlu olmayan şirketlerden (ŞUOŞ) ne kadar farklı olabileceğini belirlemeyi amaçlamaktadır. Sermaye yapısı üzerinde çok sayıda çalışma yapılmıştır. Bununla birlikte, çalışmaların çoğu sermaye yapısı belirleyicileri, sermaye yapısının finansal performans üzerindeki etkileri, verginin finansal yapıdaki sermaye yapısını ve kısa vadeli borçları nasıl etkilediğine odaklanmıştır. Bu geçmiş çalışmalarda örneklem olarak, finansal kurumlar, küçük ve orta ölçekli işletmeler ve halka açık şirketler kullanmaktadır. Ancak Şeriate Uygun Şirketlerin sermaye yapıları ve sermaye yapısının finansal performans üzerindeki etkisi konusunda az sayıda çalışma vardır. Özellikle ŞUŞ'lerin sermaye yapıları göz önünde bulundurulduğunda, bu şirketlerin kriz döneminde daha avantajlı olmaları beklenmektedir. Ancak ŞUŞ'lerin finansal yapılarının, fiannsal kriz döneminde onlar için nasıl bir avantaj sağladığı bugüne kadar bir araştırma konusu yapılmamıştır. Bu nedenle, araştırma boşluğunu doldurmak için, ŞUŞ'lerin örnek olarak kullanıldığı, finansal kriz sırasında sermaye yapısının finansal performans üzerindekini araştıran bir çalışma yapılması gerektirmektedir. Bildiğimiz kadarıyla, bugüne kadar yapılmış böyle bir ampirik çalışma yoktur. Şeriat uyumlu şirketler (ŞUŞ), finansman faaliyetlerini yürütürken Şeriat ilkelerine, kurallarına, değerlerine ve kısıtlamalarına uymaktadır. ŞUŞ'in tüm Şeriat ilkelerine uyması, ayrıca riba, masyar ve gharar gibi yasaklanmış unsurlardan arındırılmasını sağlamak için, Şeriat Danışma Kurulu (ŞDK) ŞUŞ'lerin faaliyetlerini izlemek üzere kurulur. Bunlara ek olarak İslami endekste listelenmeden önce, tüm şirketler, endeks sağlayıcısı tarafından belirlenen tarama süreci için nitel ve nicel kriterlere uymalıdır. Bu çalışmada kullanılan örneklem, FTSE şeriat küresel sermaye endeksinde yer alan şirketlerden oluşturulmuştur. Bu endeks sağlayıcısı altında, xvii tarama süreci de dahil olmak üzere Şeriat konularının ele alınmasında Yasaar Ltd. tarafsız bir danışmanlık ve lider otorite olarak kabul edilmektedir. Şirketlerin Şeriat uyumlu statüsünü elde edebilmesi için, nicel tarama başlığı altında, uyması gereken bir dizi finansal kriterler de vardır. Haron ve Ibrahim'e (2012) göre, endeks sağlayıcı tarafından belirlenen kriter nedeniyle, ŞUŞ'ler sermaye arttrırımı yoluyla finansmanı tercih etmek durumunda kalmaktadır. Ampirik olarak, özkaynağa dayalı finansmana daha fazla ağırlık veren firmalar, finansal krizler sırasında daha dirençli olma eğilimindedir. Gitman ve Zutter (2012, s.508) sermaye yapısını "firma tarafından tutulan borç ve özkaynak karışımı" olarak tanımlar. Bu tanım doğrultusunda asıl amaç, borç ve özkaynak finansmanını çeşitli bileşimleri ile sermaye yapılarının nasıl optimum hale getirileceğidir. Ayrıca, sermaye yapıları aslında borç sahiplerini borç sahipleri olarak, özkaynakları ise hissedarlar veya hissedarlar olarak temsil etmektedir. O halde ortaya çıkan soru, şeriat ilkeleri uyarınca en uygun sermaye yapısı teorisi hangisidir? Firmaların veya finansal yöneticilerin, şirket performansını en üst düzeye çıkarabilmelerini sağlamak için optimum sermaye yapısını nasıl belirlediğine dair daha önce yapılmış çok sayıda çalışma vardır. Ampirik sonuçlar, kârlılık, büyüme, büyüklük, maddi varlık, vergi, kaldıraç, likidite ve sanayi gibi finansman kararını vermek için firmayı ve finans yöneticisini etkileyen çok sayıda faktöre sahip olduğunu göstermektedir. Bu arada, bu çalışmada, çalışmanın amacına ulaşmak için bazı finansal ölçütlere odaklanılacaktır. Bu örnekte, bu çalışmada kurumsal performans, borç / özsermaye oranı, borç finansman oranı, maddi duranlık oranı, nakit artı hesap alacakları oranı, büyüme oranı ve büyüklük oranı kullanılmıştır. Kurumsal Performans Bu çalışmada, kurumsal performansı ölçmek için iki bağımlı değişken kullanılmıştır. Şirketin kurumsal performansını ölçmek için il olarak vergi ve/veya zekat öncesi karın toplam varlığa olan oranıyla elde edilen ve varlıkların vergi öncesi getirisi (Vergi Öncesi Varlık Getirisi- Pre-tax Return of Asset) denilmektedir. Bu oran, işletmenin varlıklarına yaptığı yatırımdan elde ettiği getiri ile işletmenin xviii etkinliğini ölçer. Diğer bir deyişle, işletmenin varlıklarını gelir veya kârı elde etmek içine ne kadar etkin kullandığını gösterir. Önceki çalışmalarda olduğu gibi şirketin finansal performansını ölçmek için toplam aktifler üzerinden faiz ve vergi öncesi kazanç (faiz ve vergi öncesi kâr) kullanılmıştır. Öncellikle, bu çalışma, şirketin vergi veya zekat veya her ikisini birden ödemesi durumunda, işletmenin kurumsal performansının bundan önemli derecede etkilendiğini göstermeyi amaçlamaktadır. ŞUŞ'lerin Şeriat yönergelerine göre 'zekat' olarak adlandırılan, kâr veya gelirden yüzde 2,5 sabit oranda ödenen özel vergilere tabidir. Ancak, günümüze kadar zekat Müslüman ülkelerin çoğunda hala gönüllü olarak kullanılmaktadır. Bu çalışmadaki örneklem ile ilgili olarak, zekat sistemini uygulayan tek ülke Malezya'dır. Ancak burada da gönüllülük temeline dayanmaktadır ve örneklemdeki şirketlerin hiçbiri mali tablolarında zekat miktarını göstermemektedir. Bu çalışmada, firmanın kurumsal performansını temsil eden ikinci bağımlı değişken, özkaynak karlılığı (ÖKK) oranıdır (Return Of Equity-ROE). Önceki çalışmalara dayanarak, çalışmalarında ÖKK'nı ölçmek için vergi sonrası toplam özsermaye üzerinden net kar kullanılmıştır. Bu nedenle, bu çalışma daha önceki çalışmalarla aynı ölçümü kullanmaya karar verilmiştir. Bu oran, faiz, vergi ve imtiyazlı temettü sonrası net karın kullanılması suretiyle şirketin kârlılığına göre hesaplanır. ÖKK oranı, firmanın olağan hissedarlarına odaklanan ve kazanılan kar ile sermayelerini karşılaştıran ana karlılık oranlarından biridir. Bazı yatırımcılar bu oranı firmanın adi hisse senedinin cazibesini ölçmek için kullanmaktadır. Borç / Varl k Ora Bazı İslami Finans Endeksleri, örneğin Dow Jones Küresel İslam Endeksi (DJIM) tarafından yapılan nicel gözetimde, finansal kriterlerden biri özkaynak oranıdır. Toplam borç, toplam özkaynağa göre % 33'ten az olmalıdır. Bununla birlikte, bu çalışmanda kullanılan 'FTSE Global Equity Shariah Index' serisi bu oranın gözetim sürecine dahil etmemektedir. Bundan dolayı, bu çalışmada, ŞUŞ'ler ve ŞUOŞ'ler arasında önemli farklılıklar olup olmadığını genel olarak görmek için, bu oranın kullanılmasına karar verilmiştir. Toplam borcun toplam özkaynağa bölünmesiyle bulunan özkaynak oranını, bağımsız bir değişken olarak çalışmada yer xix almıştır. Margaritis ve Psillaki (2010) ve Memon ve diğerleri, (2012) gibi diğer bazı çalışmalar özkaynak oranı için, aynı ölçümü kullanmışlardır. Bu oran, borç / özkaynak veya tamamen sahip olunan fonlara dayalı şirket finansman derecesini ölçerek, bir şirketin finansal kaldıracını değerlendirmektir. Bu gösterge, şirketin bir finansal sorun yaşaması halinde, özkaynakların şirketteki tüm borçları karşılama kabiliyetini ölçer. Borç Fi a s a FTSE Global Equity Shariah Index nicel gözetimi kapsamında borç oranı, toplam varlıkların yüzde 33'ünden az olmalıdır. Bu çalışmanın amacı nedeniyle, finansal kriz sırasında etkisini daha ayrıntılı görmek amacıyla, borç oranı ikiye ayrılmıştır. Nitekim Fosberg (2013), ABD'de borsada işlem gören şirketler üzerinde bir çalışma yürütmüş ve kısa vadeli borç finansmanının 2006'da yüzde 1,3'ten 2008'de yüzde 2,2'ye yükseldiğini ve bunun 2008'de meydana gelen finansal kriz nedeniyle 34 milyon dolarlık bir artışı temsil ettiğini bulmuştur. 2008 yılında borsada çöktüğünde, kredi arzının sınırlı olmasından dolayı, şirketlerin borçlanma gücünün daha önce olduğundan daha zayıf hale geldiği sayısız çalışma ile desteklenmiştir (bakınız Brealey ve ark., 2008; Almeida ve ark., 2011; Federal Rezerv, 2012; Fosberg, 2013). Bu nedenle, firmalar finansal zorluklar sırasında KVYK finansmanını daha çok kullandılar. Hassan ve Samour (2016) sermaye yapısı finansman kararının finansal kriz sırasında etkili olduğunu açıkça belirtmişlerdir. Cheema ve arkadaşları (2017) ve Shahar ve Shahar (2015), ŞUŞ'lerin uzun vadeli borç finansmanını kısa vadeli borç finansmanından daha fazla kullandığını bulmuşlardır. Bunun nedeni, Şeriat yönergelerine göre sınırlı ilgi ve risk paylaşımının kısıtlanması olabilir. Bununla birlikte, ŞUOŞ'ler, işletme sermayesi ihtiyacını karşılamak için daha fazla KVYK kullanmaktadır. Ancak Sahudin, Ismail, Sulaiman, Rahman ve Jaafar (2019) tarafından yapılan çalışma, ŞUŞ'lerin UVYK'a kıyasla daha fazla KVYK kullandığını buldurmuştur. Malezya'daki ŞUŞ'ler uzun vadeli borcuna kıyasla daha yaygın olarak kısa vadeli borç kullanılmaktadır, çünkü İslami borçlanma araçlarının çoğu uzun xx vadeli borçtan ziyade kısa vadelidir (Aggarwal ve Yousef, 2000). Bu aynı zamanda, kısa vadeli borç fonksiyonunun, borcu kontrol etme ve acente sorununu azaltma mekanizması olarak haklı kıldığı kurum teorisini de destekler. Bu nedenle, bu çalışma özellikle finansal kriz öncesinde, sırasında ve sonrasında finansman modellerindeki önemli farklılıkları incelemeyi de amaçlamaktadır. Maddi Varl k Ora Maddi duran varlıklar, bankaların finansal krizden sonra işletmelerin yaşayabilirliğini ölçtükleri için daha popüler hale gelmektedir. Bunun nedeni maddi duran varlıkların maddi olmayan duran varlıklara göre daha fazla likidit olmasıdır. Charalambakis ve Garrett (2012) maddi duran varlıkların firma içindeki sermaye yapısını açıklamada ana nokta olduğunu belirtmiştir. Sonuç olarak, maddi duran varlıklar piyasada daha yüksek değere sahiptir ve firmalar finansal problemleri olsa veya iflas ederse bile, firmalar maddi varlıklarını kolayca ve hızlı bir şekilde satabilmektedirler. Scott (1977) ve Titman ve Wessels (1988), daha az kârlı firmanın maddi duran varlıkların yüksek değerine sahip olma eğiliminde olduğunu ve firmaların maddi duran varlıklarını daha fazla borç almak veya daha fazla borç almak için teminat olarak kullandıklarını belirtmiştir. Bu nedenle, daha yüksek somutluğu olan herhangi bir firma daha fazla borç alacaktır. Bu işletmenin daha fazla borç finansmanı sağlayarak verginin avantajından faydalanması gerektiğini vurgulayan değiş tokuş teorisine uygun şekilde, işletmenin daha fazla kâr elde etmesini sağlar. Ahmad ve Azhar (2015) bunun borcunda temerrüde düşüren işletmelere, iflastan kaçınmak için bu maddi varlığı kullanmaları için bir seçenek oluturduğunu eklediler. Naki e Alacak Topla Ora Önceki çalışmaların çoğu, işletmelerin kısa vadeli finansal yükümlülüğünü yerine getirme kabiliyetini ölçmek için likidite oranını kullanmıştır. Thabet ve Hanefah (2014) da çalışmalarında likiditenin işletmelerin kurumsal performansı üzerinde etkili olan faktörlerden biri olduğunu bulmuşlardır. xxi Bu oran, işletmenin aşırı nakit veya nakit eksikliğinden kaçınmak için, nakit ve alacakları için bir limit belirlemek açısından önemlidir. Buna ek olarak, temsil maliyetini de düşürmektedir. Bildiğimiz kadarıyla bu çalışmamızda, nakit ve alacaklar toplamı, toplam varlıklar içindeki yerinin (CashAR) kurumsal performansa etkisini inceleyen ilk çalışmadır. Bu değişken, ŞUŞ için İslami endekste listelenmesi için yerine getirmesi gereken bir ölçüt olduğu için, bu çalışmada bağımsız bir değişken olarak seçilmiştir. Farooq ve Alahkam (2016), İslami esaslara dayanan ekonomi nedeniyle, İslami finansal sistemin daha istikrarlı ve dayanıklı olduğunu çalışmalarıyla desteklemişlerdir. Büyüme Ora Bu çalışmada, cari yılki satış eksi geçmiş yılki satışların cari yılki satışlara bölünmesi, işletme büyüme oranının bir göstergesi olarak kullanılmıştır. Çalışmalarında büyüme oranı için aynı ölçümü kullanan önceki çalışmalar (Salim ve Yadav, 2012; Bundala, 2012; Proença ve diğerleri, 2014; Cheema ve diğerleri, 2017) bulunmaktadır. Titman & Wessel'e (1988) ve Rajan & Zingales'e (1995) göre, gelecekteki büyümesi yüksek olan firmaların finansman kararlarında daha az kaldıraç kullanıldığını göstermektedir. Çünkü firma borç finansman yerine özkaynakla finansmanı tercih edecektir. Ayrıca, büyüme firmanın karlılığını etkileyecektir. Bu çalışma Güneydoğu Asya'dan Malezya, Endonezya, Vietnam, Singapur ve Tayland gibi seçilmiş ülkelere odaklanacaktır. Örneklem seçimi, Güneydoğu Asya bölgesindeki İslami sermaye piyasasının en ilerici bölgelerini içermektedir (Yakcop, 2002). Bu çalışmanın başlangıcında, Güneydoğu Asya'da sanayi sektörü altındaki Halka Açık Şirketlerden 595 örnek tespit edilmiştir. Bununla birlikte, tamamlanmamış finansal tablolar ve hesap dönemi boyunca muhasebe yılı değişikliği gibi çeşitli nedenlerden dolayı 114 şirket, örneklemden çıkarılmıştır. Bu nedenle, seçilen son örnekler ŞUŞ'lerden 197 ve ŞUOŞ'lerden 284 halka açık şirketten meydana gelmektedir. Tüm örnekler, Thomson Reuter Eikon tarafından yayınlanan DataStream aracılığıyla toplanmıştır. Bu çalışma, amacına ulaşmak için bilanço, gelir tablosu ve nakit akım tablosu gibi tüm finansal tabloları bir araya getirmektedir. Bu çalışmada veriler, Python Pandas yazılımı kullanılarak analiz edilmiştir. Bu, sermaye yapısının xxii finansal kriz sırasında kurumsal performans üzerindeki etkisini analiz etmek için Python Pandas'ın kullanıldığı ilk çalışmadır. Pandas veri işleme ve analiz için Python programlama dili için yazılan yazılım kütüphanesidir. Pandas sayısal tabloları ve zaman serilerini değiştirmek için veri yapıları ve işlemler sunar. Bu nedenle, bu çalışma için gerekli olan kodlama sistemini oluşturmak, verileri analiz etmek için ilk adım olarak gerçekleştirilmiştir. Bu çalışmada amacına ulaşmak için regresyon denklemleri aşağıdaki gibi geliştirilmiştir: 1. Y (Pretax ROA) = β0 + β1D/Eit + β2Tangit + β3STDit + β4LTDit + β5CASH/ARit + β6GRWit + β7BOYUTit + β8(X) + ε 2. Y (ROE) = β0 + β1D/Eit + β2Tangit + β3STDit + β4LTDit + β5CASH/ARit + β6GRWit + β7BOYUTit + β8(X) + ε Vasıtasıyla: Pre-tax ROA = Vergi oranından önce varlığın getirisi ROE = Özkaynak karlılığı D/E = Borç / Özkaynak oranı STD = Kısa vadeli borç oranı LTD = Uzun vadeli borç oranı TANG = Maddi varlık oranı CASHAR = Nakit artı alacak oranı GRW = Büyüme oranı BOYUT = Boyut oranı ε = Hata terimi X = kukla değişken 0: Şeriat Uyumlu Olmayan Şirketler (ŞUOŞ) 1: Şeriat Uyumlu Şirketler (ŞUŞ) xxiii Analiz, çoklu doğrusallık testi ile başlar ve bu testin amacı, değişkenler arasında çoklu doğrusallık sorunu bulunmadığından emin olmaktır. Sonuçlara göre, tolerans değerlerinin hiçbiri 0,2'den az ve hiçbir Varyans Enflasyon Faktörü (VIF) 10'dan büyük değildir. Bu nedenle, bu çalışma için çoklu bağlantı sorunu yoktur denilebilir. Analizlere, tanımlayıcı istatistik analizleri ile devam edilmiştir. Şeriat uyumlu şirketlerin (ŞUŞ) kurumsal performansının mali kriz sırasında ve her iki bağımlı değişken için de, vergi öncesi varlık karlılığı (vergi öncesi AK) ve özkaynak kârlılığı (ÖKK), finansal krizden sonra şeriat uyumlu olmayan şirketlerde (ŞUOŞ) daha yüksek olduğu tespit edilmiştir. Ancak bağımsız değişkenler, borç / özkaynak oranı için kısa vadeli borç oranı, uzun vadeli borç oranı, nakit artı hesap alacakları hesap oranı, SCC'nin finansal öncesi, sırasında ve sonrasındaki tüm dönemler için daha düşük bir orana sahip olduğunu göstermektedir. Bu sonuçlar, niceliksel tarama işlemi sırasında endeks sağlayıcı tarafından belirlenen koşullar nedeniyle beklenen bir durumdur. Ayrıca Şeriat endeksinde yer almak ve Şeriat statüsü kazanmak için bir ŞUŞ'in, her zaman söz konusu koşulların yerine getirildiği takip etmesi gerekir. Bu nedenle, ŞUŞ'lerin ŞUOŞ'lere kıyasla her zaman daha düşük kaldıraç oranına sahip olduğunu gözlemleyebiliriz. Bu oranların düşük olması daha iyidir, çünkü yüksek kaldıraç oranı veya borç finansman oranı, şirketin ödeme gücü ve istikrarsızlık riskini arttırabilir. ŞUŞ için maddi varlık oranı finansal kriz öncesinde, sırasında ve sonrasında ŞUOŞ'lerden daha yüksektir. Bu oran mali kriz döneminden sonra, daha da önem kazanmaktadır. Çünkü, bankalar şirketin yaşama yeteneği için bu oranı dikkate alırlar ve şirketin teminat seviyesinin göstergesidir. Bu nedenle, daha yüksek maddi varlık oranına sahip ŞUŞ'e daha fazla borç verebilir. İflas durumunda daha güvenli hale gelir, şirketler, borçlarını ödemek için maddi duran varlıklarını satabilir. Toplam nakit ve alacak oranı, finansal kriz öncesinde, sırasında ve sonrasında ŞUOŞ'den daha düşüktür. Her ne kadar yüksek likidite ile daha fazla kredi hacmine ulaşmayı ve yöneticilerin yatırım yapmasını kolaylaşsa da, bu durum yüksek bir iflas riskini ve yüksek ödeme yapmama riskini beraberinde getirir. Ek olarak, düşük likidite temsil sorununun artmaması açısından bir avantaj sağlar. xxiv Öncesinde ve mali kriz döneminde ŞUOŞ'lerin ŞUŞ'lerden daha yüksek bir büyüme oranına sahip olduğunu göstermektedir. Ancak, mali kriz döneminden sonra ŞUŞ'ler, ŞUOŞ'lerden daha yüksek bir büyüme oranına sahiptir. Finansal kriz döneminden sonra ŞUŞ'lerin daha iyi büyüdüğünü göstermektedir. Ayrıca, finansal kriz döneminden sonra ŞUŞ'lerin yatırımcıdan daha fazla ilgi gördüğü kanıtlanmıştır. Kurumsal performans için ilk bağımlı değişken olarak, vergi öncesi AK'na dayalı çoklu regresyon analizinden elde edilen ikinci önemli bulgu, finansal kriz döneminden önceki borç / özkaynak oranı hariç tüm bağımsız değişkenlerin istatistiksel olarak önemli olduğunu ortaya koymuştur. Ancak finansal kriz döneminde sadece uzun vadeli borç oranları anlamlı değildir ve finansal kriz döneminden sonra hem kısa vadeli borç hem de uzun vadeli borç değişkenleri istatistiksel olarak önemli değildir. Şeriat uyumlu şirketler ancak finansal kriz döneminden sonra önemli bir seviyeye sahiptir. Sermaye yapısının vergi öncesi AK için ŞUŞ üzerindeki etkisi, finansal kriz döneminden sonra ŞUOŞ'lerden 1,6617 kat daha yüksektir. Kurumsal performansın ikinci bağımlı değişkeni ÖKK'dır. Finansal kriz döneminden önce borç / özsermaye oranı ve nakit artı hesap alacak oranı hariç, finansal kriz dönemi içinde ve sonrasında uzun vadeli borç oranı hariç tüm bağımsız değişkenler ÖKK açısından istatistiksel olarak önemlidir. Finansal krizden önce ÖKK ile ŞUŞ önemli ölçüde artmakta ve sermaye yapısının ÖKK için ŞUŞ üzerindeki etkisinin finansal kriz döneminden önce ŞUOŞ'lerden -2.9264 kat daha düşük olduğunu göstermektedir. Ancak, finansal kriz döneminden sonra, sermaye yapısının ÖKK için ŞUŞ üzerindeki etkisi ŞUOŞ'lerden 4.3171 kat daha fazladır. Bu çalışmada elde edilen bulgular, akademisyenler, araştırmacılar, düzenleyici kurumlar ve özellikle ŞUŞ ve ŞUOŞ gibi şirketlerin yönetimi için daha fazla araştırma yapmalarının gerektiğini sonucunu doğurmuştur. Bu çalışma düzenleyici kurumlara ve ilgili devlet kurumlarına, şeriat uyumlu statüye ilişkin yönergeler ve çerçeve çıkarmaları rehber olabilir. Bu nedenle, yeni düzenleme ve kılavuz ilkeler oluşturmak için, bu kurumların daha fazla yatırımcı çekmek için yeni kılavuzlar geliştirmek amacıyla yatırımcıların ihtiyaçlarını ve ŞUŞ'lerin özelliklerini anlamaları gerekmektedir. Malezya'da hükümet beş yıl vergi muafiyeti ile yeni xxv ŞUŞ'lere teşvik vermektedir. Ayrıca, İngiltere ve Fransa'da ŞUŞ'ler de dahil olmak üzere İslami finans sektörü için vergi yapılarını değiştirdiler. Bu çalışmanın yürütülmesinde bazı sınırlamalar bulunmaktadır. Bu çalışmada, finansal piyasadaki farklı düzeylerde gelişme, hükümet politikaları ve o ülkenin dış olaylara duyarlılığı nedeniyle Asya'daki finansal krizin ülke genelinde farklı olduğu göz önünde bulundurulmamıştır. Buna ek olarak, ülkeler arası bu çapraz çalışma nedeniyle, farklı hukuk sistemleri ve düzenlemeleri, bürokrasi, şirketlerin her ülkede karşılaştığı farklı maliyetler ve faydalar nedeniyle farklılıklar beklenmektedir. Bu sınırlamalar gelecekteki araştırmaların yolunu açmaktadır. Dolayısıyla, gelecekte sermaye yapısı alanındaki araştırma boşluğunu doldurmak için bu sınırlamaları dikkate alınmalıdır
Background: Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods: Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings: Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation: The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC.
Background Achieving universal health coverage (UHC) involves all people receiving the health services they need, of high quality, without experiencing financial hardship. Making progress towards UHC is a policy priority for both countries and global institutions, as highlighted by the agenda of the UN Sustainable Development Goals (SDGs) and WHO's Thirteenth General Programme of Work (GPW13). Measuring effective coverage at the health-system level is important for understanding whether health services are aligned with countries' health profiles and are of sufficient quality to produce health gains for populations of all ages. Methods Based on the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we assessed UHC effective coverage for 204 countries and territories from 1990 to 2019. Drawing from a measurement framework developed through WHO's GPW13 consultation, we mapped 23 effective coverage indicators to a matrix representing health service types (eg, promotion, prevention, and treatment) and five population-age groups spanning from reproductive and newborn to older adults (≥65 years). Effective coverage indicators were based on intervention coverage or outcome-based measures such as mortality-to-incidence ratios to approximate access to quality care; outcome-based measures were transformed to values on a scale of 0–100 based on the 2·5th and 97·5th percentile of location-year values. We constructed the UHC effective coverage index by weighting each effective coverage indicator relative to its associated potential health gains, as measured by disability-adjusted life-years for each location-year and population-age group. For three tests of validity (content, known-groups, and convergent), UHC effective coverage index performance was generally better than that of other UHC service coverage indices from WHO (ie, the current metric for SDG indicator 3.8.1 on UHC service coverage), the World Bank, and GBD 2017. We quantified frontiers of UHC effective coverage performance on the basis of pooled health spending per capita, representing UHC effective coverage index levels achieved in 2019 relative to country-level government health spending, prepaid private expenditures, and development assistance for health. To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—we estimated additional population equivalents with UHC effective coverage from 2018 to 2023. Findings Globally, performance on the UHC effective coverage index improved from 45·8 (95% uncertainty interval 44·2–47·5) in 1990 to 60·3 (58·7–61·9) in 2019, yet country-level UHC effective coverage in 2019 still spanned from 95 or higher in Japan and Iceland to lower than 25 in Somalia and the Central African Republic. Since 2010, sub-Saharan Africa showed accelerated gains on the UHC effective coverage index (at an average increase of 2·6% [1·9–3·3] per year up to 2019); by contrast, most other GBD super-regions had slowed rates of progress in 2010–2019 relative to 1990–2010. Many countries showed lagging performance on effective coverage indicators for non-communicable diseases relative to those for communicable diseases and maternal and child health, despite non-communicable diseases accounting for a greater proportion of potential health gains in 2019, suggesting that many health systems are not keeping pace with the rising non-communicable disease burden and associated population health needs. In 2019, the UHC effective coverage index was associated with pooled health spending per capita (r=0·79), although countries across the development spectrum had much lower UHC effective coverage than is potentially achievable relative to their health spending. Under maximum efficiency of translating health spending into UHC effective coverage performance, countries would need to reach $1398 pooled health spending per capita (US$ adjusted for purchasing power parity) in order to achieve 80 on the UHC effective coverage index. From 2018 to 2023, an estimated 388·9 million (358·6–421·3) more population equivalents would have UHC effective coverage, falling well short of the GPW13 target of 1 billion more people benefiting from UHC during this time. Current projections point to an estimated 3·1 billion (3·0–3·2) population equivalents still lacking UHC effective coverage in 2023, with nearly a third (968·1 million [903·5–1040·3]) residing in south Asia. Interpretation The present study demonstrates the utility of measuring effective coverage and its role in supporting improved health outcomes for all people—the ultimate goal of UHC and its achievement. Global ambitions to accelerate progress on UHC service coverage are increasingly unlikely unless concerted action on non-communicable diseases occurs and countries can better translate health spending into improved performance. Focusing on effective coverage and accounting for the world's evolving health needs lays the groundwork for better understanding how close—or how far—all populations are in benefiting from UHC. Funding Bill & Melinda Gates Foundation.
The Situation In Guinea-Bissau Report Of The Secretary-General On Developments In Guinea-Bissau And The Activities Of The United Nations Integrated Peacebuilding Office In ; United Nations S/PV.8186 Security Council Seventy-third year 8186th meeting Thursday, 22 February 2018, noon New York Provisional President: Sheikh Al Sabah . (Kuwait) Members: Bolivia (Plurinational State of). . Mr. Llorentty Solíz China. . Mr. Ma Zhaoxu Côte d'Ivoire. . Mr. Tanoh-Boutchoue Equatorial Guinea. . Mr. Ndong Mba Ethiopia. . Mr. Alemu France. . Mr. Delattre Kazakhstan. . Mr. Temenov Netherlands. . Mr. Van Oosterom Peru. . Mr. Meza-Cuadra Poland. . Ms. Wronecka Russian Federation. . Mr. Nebenzia Sweden . Mr. Skoog United Kingdom of Great Britain and Northern Ireland . Mr. Hickey United States of America. . Ms. Eckels-Currie Agenda The situation in the Middle East This record contains the text of speeches delivered in English and of the translation of speeches delivered in other languages. The final text will be printed in the Official Records of the Security Council. Corrections should be submitted to the original languages only. They should be incorporated in a copy of the record and sent under the signature of a member of the delegation concerned to the Chief of the Verbatim Reporting Service, room U-0506 (verbatimrecords@un.org). Corrected records will be reissued electronically on the Official Document System of the United Nations (http://documents.un.org). 18-04815 (E) *1804815* S/PV.8186 The situation in the Middle East 22/02/2018 2/19 18-04815 The meeting was called to order at 12.10 p.m. Adoption of the agenda The agenda was adopted. The situation in the Middle East The President (spoke in Arabic): In accordance with rule 37 of the Council's provisional rules of procedure, I invite the representative of the Syrian Arab Republic to participate in this meeting. In accordance with rule 39 of the Council's provisional rules of procedure, I invite Mr. Mark Lowcock, Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator to participate in this meeting: Mr. Lowcock is joining the meeting via video-teleconference from Geneva. The Security Council will now begin its consideration of the item on its agenda. I give the floor to Mr. Lowcock. Mr. Lowcock: My colleagues and I have given the Security Council a lot of updates on the situation in eastern Ghouta over the past three months. I want to start today by bringing members some voices directly from eastern Ghouta. The Office of the Special Envoy in Geneva has, just in the past three days, received thousands of messages on instant messaging applications from civilians there. They are pleading for help. Here is one of them, from a humanitarian worker in the area — a person well versed in international humanitarian law: "During the past two months, military operations turned into a process of systematic targeting of civilians. Most air raids have intentionally targeted civilian residential buildings. Whole families have died under the rubble. Today, and as battles intensify, I call on you, as a father now expecting my first child to be born, and as a humanitarian worker trying to maintain what is left of life, to act to stop the systematic operations against civilians and open the roads for humanitarian assistance." Here are more voices. "There are entire families being targeted. A mother and her three children. Four pregnant women; one died, another is in a critical condition, the third lost her baby, and the fourth is under observation. A young girl lost both eyes, and it is continuing." "We do not want war, we do not want war, we do not want war." "Can you hear our messages, voices and fear?" "Our situation is so tragic. Our basements are not safe and lack basic needs. Help us, be with us." "Instead of saying 'no more', the world is saying 'one more.'" As representatives of Member States, all here aware that their obligations under international humanitarian law are just that — they are binding obligations. They are not favours to be traded in a game of death and destruction. Humanitarian access is not a nice-to-have; it is a legal requirement. Counterterrorism efforts cannot supersede the obligation to respect and protect civilians. They do not justify the killing of civilians and the destruction of entire cities and neighbourhoods. The Council has been briefed in minute detail, month after month, on the scale of the suffering of the Syrian people. Our reports have indeed been endless: dead and injured children, women and men; airstrikes, mortars, rockets, barrel bombs, cluster munitions, chemical weapons, thermite bombs, suicide bombs, snipers, double-tap attacks on civilians and the essential infrastructure they depend on, including hospitals and schools; rape, illegal detention, torture, child recruitment and sieges of entire cities reminiscent of medieval times. Over the past 24 hours, heavy shelling and aerial bombardment of multiple communities in eastern Ghouta have reportedly continued, resulting in the deaths of at least 50 people and wounding at least 200. According to some sources, the total death toll since 19 February is close to 300 people. Twenty-three attacks on vital civilian infrastructure have been reported since 19 February. At least seven health facilities were reportedly hit on 21 February. The only primary health-care centre in Modira town was reportedly rendered out of service by airstrikes. A hospital in Duma city sustained significant damage from nearby barrel bombs. Also in Duma city, an obstetrics centre was damaged A hospital in Jisrein town was reportedly attacked, resulting in the death of a nurse. The two Syrian Arab Red Crescent centres in Duma city and Harasta town were reportedly damaged 22/02/2018 The situation in the Middle East S/PV.8186 18-04815 3/19 by the bombardment. Meanwhile — and this is also a point I have consistently emphasized — mortar shelling from eastern Ghouta is reportedly killing and injuring scores of civilians in Damascus city, too.Members all know the statistics of this conflict. They know that half the Syrian population has either fled the country or faced repeated internal displacement. These people have lost everything. They have seen their homes destroyed, their neighbours killed, their loved ones disappear. Everyone knows that the repeated confirmed or alleged chemical attacks in Syria have killed and terrorized Syrian civilians.Eastern Ghouta is a living example of an entirely known, predictable and preventable humanitarian disaster unfolding before our eyes. Everyone knows that nearly 400,000 people are besieged and that they have been besieged for more than four years. Everyone knows that in eastern Ghouta thousands upon thousands of children are facing acute malnutrition the likes of which we have not seen elsewhere in Syria since the onset of the conflict. Everyone knows that more than 700 people are in need of urgent medical evacuation to hospitals just miles away in Damascus city.We have all seen in recent days the images of bombs and mortars raining down on bakeries and medical facilities. According to reports documented by United Nations human rights colleagues, at least 346 civilians have been killed since the beginning of this month and close to 900 people have been injured. Members all heard the Secretary-General yesterday, in the Chamber, describing eastern Ghouta as "hell on Earth" and saying that we cannot "allow things to go on happening in this horrendous way". They also heard him pleading for "the immediate suspension of all war activities in eastern Ghouta" (S/PV.8185, p. 2).Earlier this week, UNICEF issued a blank statement, as it could no longer find the words to describe the brutality of this war. Its only message was that "no words will do justice to the children killed, their mothers, their fathers and their loved ones."This appalling violence is happening as we face significantly increased constraints on our ability to reach people trapped behind conflict lines. In recent months we have encountered greater difficulties in accessing people in hard-to-reach and besieged areas, particularly through cross-line convoys, than during any period since 2015. Since 1 December, for nearly three months, we have been able to deploy only three cross-line convoys, reaching just 67,200 people. Only 7,200 of those people were in besieged areas, less than 2 per cent of the overall besieged population. In 2017, through November, approximately 53 cross-line convoys reached people in need, an average of nearly five convoys per month. A cumulative total of nearly 2 million people were reached in the first 11 months of 2017, or around 175,000 people per month. Therefore in 2017 we reached 175,000 a month; in the past three months we have reached 22,000 a month. Those are not reports or allegations. We have complete, factual information on this, because they are our convoys.Moreover, the 2017 access levels were themselves nearly 40 per cent below our access levels in 2016. Access is not only limited on aid deliveries, but we are also seeing growing challenges to our ability to independently assess needs on the ground and to monitor aid delivery.When an entire generation is robbed of its future, when hospital attacks have become the new normal, when sieges of entire cities and neighbourhoods have become a lasting reality for hundreds of thousands of people, the international community must take urgent and concrete action. I have said this before and I will say it again. What we need is a sustained cessation of hostilities, and we need it desperately — a cessation of violence that will enable the immediate, safe, unimpeded and sustained delivery of humanitarian aid and services, the evacuation of the critically sick and wounded and an alleviation of the suffering of the Syrian people.The Council can still save lives in eastern Ghouta, and elsewhere in Syria. I urge it to do so. Millions of battered and beleaguered children, women and men depend on meaningful action by the Council.The President (spoke in Arabic): I thank Mr. Lowcock for his briefing.I shall now give the floor to those members of the Council who wish to make statements.Mr. Nebenzia (Russian Federation) (spoke in Russian): We are grateful to you, Mr. President, for the prompt response to our delegation's proposal to convene a special meeting on the situation in eastern Ghouta, in Syria. That certainly does not mean that other problematic areas require any less attention. In particular, not long ago, at our initiative, the Security Council discussed the dire situation in Raqqa in detail. S/PV.8186 The situation in the Middle East 22/02/2018 4/19 18-04815 And in general, over the past month we have revisited Syria's humanitarian issues more than once. I would like to ask Council members to listen carefully to what I have to say.It is past time to discuss frankly what is going on in this Damascus suburb. The mass psychosis in global media outlets of the past few days, working in coordination to circulate all the same rumours, is certainly not contributing to an understanding of the situation. When eastern Aleppo was in the news, propagandistic disaster scenarios were put forward for it — a city where, after it was liberated from the terrorists, warehouses full of medicines and medical equipment were discovered. At the time we demanded that the Secretariat conduct an investigation, but the report presented to the Security Council was blatantly superficial.We are constantly seeing images of the activities of the White Helmets, who pass themselves off as rescuers. They were long ago shown to be supported by generous foreign assistance, and they work closely with terrorist groups. As a general rule, they serve as the original sources of well-rewarded disinformation. We are given the impression that the whole of eastern Ghouta consists of nothing but hospitals and that it is the hospitals that the Syrian army is attacking. That is a well-known tactic in information warfare. It is a very well-known fact, however, that the militants everywhere make a habit of locating their military facilities in medical and educational institutions, but for some reason that inconvenient truth is not advertised.It would be a good idea to begin with the fact that there are still several thousand defiant militants in eastern Ghouta, including some affiliated with terrorist organizations, mainly Jabhat Al-Nusra. Some time ago, they breached the agreement on a cessation of hostilities with an attack on an armoured tank unit of the Syrian armed forces in Harasta. They are shelling Damascus, and the intensity of the attacks increases daily. Dozens of missiles are launched every day, and not a single area of the capital has been spared. For some reason, those statistics are not being taken into account by United Nations representatives, although the Permanent Mission of Syria distributes them regularly. We have pointed out that in a 20 February statement, an official representative of the Secretary-General described factual information as "reported" (see S/PV.8183). And today the Under-Secretary-General talked about reported shelling. But those reports could easily have been verified by United Nations staff if they had inspected the areas of destruction and visited the victims.The Russian Embassy facilities have been repeatedly shelled, and each time the same delegations in the Security Council have made up excuses to lay off the blame for these terrorist acts. One is compelled to conclude that someone is purposely helping the criminals avoid accountability. Incidentally, we are disturbed by the fact that not so long ago, representatives of some delegations who view themselves as leaders in the protection of human rights and international humanitarian law quite seriously said that the damage resulting from the shelling in Damascus did not reach a level deserving of the attention given to eastern Ghouta. Our immediate response was to ask how many people have to die to attain, as it were, the gold standard of sympathy? There has been no answer. Is it appropriate to pass over the tragedies in Ramadi, Fallujah, Mosul and Raqqa in silence while drumming up hysteria about Madaya, Daraya, eastern Aleppo and eastern Ghouta, encouraging militants to to further humiliate civilians?Incidentally, the coalition forces' methodical destruction of Raqqa is extremely recent. The memory of it is hardly likely to have faded so quickly. For some reason, when the Coalition bombing flattened Raqqa, no one sounded the alarm, demanded compliance with international humanitarian law or proposed an immediate ceasefire. Yes, the Coalition smoked the Islamic State in Iraq and the Levant (ISIL) out of Raqqa. We know that. But with that done, the United States has forgotten about the city. No one is clearing any mines there. Who is aware of the fact that as many as 50 returning civilians are blown up by mines in Raqqa every day? Nor do we see much enthusiasm from these famous activists about the worst humanitarian crisis of our time, which happens to be unfolding against the backdrop of the armed conflict in Yemen.The militants have turned the people who are left in eastern Ghouta into hostages who are not allowed to leave the area under rebel control through the Al-Wafideen checkpoint. The Russian Centre for Reconciliation of Opposing Sides has urged the illegal groups to lay down their arms and resolve their status, but they broke off negotiations yesterday, on 21 February. It is quite obvious that they do not care about the life and safety of the residents of eastern Ghouta, whom they use as human shields to hide behind. Their aim consists of continuing to negotiate 22/02/2018 The situation in the Middle East S/PV.8186 18-04815 5/19 tactical and logistical advantages for themselves. That does not seem to particularly worry these groups' foreign sponsors, who might be able to exert crucial influence on them. But no, they would rather maintain the status quo and organize loud campaigns blackening Syria and Russia.Energy is also being wasted on fragmenting the international efforts regarding a settlement in Syria. Instead of giving due backing to the Astana de-escalation process and the Syrian National Dialogue Congress in Sochi, which have become an important support to the inter-Syrian negotiations under the auspices of the United Nations in Geneva, we see ongoing backroom efforts designed to openly undermine the work being done through those platforms. On top of that, exclusive clubs are being created, one striking example of which is the so-called International Partnership against Impunity for the Use of Chemical Weapons, which undermines the established frameworks for international cooperation on non-proliferation. We know that preparations are being made for an unofficial presentation of that initiative in Geneva. We would like to reaffirm our position in that regard, which is that in view of the neutral status of respected international organizations such as the United Nations and the Organization for the Prohibition of Chemical Weapons, representatives of their secretariats should not be associated with narrow initiatives such as these, which do not enjoy universal support.Many are now asking the logical question of how de-escalation in eastern Ghouta and other problematic areas of Syria can be achieved as soon as possible. The delegations of Sweden and Kuwait have come up with their recipe for this, in their role as informal monitors of the humanitarian dimension of the Syrian conflict in the Security Council. Their draft resolution — which has now been officially prepared for a vote, despite the fact that the authors know perfectly well that there is no agreement on it — proposes an apparently simple idea, which is the establishment of a ceasefire throughout Syria for not less than 30 days. We would very much like to know how such a truce will be guaranteed, but we have had no intelligible answers. The important thing, they say, is adopting the decision, and we can come up with the details later. An issue as complex as the Syrian conflict does not respond to such logic. We have been through this before, including, once again, in the case of eastern Aleppo.In principle, a ceasefire would be extremely significant, and not just for ensuring the delivery of humanitarian aid. The challenge is in how to achieve it. What we need here is not resolutions for the sake of resolutions, but measures that correspond to the realities on the ground. We are constantly talking about ensuring that the Security Council agrees on feasible decisions that are not divorced from reality or that cater to populist demands. This is about the credibility of the principal organ of the United Nations, responsible for the maintenance of international peace and security, in accordance with the Charter, whose purposes and principles we were discussing only yesterday. If we could stop the violence in crisis zones with resolutions, we would already be living in a completely different world.It will take long and hard work with the sides to the conflict to stabilize the situation so that the parties can sit down at the negotiating table and come up with the parameters for a ceasefire. There is no other way. It will also be impossible to ensure on paper that in 48 hours, or any other amount of time, humanitarian convoys can get going and mass medical evacuations begin. By the way, specific parameters for normalizing a number of complex issues are currently being formulated in Geneva, including by using the potential of the specialist International Syria Support Group. They include the Rukban camp for displaced persons — where, we understand, the United States military presence occupying the area has finally given the United Nations written guarantees — the Yarmouk camp, where the ISIL terrorists still have a presence, and the Fua and Kefraya enclaves.In that connection, I would like to know if the authors of today's initiative genuinely do not understand its utopian nature or if there is some other purpose at work here that has nothing to do with a desire to help struggling Syrians. Unfortunately, the story of eastern Aleppo in 2016 suggests that the second is true, and that the aim is to start a fight so as to strengthen international pressure on the Syrian authorities and slander Russia. Besides that, it shifts the focus from the importance of reviving the Geneva process as quickly as possible on the basis of the agreements that the Syrians arrived at in Sochi to indiscriminate accusations against the Syrian Government. Will that improve Geneva's chances of success?I will say it again to make sure that everyone hears it one more time. Russia will continue to do everything S/PV.8186 The situation in the Middle East 22/02/2018 6/19 18-04815 possible to achieve peace in Syria and restore stability to the Middle East. We call on our partners to do the same in a spirit of constructive cooperation and in cooperation with the United Nations, rather than continuing to sow confusion, ramp up support for jihadists and tear the region apart. For this draft resolution to be meaningful and realistic, the Russian delegation has prepared some amendments to it that we will now circulated to Council members.Mr. Skoog (Sweden): I would like to thank the Russian Federation for calling for a meeting on the horrendous situation in eastern Ghouta, and Mr. Mark Lowcock for his briefing. I will now make some brief remarks on behalf of Sweden and Kuwait.In seven years of war, the situation in the besieged area of eastern Ghouta has never been worse. I would like to thank the Office for the Coordination of Humanitarian Affairs for another briefing reminding us of the horrific reality for citizens in eastern Ghouta and of the Council's responsibilities. Yesterday, in this Chamber, the Secretary-General said that the 400,000 inhabitants of eastern Ghouta live in hell on earth. His appeal to all of us in the Council was to act — to immediately suspend all war activities in eastern Ghouta, allowing for humanitarian aid to reach all of those in need, allowing for the evacuation of the hundreds of people that need urgent treatment and that cannot be provided for and allowing the possibility for other civilians to be effectively treated. I want to take this opportunity to remind all parties, as Mark Lowcock just did, of their obligations under international law to protect civilians and hospitals and other medical facilities.The co-penholders, Sweden and Kuwait, have put forward a draft resolution to respond to the constant legitimate calls from the United Nations for a nationwide cessation of hostilities for 30 days in order to allow for humanitarian access and emergency medical evacuations. Our draft resolution also calls for the lifting of the siege directed against eastern Ghouta. We plead to all Council members to come together to support the draft resolution and to urgently adopt it so that we can halt the incessant attacks against eastern Ghouta and beyond, and we can avert a situation that is beyond words in its desperation. We, Sweden and Kuwait, furthermore urge the parties to the de-escalation agreement in eastern Ghouta to comply and implement it. We call upon the Astana guarantors — Russia, Iran and Turkey — to spare no effort and bring all their influence to bear on the parties to that end to avert the human disaster unfolding before our eyes.In response to our Russian colleague on our draft resolution, the United Nations convoys and evacuation teams are ready to go, subject to standard security procedures. The draft resolution that we are putting forward is not a comprehensive peace deal. Its aim is a much-needed humanitarian pause for an initial period of 30 days. There are already ceasefire agreements in force for the areas where fighting has escalated the most recently. They must be complied with. There are existing monitoring mechanisms that can be utilized. The role of the Council, I believe, is to push the parties to the conflict to comply with the proposed cessation of hostilities. Compliance is on the shoulders of the parties. I think that we can make a difference, and I think that we are tested today — not just as Ambassadors representing our countries, but as human beings. That is a massive responsibility.The President (spoke in Arabic): I shall now make a statement in my capacity as the Deputy Prime Minister and Minister for Foreign Affairs of Kuwait. At the outset, I would like to thank Mr. Mark Lowcock, Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, for his briefing today. The remarks in Mr. Lowcock's statements are in line with the Secretary-General's remarks yesterday morning (see S/PV.8185) — that eastern Ghouta can wait no longer. There is tremendous suffering there, with 400,000 people who are living hell on Earth.We support all what the Permanent Representative of Sweden, Mr. Skoog, said in his statement on behalf of Kuwait and Sweden as co-penholders of the humanitarian dossier in Syria. It is unfortunate that the number of people killed since the beginning of this month in eastern Ghouta has reached 1,200 civilians. The international community is silent; it stands still. The question here is: How long we are going to remain silent? How many more civilians, women, children and elderly must die or be displaced until the international community starts taking action and speaking in one voice and saying enough — enough carnage and grave violations of human rights law and international human law? In that regard, I would like to make the following points.22/02/2018 The situation in the Middle East S/PV.8186 18-04815 7/19 First, Kuwait and Sweden, in response to the clear-cut demands of the United Nations on the humanitarian situation in Syria, have jointly submitted a simple and clear draft resolution that demands a cessation of hostilities across Syria for a 30-day period in order for the United Nations and its partners to be able to deliver humanitarian aid and services and provide critical medical evacuation to the sick and wounded, in accordance with the provisions of international law, and end the blockade on residential areas.Secondly, action on the part of the the State of Kuwait is based on our religious and national duty to our brothers in Syria. We have a legal, human and ethical responsibility to end their suffering. In that connection, we call on all Member States to support the draft resolution and vote in its favour. We should rise above our political differences to protect civilians.Thirdly, a failure to ende the systematic and horrendous carnage and bloodshed that has continued for seven years with various weapons would only serve to encourage the perpetuation of such crimes without accountability, as those who commit them are heartened by impunity.I now resume my functions as President of the Council.Ms. Eckels-Currie (United States of America): I thank Under-Secretary-General Lowcock for his briefing, particularly his noting of the systematic targeting of civilians in eastern Ghouta and the toll that it is taking on the people there.Yesterday, Russia's Permanent Representative requested this meeting in order to "make sure that all parties can present their views". The view that Mr. Lowcock presented today is, as the Secretary-General said and others have repeated, one of hell on Earth for the people of eastern Ghouta. I would also like to share the vision of some of the people of eastern Ghouta.Bilal is 22 years old, with a wife who is five months pregnant. He says, "We are waiting our turn to die; this is the only thing I can say". Abdullah is a construction worker, with a wife and six children. He says,"Bombs were falling everywhere near our house. We have been spending the last week digging into the rubble of nearby areas with our bare hands."Malik is a doctor treating the wounded. He says,"The hospitals have been overflowing with blood. We are doing what we can to help, but the situation is becoming unbearable."Those are just a few of the overwhelming number of horrific stories coming out of eastern Ghouta everyday. The pictures and videos are everywhere — screaming parents digging through rubble to find their children; doctors working frantically with no medicine and no equipment in underground hospitals to save whoever they can. Those are not terrorists showing up in these makeshift emergency rooms — they are civilians. They are ordinary people, under attack by a barbaric Al-Assad regime that is bent on levelling eastern Ghouta to the ground, with no regard for the 400,000 men, women and children who live there.No one needs to use their imagination to know what the Al-Assad regime is planning. It is exactly what we saw in Aleppo in 2016, and in Hama and Homs before that. The Al-Assad regime wants to bomb or starve of all of its opponents into submission. That is why, except for two small deliveries of aid, the regime has not allowed any medical convoys or deliveries of food into eastern Ghouta since November, and the bombing attacks have been relentless. The regime wants to keep bombing and gassing these 400,000 people, and the Al-Assad regime is counting on Russia to make sure the Council is unable to stop their suffering.Yesterday the Russian representative asked for the parties to present their views, and has put forward a deeply cynical one today. Those present have now also heard from the United Nations humanitarian leader and from people, like Bilal, Abdullah and Malik. The assault from the regime is relentless, and the suffering is overwhelming. The Russian Permanent Representative also asked that we "come up with ways of getting out of the situation." Yet it appears to be intent on blocking any meaningful effort to do so.None of us on the Council need to look very far for the way out. Thanks to the tireless efforts of our colleagues from Kuwait and Sweden, the way is sitting in front of us. We have a draft resolution establishing a 30-day ceasefire to help shield the people of eastern Ghouta and allow for deliveries of food and medicine to arrive. All 15 of us have spent the past three weeks negotiating that text, patiently attempting to work with each other, including the Russian delegation. We believed we had an agreed text. There are no surprises here. The United S/PV.8186 The situation in the Middle East 22/02/2018 8/19 18-04815 States is ready to vote on the draft resolution — right here and right now. All of us should be ready. Sweden and Kuwait have consulted everyone on that text. They have done their part. There is no reason to delay. Literally, the minute this meeting ends, the Council can take the clearest possible step to help — vote for a ceasefire and vote for humanitarian access.What the people of Eastern Ghouta need is not complicated, and do not just take our word for it. The International Committee of the Red Cross head of delegation in Syria summed it up, "This is madness and it has to stop". The United Nations High Commissioner for Human Rights, Prince Zeid, asked,"How much cruelty will it take before the international community can speak with one voice to say enough dead children, enough wrecked families, enough violence, and take resolute concerted action to bring this monstrous campaign of annihilation to an end?"UNICEF can hardly put words on a page. All UNICEF said in a haunting statement was, "No words will do justice to the children killed, their mothers, their fathers and their loved ones". The Secretary-General made his point clearly yesterday. He supports the cessation of hostilities because eastern Ghouta cannot wait.Yesterday Russia's Permanent Representative asked what we should do about eastern Ghouta. The people of eastern Ghouta, United Nations officials, humanitarian and human rights leaders and, indeed, pretty much the entirety of the Council have answered: stop the bombing of eastern Ghouta and allow medical assistance in. The rest of the Council is ready to act. We urge the Council to move forward with the ceasefire and humanitarian draft resolution immediately.Mr. Ma Zhaoxu (China) (spoke in Chinese): I would like to thank Russia for its initiative in convening this meeting. I also thank Under-Secretary-General Lowcock for his briefing.Recently, the security situation in parts of Syria, including its capital, Damascus, and the eastern Ghouta region, has escalated, causing significant civilian casualties, which is drawing broad attention from the international community. China would like to express its profound sympathy to the Syrian people for their suffering. We condemn all acts of violence that target civilians and civilian facilities and harm innocent lives. China has always believed that there is no military solution to the Syrian issue; it would only aggravate the suffering of the Syrian people. A political settlement is the only way out.The present situation is now such that the international community needs to support the Syrian parties in the resumption of dialogue and negotiations under the United Nations mediation as soon as possible and in seeking a solution that is accepted by all parties through a Syrian-owned and Syrian-led political process. That is the only way to fundamentally ease the humanitarian situation in Syria and rid the Syrian people of their suffering at an early date.Terrorist organizations are still launching attacks in Syria, which have caused significant civilian casualties and impeded humanitarian relief efforts by the United Nations. The international community should strengthen its cooperation on counter-terrorism, adopt unified standards and resolutely combat all terrorist organizations designated as such by the Security Council.As part of the Syrian issue, the humanitarian aspect in the country is closely linked to Syria's overall situation, in addition to its political process. Actions taken by the Security Council on Syria's humanitarian issue should not only help ease the overall humanitarian situation in the country, but also help consolidate the momentum for a ceasefire in Syria and be conducive to the bigger picture of a political settlement to the issue. China calls upon the Security Council to remain united on the issue of Syria, speak with one voice and create favourable conditions for substantive progress in Syria's political process at an early date.Mr. Delattre (France) (spoke in French): I would like to thank Mr. Mark Lowcock for his enlightening briefing of the situation of the inhabitants of eastern Ghouta. Mr. Lowcock has said it all — the torrent of fire that is indiscriminately falling eastern Ghouta is relentlessly pushing the limits of horror and human suffering. There are no words to describe what is taking place in eastern Ghouta as we speak.The regime is not merely bombing its own people. It is methodically targeting hospitals and vital infrastructure for the population with the macabre aim of ensuring that the injured who have not perished during the shelling do not survive the wounds inflicted upon them. We must insist that the attacks against hospitals and health-care personnel constitute war crimes, and the perpetrators must be held accountable.22/02/2018 The situation in the Middle East S/PV.8186 18-04815 9/19 The reports we have received from non-governmental organizations and the Office of the United Nations High Commissioner for Human Rights are unbearable. Twenty eight attacks struck 20 hospitals in eastern Ghouta since January. More than 700 individuals are in need of urgent medical evacuation. Those evacuations are systematically blocked by the Damascus regime, which has been the case for months. More than 400,000 people, including 130,000 children, have been besieged for months by the regime as part of a siege that is reminiscent of the Middle Ages.We should make no mistake: the Syrian regime and its allies are brandishing the fight against jihadist fighters, the need for which no one is disputing, as justification of an offensive aimed at entirely different goals. Its real intentions are indeed to annihilate any and all opposition and break the morale of civilians by indiscriminately massacring them. The offensive against eastern Ghouta, which has seen an unbridled acceleration in recent years — the worst of which is undoubtedly yet to come — has added to both the methods and consequences of the new Aleppo. Let us recall that in that city the intensification of bombing preceded a reconquest operation and unknown levels of violence that never sought to shield civilians or rule out the use of chemical weapons. We shall be particularly vigilant on the latter.Yesterday, through President Macron, France emphatically condemned the indiscriminate shelling of residential areas and civilian infrastructure. We called for the immediate establishment of a ceasefire to enable medical evacuations and humanitarian access to the people. The Secretary-General also spoke resolutely along the same lines. As was recalled this morning by the French Foreign Minister, Mr. Jean-Yves Le Drian, any lack of action is an indication of guilt. We must act swiftly, for the Council has the means at its disposal, if the willingness is put forth.Sweden and Kuwait, the commitment of which France commends, have proposed a draft resolution demanding an immediate cessation of hostilities to enable humanitarians to evacuate the wounded and gain access to the people. The draft resolution before us does not seem to me to be a political judgement. It conveys the humanitarian imperative that, as such, must bring us together. Accordingly, we have noted Russia's intention to propose changes to the draft resolution. We will consider them, but it is crucial that we quickly adopt the draft resolution so that a cessation of hostilities takes place immediately, as addressing the situation on the ground is of the utmost urgency.A cessation of hostilities is not a concession. It is the minimal form of response to the repeated requests of the United Nations and humanitarian actors, which have been communicated by members of the Council. Subsequently, it is up to the regime's supporters to ensure full respect and to respond to all calls for access to humanitarian assistance and medical evacuations under international humanitarian law. It is inconceivable to us that a Council member could be opposed to that.At the same time, we must — and France stands ready to — redouble our efforts to establish a neutral environment that will allow for a credible political process and the holding of elections in Syria. Since the beginning of the Syrian crisis, France has consistently advocated for the priority of achieving a negotiated solution to the military situation and of finding a political solution that satisfies the aspirations of the Syrian people, ensures lasting peace and stops terrorism in its tracks. France will not deviate from the road map adopted by the international community. We have already said, and will say once again, that only a political, inclusive solution, established under the auspices of the United Nations through enabling a political transition within the framework of the Geneva process and resolution 2254 (2015), will end the suffering of the Syrian people in a credible and lasting manner.I should like to conclude with both a warning and an appeal. Not only has the situation in Syria reverted to the tragic darkest hours of the crisis, but, if we fail to react robustly and immediately — let us make no mistake — the worst is yet to come. The worst is the endless escalation of the humanitarian crisis that is crushing the people, any semblance of humanity and the very values underpinning the United Nations. A widespread ground campaign directed against eastern Ghouta might well be the next deadly stage. The worst is also the expansion of the conflict. The combination of circumstances before us today might lead to a potentially major regional or even international confrontation. That risk must be taken very seriously.In the name of our shared values and interests, I call on every member of the Council to join and act together. We owe that to the civilians who are dying by the hundreds in the hell in eastern Ghouta. We owe it to the security of the region and of the world, which S/PV.8186 The situation in the Middle East 22/02/2018 10/19 18-04815 we have the collective responsibility to protect. We owe it to upholding the credibility of the United Nations, which is our shared heritage. Let us beware that the Syrian tragedy does not also become the grave of the United Nations.Mr. Meza-Cuadra (Peru) (spoke in Spanish): We thank Mr. Lowcock, Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator, for his briefing today on the tragic situation facing the more than 400,000 people living in eastern Ghouta and in other cities.We heard with dismay that, in that area, the basic principles of international humanitarian law and human rights continue to be disregarded. That has been evidenced by the incessant and merciless bombardments resulting in hundreds of civilian casualties — many of whom are women and children — on a daily basis. Far from decreasing, the bombardments have intensified over the past several days and weeks, as has been the case with regard to the number of people with urgent medical issues who are dying because they cannot be evacuated. We deeply regret that humanitarian convoys are unable to reach besieged and difficult-to-access areas, such as eastern Ghouta, among others, despite repeated appeals from the United Nations and various countries, including Peru, to facilitate immediate, safe and unrestricted access in eastern Ghouta, as well as other areas of Syria.All those facts, which are ultimately allowing for and fuelling a hell on Earth, as the Under-Secretary-General just pointed out to us, warrant our strongest condemnation. We must remind all parties, including the Syrian authorities, of the responsibility to protect the civilian population. The United Nations has determined various actions that can be taken to alleviate the suffering of civilians in eastern Ghouta and other affected areas. We stress the importance of the immediate implementation of a 30-day cessation of hostilities to allow for providing aid and setting out and implementing the humanitarian assistance response plan and the five priorities that Mr. Lowcock mentioned. Those are all indispensable and urgently needed measures that Peru fully supports.Implementing them will require a genuine political will to reverse direction and turn them into a reality. Accordingly, we thank Sweden and Kuwait for their generous efforts to reach a consensus on a draft resolution on a cessation of hostilities, which we hope can be adopted as soon as possible. It is of the utmost importance that Council members, in particular those who are able to exercise their influence on the ground, show the world their unity, sense of duty and willingness to compromise, and that we send a clear signal that prioritizes human beings over other interests.The Council must be able to rise to the occasion and fulfil its sensitive and important responsibilities. All can count on my delegation's commitment to carrying out actions that will alleviate the human suffering in eastern Ghouta and throughout Syria.Mr. Van Oosterom (Netherlands): We thank the presidency for convening this meeting, and I thank Mark Lowcock for his sobering briefing. I will address the following three points: first, the escalation of violence in eastern Ghouta, secondly, international humanitarian law, and, thirdly, action by the Security Council.First, with regard to the escalation of violence in eastern Ghouta, we are meeting at a moment of grave distress for the people in eastern Ghouta and elsewhere in Syria. We have seen the extreme escalation of violence in Idlib and eastern Ghouta, which was initiated a few weeks ago by the Syrian regime and its allies. That has severely intensified over the past several days and continues without pause, as Mark Lowcock clearly described. We condemn all indiscriminate attacks directed against civilians. Communities in eastern Ghouta have experienced the most intense bombardments since the beginning of the siege in 2012. Mortars are also being fired into Damascus. Families do not have a safe place to hide. Women and children are dying. Last Monday, the United Nations reported, over a period of just 13 hours, at least, 92 civilian deaths in eastern Ghouta, and the total death toll since Monday appears to stand now at approximately 300.We continue to receive reports of attacks on hospitals and of the renewed use of chemical weapons, thereby leading to the inhumane suffering of civilians and those who try to help them. We pay tribute to the humanitarian efforts of the White Helmets. We condemn targeted attacks against them. While the indiscriminate bombardment of civilian-populated areas continues, desperately needed humanitarian aid, including medical aid, for the people of eastern Ghouta cannot be delivered. We condemn the incessant violence and the barbaric tactics of besiegement. We have seen those tactics before. If we think back to Aleppo in December 2016, the same scenario took place. The regime turned 22/02/2018 The situation in the Middle East S/PV.8186 18-04815 11/19 that city into an unlivable hell where civilians were imprisoned, constantly targeted from the air and cut off from any form of aid. The Council should not stand by and watch a repetition of such events in eastern Ghouta.Secondly, concerning the erosion of international humanitarian law, in witnessing the sheer disregard for human life, we must ask ourselves: What has become of the hard-won gains in the area of international humanitarian law? The lack of compliance with the Geneva Conventions by parties to the Syrian conflict erodes the very norms enshrined therein. It also erodes the rules-based international order. We cannot let that happen. The carnage in Syria must stop. The Council must take effective, credible and decisive action today. The world is watching. We call upon all parties to the Syrian conflict, in particular the Syrian regime and its allies, to stop the targeting of civilians, stop the attacks on hospitals and facilitate immediate access for humanitarian organizations to deliver much needed aid.That brings me to my third point, which is action by the Council on the cessation of hostilities. We thank penholders Kuwait and Sweden for negotiating a draft resolution during the past two weeks that addresses the dire situation in Syria. We pay tribute to the prudent, inclusive manner in which Sweden and Kuwait have organized negotiations on the draft resolution. We wholeheartedly support the Swedish-Kuwaiti appeal to support their text.The draft resolution includes clear and implementable measures. We fully support an immediate cessation of hostilities in Syria to enable aid convoys to deliver food and medicines to all those in need, and the safe medical evacuation of the critically ill and wounded. That must happen as soon as possible. Parties to the Syrian conflict and those with influence on them have a heavy responsibility to assure the safety of humanitarian operations and to ensure that no forced evacuations of civilians take place.In conclusion, some Council members say that the draft resolution cannot be implemented because it is not realistic. But with sufficient political will on the part of the parties involved in Syria, the cessation of hostilities can become a most urgently needed reality. The Council showed forceful action when it adopted resolution 2393 (2017) in December 2017 to alleviate the suffering in Syria by allowing for vital cross-border humanitarian aid. Let us again show forceful action. Let us prove to the world that we can agree to put the safety of civilians first, throughout Syria.The human suffering in Syria, in particular in Ghouta, must end. We need a cessation of hostilities now. We call on the Russian Federation in particular to use its influence, do its utmost to achieve that objective and allow the Council to act effectively. Let us adopt the realistic, clear and balanced draft resolution as it stands, end the violence and allow access for humanitarian assistance.Mr. Alemu (Ethiopia): We thank Under-Secretary-General Mark Lowcock for his briefing. We appreciate his efforts and understand the challenges he faces.We are deeply concerned about the military escalation in eastern Ghouta and its devastating impact on civilians. We are also equally concerned about escalating conflict in other parts of Syria. The continued reports of attacks against medical facilities, resulting in a number of civilian deaths and injuries, is indeed extremely worrying. We stress that it is absolutely imperative to protect civilians in eastern Ghouta and other affected areas.Nonetheless, we should never overlook the fact that the capital, Damascus, is being shelled from eastern Ghouta — one of its suburbs. All the same, it is impossible to deny the fact that life-saving aid must reach all Syrians in need of urgent assistance. In that regard, while we welcome the fact that the United Nations inter-agency convoy delivered life-saving assistance to more than 7,000 persons on 14 February, we acknowledge that, given the severity of the humanitarian situation, it is obviously not enough.To address humanitarian needs, the United Nations and its humanitarian partners should be allowed safe, improved and unhindered humanitarian access. As the Secretary-General recalled in his statement on 20 February and through his strong appeal yesterday in the Chamber (see S/PV.8185), a cessation of hostilities is desirable to enable humanitarian aid deliveries and medical evacuation. We see no problem with reaching a consensus on the matter. In that connection, members of the Council have been engaged in constructive discussions on how to ensure the implementation of a cessation of hostilities.As the situation on the ground becomes increasingly complex, we understand that implementing a humanitarian pause will not be easy. We understand S/PV.8186 The situation in the Middle East 22/02/2018 12/19 18-04815 the concerns of some in that regard. We do not ignore the possibility that terrorist elements might exploit that tool to advance their goals. It will require the political will and tangible cooperation, in good faith, of all Syrian actors, as well as of all States with influence over the parties. Let us not forget that the situation in Syria is becoming extremely complicated and that the humanitarian situation has not remained unaffected. We are extremely worried about the current trajectory.As a human tragedy unfolds before our very eyes, it is expected that the Council will take meaningful, collective action that could help save lives on the ground. That is why we have reiterated that the Council should extend its unified support for the humanitarian work of the United Nations and its partners. Only by working together will the Council convey a strong and unified message that could help facilitate the much-needed humanitarian work of the United Nations and alleviate the continued suffering of the Syrians. In that regard, the humanitarian draft resolution will perhaps provide us with a good opportunity to demonstrate our resolve for concrete action. It may not be a perfect text but we believe it paves the way for all parties to coordinate their existing efforts to halt hostilities for the sake of civilians who are in an extremely difficult situation.Let me take this opportunity to thank the two penholders Kuwait and Sweden, which have been working tirelessly to achieve a consensus outcome. We hope they will continue their much-appreciated efforts until the last minute to address the concerns — real, legitimate concerns — of all delegations.Let me conclude by reiterating that the escalating violence in eastern Ghouta and other parts of Syria should reinforce the importance and urgency of finding a comprehensive political solution, without which the suffering of Syrians will continue unabated.Ms. Wronecka (Poland): I would like to thank Mr. Mark Lowcock for his briefing.As our Minister for Foreign Affairs, Mr. Jacek Czaputowicz, stated yesterday with regard to eastern Ghouta, there is no justification for the indiscriminate attacks on innocent civilians, including children, or on civilian infrastructure, such as health facilities. They must stop immediately and all parties to the conflict must strictly comply with their obligations under international humanitarian law. We would like to stress that all actors should use their influence to bring about immediate and improved conditions on the ground.Once again, we urgently call for the cessation of hostilities in the whole of Syria. Attacks against civilian targets, including medical facilities, must stop now in order to relieve the enormous and unreasonable suffering of the Syrian people. We therefore call upon all parties to alleviate the suffering of civilians, including children, by granting them urgent, free and safe access to humanitarian assistance.With regard to the de-escalation zones, which include eastern Ghouta, I should recall that they were aimed at ensuring a ceasefire and humanitarian access in accordance with international law, including international humanitarian law. In the light of this fact, I call on all parties engaged to respect their ceasefire-related commitments. I also call on States members of the Security Council to use their leverage on the parties in order to implement relevant previous commitments and to create conditions for a permanent ceasefire.In conclusion, I would like to stress the importance of maintaining the unity of the Council on the question of humanitarian access. We should find a mutually acceptable way to express a clear position of the Security Council in this regard. Accordingly, Poland would like to reiterate its support for the work of Sweden and Kuwait as penholders of the draft humanitarian resolution for Syria. Now more than ever do we need to make every possible effort to adopt the draft resolution as soon as possible. It is the Council's responsibility not to fail to stop the ongoing humanitarian tragedy in the eastern Ghouta.Mr. Hickey (United Kingdom): I thank Under-Secretary-General Lowcock for his very detailed and clear briefing today. It was very powerful to hear through him the voices of the people of eastern Ghouta.Russia called this meeting today to allow us to present our understanding of the situation on the ground and come up with ways of getting out of the situation. We have heard very clearly from Under-Secretary-General Lowcock today and from the Secretary-General yesterday about the situation on the ground (see S/PV.8185). This is hell on Earth; the scale of the human suffering and destruction is unbearable. The suffering of the Syrian people, while primarily the responsibility of the Syrian regime, brings shame on all of us in the Security Council.Let us be very clear about the main cause of this hell on Earth. It is the direct result of an escalation by 22/02/2018 The situation in the Middle East S/PV.8186 18-04815 13/19 the Syrian regime of its aerial bombardment of civilian areas, using cluster bombs and chemical weapons and systematically killing hundreds of its own civilians. As others in this Chamber have said today, these are breaches of international humanitarian law and are war crimes. The United Kingdom will be unrelenting in its campaign to ensure accountability and justice for these crimes using all mechanisms at our disposal.We owe it to the people of eastern Ghouta to highlight the utter devastation facing them and then to take measures to stop it. According to the Syrian American Medical Society, in the first 48 hours of this week, 250 civilians were killed and 460 injured. Those who survived these attacks have been further targeted by the regime while trying to get help for their injuries. There have been 22 separate attacks on 20 different hospitals in the three days since Monday. We applaud the incredible work of the brave doctors on the ground who risk their own lives to save others. And like the Netherlands, we salute the heroes of the White Helmets who have demonstrated incredible bravery, courage and resilience to save the lives of thousands of Syrians on all sides of this conflict.From the start of the conflict, the Al-Assad regime has peddled the myth that all of those opposing Al-Assad are terrorists. This is manifestly not the case. The people of eastern Ghouta are not terrorists. Jabhat Al-Nusra has only a small presence in eastern Ghouta; its fighters number less than a quarter of 1 per cent of the population of that area. Nothing can justify the barbaric bombardment we have seen in recent days or the blocking of humanitarian aid or the denial of medical evacuations. We also condemn the mortar shelling from eastern Ghouta of civilian areas of Damascus and attacks against the Russian embassy in that city.The Security Council has failed to uphold its responsibilities in Syria. We all know why this is the case, but we have all agreed that there can be no military solution to the conflict — only a political one. The actions of the Al-Assad regime in recent weeks and the military escalation in an area guaranteed by Russia and Iran as a de-escalation zone show cynical disregard by the regime for every member of the Security Council and for our resolutions. It is therefore vital that we all send a clear and unified message in response.The solution to the situation is not difficult. We need to see an immediate cessation of hostilities, including an immediate end to the aerial bombing of eastern Ghouta. If everyone in this Chamber were to commit unequivocally to this today, it could have an impact on the ground. It could save the lives of thousands of innocent men, women and children who are being killed as we speak here in this Chamber today. We therefore welcome the draft resolution put forward into blue by you, Mr. President, and by the delegation of Sweden, and we look forward to a vote later today.In conclusion, yesterday we discussed the principles of the United Nations Charter, which our predecessors drafted in the name of the peoples of the world to help save succeeding generations from the scourge of war (see S/PV.8185). It is clear that we have fallen woefully short of this aim. We have failed the people of eastern Ghouta. But let us reverse this trend today. Let us adopt the draft resolution and take the concrete actions needed to ease the suffering in this zone of death and destruction.Mr. Ndong Mba (Equatorial Guinea) (spoke in Spanish): Equatorial Guinea thanks the Russian Federation for convening this meeting of the Security Council and hopes to contribute to the adoption of a decision aimed at alleviating the enormous suffering and regrettable loss of human life in eastern Ghouta and other parts of Syria. We thank the representative of the United Nations Office for the Coordination of Humanitarian Affairs, Mr. Mark Lowcock, for his informative briefing.For the Republic of Equatorial Guinea, the changing humanitarian situation in eastern Ghouta requires urgent action to alleviate the critical state of affairs of the most vulnerable members of the civilian population. In recent days, the number of victims and amount of material damage to infrastructure have increased considerably, and the international community is obliged to take some urgent action so as to halt the ongoing loss of lives, mostly of children and women.We reiterate the appeal made by the delegation of Equatorial Guinea on 14 February for the parties to the conflict to allow humanitarian aid to reach those most in need (see S/PV. 8181). The cessation of hostilities is imperative in order to ensure safe access for relief teams, the distribution of humanitarian aid and the evacuation of the wounded and sick. Equatorial Guinea calls on all parties to the conflict to take the necessary steps to cease hostilities.S/PV.8186 The situation in the Middle East 22/02/2018 14/19 18-04815 Frank, direct and inclusive dialogue is the only viable way out of the Syrian crisis. The Council must redouble its efforts and persuade the opponents to return to the negotiating table. In that sense, resolution 2254 (2015) remains a valid instrument. The recent history of this conflict has taught us the devastating implications that it can have for the entire region. A definitive and sustainable solution to the conflict is in the interests of all the countries of the world.The Republic of Equatorial Guinea urgently calls on all parties to the conflict, be they directly or indirectly involved, to declare a ceasefire with immediate effect that will be respected and guaranteed by all parties so as to allow for the evacuation of civilians and the delivery of medical care, drinking water and food that will save hundreds of human lives. Even as we debate this issue here in the Chamber, the people of eastern Ghouta and elsewhere in Syria are on the verge of perishing. We must consider any proposal to be submitted from the humanitarian perspective, taking into account the suffering of the population of eastern Ghouta and Syria.Mr. Llorentty Solíz (Plurinational State of Bolivia) (spoke in Spanish): My delegation thanks the delegation of Russia for having asked the presidency to convene this meeting, for I think it very important to exchange views about what is happening in Syria. We also grateful for the briefing by Mr. Mark Locock.Bolivia reiterates its regret that the crisis in Syria has to date led to so many lives being lost and so much destruction. According to Mr. Lowcock's office, more than 500,000 people have died since the beginning of the conflict, 13.1 million people require humanitarian assistance, of whom 2.9 million are trapped in besieged or hard-to-reach, and 6.9 million persons have been displaced internally. We regret that recent events have led to more people dying or needing humanitarian assistance. We call for the earliest possible beginning of demining operations and for the provision of humanitarian assistance — such as to the city of Raqqa — in order to facilitate the safe and dignified return of the families that were displaced as a result of the conflict.We also regret that the latest events in Syria have once again served to underscore the urgent need to revitalize the Geneva political process, while strengthening the tangible results achieved in Astana and Sochi, in consultation, of course, with all the parties concerned. We reiterate what several of our colleagues have said during this meeting: there is no military solution to the situation in Syria, only a political one.We also again reiterate our great gratitude for the work being done by the staff of the humanitarian assistance agencies and groups on the ground. We demand that the parties involved comply with their obligations under international law, in particular international humanitarian law and international human rights law.We reiterate to the parties involved that they must respect the agreements and the de-escalation zones, as well as avoid attacks on civilian facilities — such residential areas, schools and hospitals — in line with international humanitarian law, so as to ensure the protection of civilians and unrestricted access for humanitarian agencies to provide much-needed assistance.I understand that we all agree with those principles, as they are basic, fundamental principles of international humanitarian law. Each and every one of us has spoken repeatedly about the obligations of the Security Council under the Charter of the United Nations, including its highest responsibility in terms of the maintenance of international peace and security. Nevertheless, my delegation cannot agree with double standards being applied on any issue, and much less on humanitarian ones. We must not drag down the Security Council by using it as an instrument for a different agenda. Nor, as we have also said several times, should we allow the Council to become an echo chamber where we repeatedly recite well-known areas of war.In referring to double standards, I will desist from referring to the humanitarian situation in other places around the world. I will limit myself just to Syria. My delegation is surprised, and does not understand, at how the Security Council has not even been able to express itself on the terrorist attacks on the Russian Embassy in Damascus, a member the Council. We have counted six such attacks in the past two weeks, followed by silence on the part of the Council. That should draw our attention as to double standards.I repeat that we totally reject the politicization of any humanitarian issue. We know that the situation in Syria is urgent. We need to think very carefully about how we can address each of these situations, given that each has its particular characteristics.22/02/2018 The situation in the Middle East S/PV.8186 18-04815 15/19 With regard to the draft resolution that has been circulated for the Council's consideration, first of all, my delegation would like to sincerely express its gratitude for the efforts of the delegations of Sweden and Kuwait. We have seen them work with great dedication, consulting with the various delegations as part of what of course is a complicated process. That is the nature of negotiations. We hope that the various calls for the Council to do something will come to fruition. . However, I think we have to recognize that putting to a vote a draft resolution, as several delegations have called for today, in the knowledge that it will not be adopted by the Council shows that the goal is not of a humanitarian nature, the aim is political. Putting to a vote a draft resolution while knowing that it will not be adopted means that the goal is not to alleviate the humanitarian situation but to garner a few headlines in the media. That is why we say that we should avoid making the Council an instrument for political ends.We very much welcome the fact that the Russian delegation has put forward language to enable us to continue the negotiations, which is essential. I agree with what my colleague the Ambassador of Sweden said, that is, the Council is being tested in alleviating the humanitarian situation in Syria. The Council is indeed being tested, and that test is to achieve unity in the Council. If we do not, then the meeting at which the draft resolution is put to the vote will go down in history as just a few headlines. But it will come to nothing and will in no way alleviate the humanitarian situation in Syria.I therefore issue a fraternal call on my colleagues the members of the Security Council — especially my beloved brothers the Ambassadors of Sweden and Kuwait — that we do everything we can to send out a signal for there to be a change in direction with regard to what the Council has been doing repeatedly over the past months, and show that by being united we will in some way be able to meet the expectations of the rest of the membership and meet the responsibilities assigned to us by the Charter.Mr. Tanoh-Boutchoue (Côte d'Ivoire) (spoke in French): At the outset, I wish to thank the Russian Federation for having called for this meeting.I also thank Mr. Mark Lowcock, Under-Secretary-General for Humanitarian Affairs, for his helpful briefing on the latest developments in the humanitarian situation in Syria, which has reached a critical threshold.Côte d'Ivoire remains deeply concerned by the ongoing deterioration of the humanitarian situation, largely due to the resurgence of fighting on the ground, particularly in eastern Ghouta where since Monday, I regret to say, 40 civilians have been killed and more than 150 wounded, and many hospitals and schools have been destroyed. In the face of this extreme escalation of hostilities, my delegation would like, following the call issued yesterday in this Chamber by Secretary-General António Guterres (see S/PV.8185), to appeal to the sense of responsibility of the parties involved to end the tragedy of eastern Ghouta. It urges them to exercise restraint with a view to an immediate cessation of hostilities in order to enable the resumption of the delivery of humanitarian aid, including medical evacuations, to alleviate the suffering of the Syrian population.Côte d'Ivoire reiterates its conviction and principled position that the response to the crisis in Syria cannot be military. On the contrary, it should be pursued through an inclusive dialogue and political process, as provided for in the road map set out by resolution 2254 (2015).Finally, in the light of the tragic humanitarian situation in eastern Ghouta — which Mr. Lowcock so somberly described earlier — Côte d'Ivoire supports the draft resolution proposed by the delegations of Kuwait and Sweden, calling for a cessation of hostilities for a period of 30 days with a view to allowing immediate humanitarian access to the besieged populations of the region. The Council must set aside all political calculations and other distractions and undertake the commendable task of rescuing the inhabitants of eastern Ghouta and other regions of Syria, who also happen to be Syrians, from the hell in which they are living.Mr. Temenov (Kazakhstan): We thank the delegation of the Russian Federation for initiating this open briefing on the very critical humanitarian issue in Syria, and thank Mark Lowcock for his update.Like others, we express our serious concern about the continued severity of the devastating humanitarian situation in Syria, including in eastern Ghouta, Idlib and northern Hama governorates, Rukban and Raqqa. Kazakhstan urges all parties within and outside the country to prevent further violence and enable humanitarian organizations to access and assist people in need. Since early February, with the military offensive against eastern Ghouta, there have been more than 1,200 civilian casualties.S/PV.8186 The situation in the Middle East 22/02/2018 16/19 18-04815 We truly need a cessation of hostilities and all military operations throughout Syria to enable the delivery of humanitarian aid and services and the medical evacuation of the critically sick and wounded, in accordance with international law. Kazakhstan considers it critical for the Security Council to adopt a workable and effective resolution on a cessation of hostilities in Syria, a draft of which is now being considered by Council members. Kazakhstan calls on all parties to find consensus and unite in their efforts to undertake an immediate suspension of all war activities in eastern Ghouta and other parts of Syria, allowing humanitarian aid to reach all those in need, as well as the evacuation of all patients requiring urgent treatment that cannot be provided there.My delegation supports the five requests identified by the Emergency Relief Coordinator on 11 January during his mission to Syria, and calls upon all parties to facilitate the implementation of these five requests and others, as specified in relevant Security Council resolutions, so as to ensure principled, sustained and improved humanitarian assistance to Syria in 2018. In this context, we look forward to a meeting of the Foreign Ministers of the guarantor countries of the Astana process — namely, the Russian Federation, Turkey and Iran — who intend to gather in Astana in March to discuss all issues related to recent developments on the ground. The timing and the specific agenda are currently being specified. In this regard, the next round of the Astana process itself is scheduled to be held after the aforementioned meeting of the Foreign Ministers.Lastly, in May 2017 Kazakhstan welcomed the adoption of the memorandum on the creation of de-escalation areas in the Syrian Arab Republic. They have lessened hostilities between the conflicting parties. However, the ceasefire agreements in these zones are currently being violated. We attach the utmost importance to compliance by all conflicting parties with ceasefire agreements and their enforcement by the guarantor States. Likewise, each of the agreements reached in Astana should not remain on paper, but must be strictly complied with.The President (spoke in Arabic): I give the floor to the representative of the Syrian Arab Republic and urge him to limit his statement to five minutes in accordance with Security Council note S/2017/507.Mr. Ja'afari (Syrian Arab Republic) (spoke in Arabic): The delegation of my country was not aware of your decision, Sir, to limit my statement to five minutes. I oppose that decision and therefore reserve the right to express the views of my country in this important meeting devoted to the situation in my country.The President (spoke in Arabic): The representative of the Russian Federation has asked to make a further statement.Mr. Nebenzia (Russian Federation) (spoke in Russian): We fail to understand, Sir, why you have proposed limiting the statement of the representative of the Syrian Arab Republic on the important issue under discussion. His country is directly involved and where everything being discussed is taking place. We must afford an opportunity for the representative of Syria to speak for the full amount of time required to deliver his statement. I do not believe we need any artificial limits on his statement.The President (spoke in Arabic): I did not make a decision. I simply encouraged the representative of Syria to adhere to the provisions of note S/2017/507.I again give the floor to the representative of the Syrian Arab Republic.Mr. Ja'afari (Syrian Arab Republic) (spoke in Arabic): Once again, I reiterate that we were not aware of note S/2017/507. I believe that this act is unjust and raises many issues to which I already intended to refer in my statement. I hope that everyone will be patient enough to listen to the statement I shall make on behalf of the Government of my country. I shall not deliver a personal statement. All speakers have spoken on behalf of their Governments, and I shall do the same. I encourage all members to listen carefully to what I have to say.As I talk here at this moment, hundreds of rockets and mortars are targeting the capital, Damascus. To date, they have injured 37 people, including six children, and led to a number of martyrs, including two children. That comes as no surprise. As the Council is aware, every time a Security Council meeting is held to discuss the Syrian situation, there is a massacre here and a suicide bombing there, as well as the killing of civilians in some Syrian cities. We have seen not dozens, but rather hundreds of massacres over the past seven years. Mr. Lowcock did not get this information the way he gets messages from what he calls humanitarian workers in eastern Ghouta who know about international humanitarian law. Mr. Lowcock 22/02/2018 The situation in the Middle East S/PV.8186 18-04815 17/19 did not solicit the views of the Syrian Government, which we have expressed in hundreds of letters sent to him and to the Council. All those who in this meeting have used the word "regime" to refer to my country are neither objective nor impartial. They reveal their countries' involvement in the ongoing terrorist crisis in my country.We thank the delegation of the Russian Federation for convening this meeting to give us the opportunity to once again present the reality of the suffering of civilians as a result of the practices of armed terrorist groups or, as some call them, moderate armed opposition groups. Over the past seven years, they have been sowing death and destruction wherever they have operated. They have used civilians as human shields. They have targeted hospitals and schools, turning them into military centres. They have hurled missiles and rockets indiscriminately at residential and populated areas.Of course, as the Permanent Representative of France said before leaving this meeting, all of this is a form of resistance. He referred to the terrorists who bombard Damascus as the "resistance" that the Syrian regime is trying to suppress. This meeting is particularly important, as some actors — especially the United States of America and the so-called international coalition — have moved from the stage of aggression by proxy through their support for terrorism to the stage of direct aggression. Those actors have recruited terrorists from all four corners of the world. They call them jihadists and send them to Syria. Whenever terrorists have failed, those actors have been there — militarily, politically, through the media and the United Nations — to intervene in order to achieve what their terrorist proxies failed to achieve.Let us be clear. Some Council members — and I specifically mean the United States of America, the United Kingdom and France — would like to deprive the Syrian Government of its constitutional and sovereign right to defending its territories and people, as enshrined in the Charter of the United Nations back when we had wise founding fathers and international law and as guaranteed by all United Nations resolutions on counter-terrorism.Today, I have heard references to the draft resolution contained in document S/2018/146, on humanitarian issues. The penholders, Kuwait and Sweden, have been working on it for several weeks. I thank them for their efforts. However, those efforts are deeply flawed. The penholders did not coordinate with the Syrian delegation at all. They did not even ask to hear my country's view on the draft resolution that concerns it.Let us imagine for a moment that hundreds of terrorists had used the Bois de Boulogne as a centre to target civilians in Paris, launching dozens of missiles every day. Would we have seen a draft resolution calling for a humanitarian truce to give the moderate armed French opposition the opportunity to regain its power and launch missiles targeting Paris?Let us imagine for a moment that hundreds of terrorists had used Central Park here in New York as a centre to target civilians in Manhattan, and had launched dozens of missiles every day. Would we have seen a draft resolution calling for the medical evacuation of the moderate armed American opposition?Let us imagine for a moment that hundreds of terrorists had used Hyde Park as a centre to target civilians in London, launching dozens of missiles daily. Would we have seen a draft resolution calling for the delivery of humanitarian aid to the moderate armed British opposition? Would we have seen statements by high-level Secretariat officials, such as Mr. Lowcock, calling for stopping the fight against armed groups that they describe as non-State armed opposition groups? Unfortunately, that is how United Nations documents refer to terrorists nowadays — non-State armed opposition groups.Of course, those are all hypothetical scenarios that might seem far-fetched. However, that is the reality in Syria. It is the tragedy that we are seeing in Syrian cities every day, including the city of Damascus and its inhabitants. It is a bitter reality that the Syrian Government is facing as a result of the erroneous approaches adopted by the United Nations and the positions of some of its Member States. Damascus is the oldest populated city in history. It is seeing destruction, death and sorrow every day as a result of missiles, mortars and rockets launched by armed terrorist groups operating in eastern Ghouta. These terrorist groups — the Islamic State in Iraq and the Sham, the Al-Nusra Front and affiliated groups — are designated as terrorist groups in the Security Council. Today, 8 million people live in Damascus, among them hundreds of thousands who fled armed groups that attacked their villages and their homes in many parts of Syria, including eastern Ghouta.S/PV.8186 The situation in the Middle East 22/02/2018 18/19 18-04815 The United Nations today is going through a professional and moral crisis that is unfathomable. High-level Secretariat officials see no harm in adopting the positions of Governments that sponsor terrorism in my country. They are directly involved in distorting facts, manipulating figures, using insidious phrases and terminology, and depending on unreliable sources in their statements and reports. Of course, I cannot list all of those scandals today. I will only remind the Council of the Organization for the Prohibition of Chemical Weapons Fact-Finding Mission report (S/2017/567), issued in June 2017. The report states that among the open sources on which it relied was the testimony of British doctor Shajul Islam. For those who do not know who Mr. Islam is, he is a foreign terrorist fighting for the Al-Nusra Front in Idlib. He was convicted in the United Kingdom and was not allowed to practice medicine there as he was involved in crimes related to terrorism, such as kidnapping British journalist John Cantlie. That is but one example of some misleading reports issued by the Secretariat.We are convinced that those abhorrent practices will not stop and that some United Nations officials will ignore the serious information that we have conveyed to them about armed terrorist groups fabricating the story that the Syrian Government used toxic chemical substances against civilians in eastern Ghouta. Those groups are training some of their members to pretend that they have been exposed to toxic substances. Of course, those scenes are broadcast by well-known networks and correspondents of Mr. Lowcock, and the Syrian Arab Army is blamed for it. Although we have sent hundreds of letters to the Secretary-General, the President of the Security Council and specialized United Nations agencies specialized in counter-terrorism and the prohibition of chemical weapons, we are sure that some at the United Nations will not hesitate to believe that story and blame the Syrian Government. That is simply because certain agendas in the Organization compel some to join in the extortion of the Syrian Arab Republic and its allies that are fighting terrorism on behalf of all those present.For over two months now, the Syrian Government has been sending letters almost daily to the Secretary-General and the President of the Security Council documenting the number of missiles used, which have amounted in the past few weeks to almost 1,200. We have been also documenting the human and material losses of civilians in the city of Damascus as a result of being targeted by terrorists groups in eastern Ghouta. However, in its statements and appeals the Secretariat has no problem ignoring the suffering of 8 million people in Damascus. It has not hesitated to participate in the misleading campaign launched by some States to protect a few thousand members of armed terrorists groups in eastern Ghouta. They are sacrificing 8 million civilians in Damascus to protect a few thousand terrorists in eastern Ghouta. This is scene in short.Both international and United Nations sources are spreading news of a stifling siege on eastern Ghouta. That is not consistent with the indisputable reality on the ground. We are talking here about a vital area that is the main source of food for the city of Damascus. Commercial trucks constantly move back and forth to Ghouta. The Syrian Government has facilitated the delivery of humanitarian aid to people in eastern Ghouta, when conditions on the ground have allowed. We have also approved medical evacuations to Government hospitals in Damascus. The truth that we all know, and even high-level Secretariat officials know, is that armed terrorist groups are controlling the humanitarian aid that enters eastern Ghouta. They distribute it among its members and deprive civilians of any of it.There is another truth that the Secretariat is ignoring. Residents of eastern Ghouta have taken to the street in protest against the practices of terrorists who point their guns at innocent people. Of course, those besieged innocents are also sending messages, but Mr. Lowcock's radar is not receiving them. I would like to ask the Secretariat the following. How does it justify ignoring the reports and information that the Syrian Government has presented on thousands of hostages and kidnapped people being detained by armed terrorist groups in eastern Ghouta in the so-called Attawba prison? They require immediate medical evacuation. The United Nations is ignoring video footage posted by armed groups showing women and children, among the hostages, being pushed into metal cages and left on the street. It is a painful scene reminiscent of the times of slavery. It is true insanity that the Secretary-General spoke of yesterday and has been echoed by some colleagues today. Yes, there is terrorist insanity in eastern Ghouta and we must put a stop to it.What is even worse is that some in the Secretariat are trying to use the agreement on de-escalation zones to distort the facts and ignore repeated violations perpetrated by these armed terrorist groups. They are 22/02/2018 The situation in the Middle East S/PV.8186 18-04815 19/19 being instructed from the outside by actors that some of them are present in this Chamber. They are instructed to target Syrian military sites and launch attacks using rockets, missiles and car bombs on residential neighbourhoods in Damascus.These groups operating in eastern Ghouta that kill civilians in Damascus daily are armed terrorists groups, regardless of any change to their names, affiliations or alliances. Today they are Jaysh al-Islam, the Al-Rahman Corps, the Dawn of Islam and Ahrar al-Sham. Yesterday they were the Islamic Front, Hay'at Tahrir al-Sham and the Al-Nusra Front. I invite all members of the Council to take a look at the websites of those groups and the satellite television channels that Western satellites are helping broadcast. It will become apparent that they all share the same Wahhabi terrorist ideology, and that they all call for takfiri ideas and the annihilation of others. Any attempt to change their names and description by calling them moderate opposition or non-state armed groups will not change their terrorist reality. It will not prevent us, as the Government, from defending our citizens with the support of our allies, and fighting terrorism pursuant to the Council's resolutions on counter-terrorism.Some among us today are exploiting the suffering of the Syrian people and trading in their blood. They are demanding accountability while being direct partners in supporting and defending terrorism. They are involved in direct military aggression against my people, as was the case in Palestine, Afghanistan, Iraq, Libya, Africa and Latin America. The dilemma that we are facing today is that the mechanism of work inside the United Nations is being held hostage to political and financial polarization. As a result, this mechanism of work completely disregard the crimes of the so-called international coalition led by the United States of America.As mentioned by my colleague the Ambassador of the Russian Federation, the international coalition completely destroyed Raqqa, killing hundreds of civilians and destroying shelters, infrastructure and bridges over the Euphrates river and everywhere in Syria, under the pretext of fighting the Islamic State in Iraq and the Levant (ISIL). It used internationally prohibited weapons against civilians in Syria, including American Napalm, just as it did in Viet Nam. The international coalition targeted Syrian armed forces and allied forces more than once in order to break the siege on ISIL. The coalition and its militias made a deal with ISIL so that ISIL fighters, their families and their heavy weapons could leave Raqqa and other places in order to fight the Syrian forces and their allies elsewhere.The United Nations is completely disregarding the repeated aggressions of Israeli occupation forces on our territories as part of its support to armed terrorist groups. The Department of Peacekeeping Operations is clueless as to what is going on in the Golan. The United Nations itself is completely disregarding Turkish aggressions and violations against Syrian sovereignty, and the direct military aggression initiated now by Turkey on Afrin. Nobody has addressed this issue in their statements.In conclusion, responding to those who fear that eastern Ghouta might become a second Aleppo, I invite them to go to Aleppo today and see with their own eyes how millions, not thousands, have resumed their normal lives after Aleppo was liberated from terrorism. Indeed, eastern Ghouta will become a second Aleppo, as will Idlib and all areas that have suffered under the terrorism of armed groups in Syria.We will not succumb no longer to the extortion of those who have supported terrorism in Syria. We will not be complacent to the plans of the Governments of the five States that met in Washington, D.C., last month to divide Syria and ensure the failure of both the Sochi conference and the political process as a whole. That news was reported today in the United Kingdom. We will not sit idly by while those who use terrorism, take unjust economic measures and wage direct military aggression against the Syrian people seek to achieve their cheap political agendas. Rest assured that history will soon admit that we and our allies have fought a war on behalf of the entire world against terrorism, which is being supported by Governments that soon will be held accountable by their people and world public opinion. Those Governments have invested all they can in terrorism until it reached their cities, their own citizens and all safe places throughout the world.When I look at some of the faces in the Chamber and see the political hypocrisy therein, I recall the famous adage by the Great Russian writer Fyodor Dostoyevsky, who said: "Rest assured, hell is big enough for everyone. There is no need for people to compete so fiercely to be the worst."The meeting rose at 2.10 p.m.
Background: Neurological disorders are increasingly recognised as major causes of death and disability worldwide. The aim of this analysis from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2016 is to provide the most comprehensive and up-to-date estimates of the global, regional, and national burden from neurological disorders. Methods: We estimated prevalence, incidence, deaths, and disability-adjusted life-years (DALYs; the sum of years of life lost [YLLs] and years lived with disability [YLDs]) by age and sex for 15 neurological disorder categories (tetanus, meningitis, encephalitis, stroke, brain and other CNS cancers, traumatic brain injury, spinal cord injury, Alzheimer's disease and other dementias, Parkinson's disease, multiple sclerosis, motor neuron diseases, idiopathic epilepsy, migraine, tension-type headache, and a residual category for other less common neurological disorders) in 195 countries from 1990 to 2016. DisMod-MR 2.1, a Bayesian meta-regression tool, was the main method of estimation of prevalence and incidence, and the Cause of Death Ensemble model (CODEm) was used for mortality estimation. We quantified the contribution of 84 risks and combinations of risk to the disease estimates for the 15 neurological disorder categories using the GBD comparative risk assessment approach. Findings: Globally, in 2016, neurological disorders were the leading cause of DALYs (276 million [95% UI 247–308]) and second leading cause of deaths (9·0 million [8·8–9·4]). The absolute number of deaths and DALYs from all neurological disorders combined increased (deaths by 39% [34–44] and DALYs by 15% [9–21]) whereas their age-standardised rates decreased (deaths by 28% [26–30] and DALYs by 27% [24–31]) between 1990 and 2016. The only neurological disorders that had a decrease in rates and absolute numbers of deaths and DALYs were tetanus, meningitis, and encephalitis. The four largest contributors of neurological DALYs were stroke (42·2% [38·6–46·1]), migraine (16·3% [11·7–20·8]), Alzheimer's and other dementias (10·4% [9·0–12·1]), and meningitis (7·9% [6·6–10·4]). For the combined neurological disorders, age-standardised DALY rates were significantly higher in males than in females (male-to-female ratio 1·12 [1·05–1·20]), but migraine, multiple sclerosis, and tension-type headache were more common and caused more burden in females, with male-to-female ratios of less than 0·7. The 84 risks quantified in GBD explain less than 10% of neurological disorder DALY burdens, except stroke, for which 88·8% (86·5–90·9) of DALYs are attributable to risk factors, and to a lesser extent Alzheimer's disease and other dementias (22·3% [11·8–35·1] of DALYs are risk attributable) and idiopathic epilepsy (14·1% [10·8–17·5] of DALYs are risk attributable). Interpretation: Globally, the burden of neurological disorders, as measured by the absolute number of DALYs, continues to increase. As populations are growing and ageing, and the prevalence of major disabling neurological disorders steeply increases with age, governments will face increasing demand for treatment, rehabilitation, and support services for neurological disorders. The scarcity of established modifiable risks for most of the neurological burden demonstrates that new knowledge is required to develop effective prevention and treatment strategies. Funding: Bill & Melinda Gates Foundation.
DEUTSCHE NATURWISSENSCHAFT, TECHNIK UND ERFINDUNG IM WELTKRIEGE Deutsche Naturwissenschaft, Technik und Erfindung im Weltkriege ( - ) Einband ( - ) Titelseite ([V]) Impressum ([VI]) Vorwort. ([VII]) Inhaltsverzeichnis. ([XIII]) Krieg und Kultur. ([1]) Erster Teil. Allgemeine Fragen. ([3]) Einleitung. Vom Wesen der Kultur. Der Krieg in seiner Beziehung zur Kultur. ([3]) 1. Krieg und Kultur in der Geschichte der Menschheit. (5) 2. Krieg und Menschlichkeit. (7) 3. Macht- und Kulturpolitik. (9) 4. Vom Geiste der deutschen Kultur. (12) 5. Vom Sinn des Krieges. (13) Zweiter Teil. Das Geistesleben im Kriege und die Geisteswissenschaften. (15) 1. Krieg und Geschichtswissenschaft. (15) 2. Krieg und Philosophie. (18) 3. Krieg und Dichtung. (20) 4. Krieg und bildende Kunst. (22) 5. Krieg und Musik. (24) 6. Krieg und Sittlichkeit. (25) 7. Krieg und Religion. (26) Dritter Teil. Abschluß und Ausblick. (29) 1. Der Ertrag des Krieges für das innere Leben. (29) 2. Die Kulturaufgaben für die Zukunft. (30) Zur Psychologie des Krieges und der Erfindungen. ([33]) I. Die sinnliche Wahrnehmung. (36) 1. Gesichtssinn. (36) 2. Gehör. (38) 3. Raumsinn. (39) II. Das Gedächtnis und Merkfähigkeit. (41) III. Assoziationen. (42) IV. Die Bildung von psychischen Komplexen. (43) V. Affektzustände. (44) VI. Willenscharakter. (46) VII. Aussage. (47) VIII. Verstand und Begriffsbildung. (48) IX. Erfindertätigkeit. (49) Die Physik im Kriege. ([57]) [Abb.]: Fig. 1. (63) [3 Abb.]: (1)Fig. 2. (2)Fig. 3. (3)Fig. 4. (64) [Abb.]: Fig. 5. (68) [Abb.]: Fig. 6. (69) [Abb.]: Fig. 7. (70) [Abb.]: Fig. 8. (71) [Abb.]: Fig. 9. (72) [2 Abb.]: (1)Fig. 10. (2)Fig. 11. (73) [Abb.]: Fig. 12. (74) [Abb.]: Fig. 13. (75) [Abb.]: Fig. 14. (76) [Abb.]: Fig. 15. (77) [Abb.]: Fig. 16. (78) Die Meteorologie im Kriege. ([81]) Die Lehre von der irdischen Lufthülle. ([83]) Erster Abschnitt. Die Meteorologie im engeren Sinne. (84) Zweiter Abschnitt. Die Klimatologie. (100) Die Aeronautik im Kriege. ([111]) 1. Entwicklung der deutschen Luftfahrt. ([113]) 2. Verwendung der Ballone ohne Triebwerk. (115) 3. Luftschiffe. (116) [Tabelle]: Das zeigt sich schon in der Vergleichung des ersten erfolgreichen Zeppelin-Luftschiffes aus dem Jahre 1900 mit der Bauart von 1914: (118) [Abb.]: Zeppelin ([119]) 4. Flugzeuge. (120) [Abb.]: Boelcke (121) Die Photographie im Kriege. ([125]) [Abb.]: Abb. 1. (133) [Abb.]: Abb. 2. (134) [Abb.]: Abb. 3. (136) [Abb.]: Abb. 4. (138) [Abb.]: Abb. 5. (141) [Abb.]: Abb. 6. (142) Die Chemie im Kriege. ([143]) Die deutsche chemische Industrie vor dem Kriege. ([143]) Die physiologische Chemie im Kriege. ([159]) Arzneimittelwesen. ([179]) [Tabelle]: Daß es tatsächlich gelungen ist, die Verbreitung der Kriegsseuchen Pocken, Unterleibstyphus, Cholera und Ruhr im Verlaufe der Kriegszeit dank der vorzüglichen sanitären Versorgungsmaßnahmen einzuschränken, besagen folgende Zahlen, die anzeigen, wie viele Krankheitsfälle während des ersten und während des zweiten Kriegsjahres, berechnet auf 1000 Mann, eingetreten sind: (183) Neue Arzneimittel. (187) Die folgende Aufzählung der neuen Arzneipräparate ist unter Anführung ihrer Handelsnamen in alphabetischer Anordnung erfolgt. (188) Acridinfarbstoffe - Arzeimittelzubereitungsformen (M. B. K.) (188) Baldrianol - Bolusal mit Tierkohle (189) Calciglycin - Compretten (189) Desazon (Bayer) - Dispargen (190) Electrocollargol (Heyden) - Gynormon (191) Hämostaticum - Jodiperol (192) Kalzan - Kremulsion R (192) Laneps - Lutosargin (193) Magnesiumglycerophosphat (Merck) - Moronal (193) Narkophin - Nucleohexyl (194) Optannin - Ormizet (195) Panchelidon - Purostrophan (195) Quecksilbersalbe - Spuman (196) Tegoglykol - Typhus-Impfstoff "Höchst" (197) Upsalan - Wismutsubacetat (Merck) (198) Die Explosivstoffe. ([199]) Die Ballistik im Kriege. ([209]) [Abb.]: Franz Külp † Hauptmann im Inf.-Reg. 118, Assistent an der militärtechnischen Akademie in Berlin-Charlottenburg bei Herrn Geheimrat Cranz, geboren am 11. April 1879 zu Eberbach in Baden gefallen am 9. August 1917 in Rußland. ([210]) Die innere Ballistik ([212]) [Abb.]: Bild 1 (213) [Abb.]: Bild 2 (215) [Abb.]: Bild 3 (216) Die äußere Ballistik. (217) Die experimentellen Methoden der äußeren Ballistik. (218) [Abb.]: Bild 4 (218) [Abb.]: Bild 5 (220) [Abb.]: Bild 6 (221) Ballistische Photographie. (222) [Abb.]: Bild 7 (223) [2 Abb.]: (1)Bild 8 (2)Bild 9 (224) [3 Abb.]: (1)Bild 10 (2)Bild 11 (3)Bild 12 (225) [3 Abb.]: (1)Bild 13 (2)Bild 14 (3)Bild 15 (226) [4 Abb.]: (1)Bild 16 (2)Bild 17 (3)Bild 18 (4)Bild 19 (227) [2 Abb.]: (1)Bild 20 (2)Bild 21 (228) [Abb.]: Bild 22, I (230) [Abb.]: Bild 22, II (231) [Abb.]: Bild 23 (232) Waffen. ([235]) Waffen. ([235]) Allgemeines. ([237]) [Abb.]: Kanonenwerkstatt ([238]) [Abb.]: Panzerbearbeitungswerkstatt (239) Landkrieg. (240) A. Angriffsmittel. (241) I. Fernkampfwaffen. (241) [Abb.]: Trommelfeuer auf den Cailettewald (241) [Abb.]: Entladen eines Munitionszuges (243) 1. Geschütze. (245) [2 Abb.]: (1)Am Scherenfernrohr im Schützengraben (2)Beobachtungsstelle (aus mitgeführtem Gerät errichtet) (251) Feldartillerie. (251) [Abb.]: Feldgeschütz in Feuerstellung (252) [Abb.]: Die Verpackung der Geschosse (253) Gebirgsartillerie. (253) [Abb.]: Gebirgsartillerie (254) Die schwere Artillerie des Feldes. (255) [Abb.]: Schwere deutsche Mörser (256) [Abb.]: Wirkung eines Mörsergeschosses auf einen Panzerturm (258) Belagerungsartillerie. (259) [Abb.]: Einschußöffnung eines schweren Mörsergeschosses (259) Festungsartillerie. (261) Luftabwehrartillerie. (261) 2. Handfeuerwaffen. (262) 3. Maschinengewehre. (265) [2 Abb.]: Verwendung Maxim-Maschinengewehr (1)Maschinengewehre in Feuerstellung (2)Maschinengewehrbeförderung a. Gewehrwagen (266) [2 Abb.]: (1)Maschinengewehrbeförderung durch Tragtier (2)Vorbringen der Maschinengewehre in Feuerstellung (267) II. Nahkampfmittel. (268) [Abb.]: Granatwerfer (271) [2 Abb.]: (1)Leichter Minenwerfer (2)Schwerer Minenwerfer (272) [Abb.]: Einschlag einer schweren Mine (273) [Abb.]: Gasangriff (274) [Abb.]: Arbeiten im Minengang (275) B. Abwehrmittel. (276) I. Geländeverstärkung und Befestigung. (276) Feldbefestigung. (277) [Abb.]: Gewöhnlicher Schützengraben (277) [2 Abb.]: (1)Sandsackverwertung (2)Ausgebauter Sprengtrichter (278) [Abb.]: Feldbefestigung im Sumpfgebiet (279) Ständige Befestigung. (279) [2 Abb.]: (1)Eingedeckter Laufgang (2)Im Inneren eines bombensicheren Unterstandes (279) [2 Abb.]: (1)Fliegeraufnahme eines Außenforts von Bukarest (2)Grabenstreiche in der Kehle eines Forts (280) [2 Abb.]: (1)Spanische Reiter auf dem Sumpfeis (2)Drahthindernisse auf dem Eis eines Sees (281) Hindernisse. (281) [2 Abb.]: (1)Explodieren einer Flattermine (2)Drahthindernis in einem Fortsgraben (282) II. Schutzmittel und Schutzwaffen. (283) Panzerung in der Befestigung. (283) [Abb.]: Gesprengter Panzerturm (283) Panzerschutz an beweglichen Kampfmitteln. (284) [Abb.]: Deutscher Panzerzug (284) Persönlcihe Schutzmittel. (286) [Abb.]: Deutsche Posten mit Stahlhelmen (286) [Abb.]: Grabenposten mit Gasmasken (287) Seekrieg. (287) A. Schiffsartillerie. (288) [Abb.]: Schwere Schiffsgeschütze in Panzertürmen (290) B. Kriegsschiffe. (292) [2 Abb.]: (1)Schlachtschiff-Geschwader (2)Linienschiff "Kaiser" (24700 Tonnen) (294) [2 Abb.]: (1)Panzerkreuzer "Goeben" (23000 Tonnen) (2)Kleiner Kreuzer "Mainz" (4350 Tonnen) (3)Hilfskreuzer "Prinz Eitel Friedrich" (295) C. Küstenartillerie. (296) [Abb.]: Küstenartillerie b. feuern (freisteh. Flachbahngeschütz) (296) [Abb.]: Eingraben leichter Geschütze an der Küste (297) D. Torpedo und Torpedofahrzeuge. (297) [2 Abb.]: (1)Aufgefischter Torpedo (2)Torpedoausstoßrohr (Überwasserrohr) (298) [2 Abb.]: (1)Deutsches Torpedoboot (2)Deutsches U-Boot (Überwasserfahrt) (299) [2 Abb.]: (1)Deutsches U-Boot, halb untergetaucht (2)Längsschnitt durch ein U-Boot-Modell (300) [Abb.]: Der Maschinenraum eines im Bau befindlichen U-Bootes (301) [2 Abb.]: (1)Das Seebild des Periskops eines U-Bootes (2)Blick in das Torpedoausstoßrohr eines U-Bootes (Unterwasserrohr) (303) [Abb.]: Aufgerichtetes U-Boot-Geschütz (304) E. Minen und Minenfahrzeuge. (304) [Abb.]: Versenktes U-Boot-Geschütz (304) [Abb.]: Ans Land getriebene Seemine (305) [Abb.]: Wirkung einer Seemine im Unterbau eines Dampfers (306) Luftkrieg. (306) A. Luftschiffe. (307) [Abb.]: Wirkung einer Zeppelinbrandbombe (308) B. Flugzeuge. (308) [Abb.]: Bombenwirkung in einer Londoner Straße. (308) [2 Abb.]: (1)Einschlag einer Fliegerbombe (2)Bombenwirkung auf ein Gleis (309) [Abb.]: Immelmanns Kampftaube (310) Die Technik im Kriege. ([313]) I. ([315]) [2 Abb.]: (1)Der gesprengte Lubizina-Viadukt bei Delatyn (Hanomag-Nachr. 1917, Nr.) (2)Abb. I. Lubizina-Viadukt bei Delatyn. Belastungsprobe an dem wiederhergestellten Viadukt (317) [3 Abb.]: A. Der eiserne probewagen für die AEG-Schnellbahn (Gesundbrunnen - Neuköln). Abbildungen 1a (3)Wageninneres. An der Strinwand rechts befindet sich der Führerstand ([318]) [3 Abb.]: B. Akkumulatorenwagen. Abbildungen 1a (2)Führerstand des Doppelwagens mit Stromrückgewinnung (3)Akkumulatorenwagen mit Stromrückgewinnung ([319]) [5 Abb.]: C. Tunneluntersuchungswagen. Abbildungen 1a (1)Lichtbatterie für den Akkumulator-Tunneluntersuchungswagen (2)Dynamo und Benzolmotor des benzoelektrischen Tunneluntersuchungswagens (3)Führerstand des 120 PS.-benzoelektrischen Triebwagens (4)Benzoelektrischer Tunneluntersuchungswagen (5)Akkumulator-Tunneluntersuchungswagen neuer Bauart ([320]) [2 Abb.]: D. Elektrischer Triebwagen mit Schwerölmotor Abbildungen 1a (1)Elektrischer Triebwagen mit Schwerölmotor (2)Maschinendrehgestell mit Ölmotor, Dynamo, Erregermaschine und den Druckluftmaschinen (321) [Abb.]: Abb. 2 (322) [2 Abb.]: (1)Abb. 3 (2)Abb. 3. (324) [2 Abb.]: (1)Abb. 3a (2)Abb. 4 (325) [2 Abb.]: (1)Abb. 5 (2)Abb. 6 (326) [2 Abb.]: (1)Abb. 7 Beton-Mischmaschine (2)Abb. 8. Wagonkipper: Wagen aufgezogen (327) [Abb.]: Abb. 9 (329) [Abb.]: Abb. 9a (330) [Abb.]: Abb. 10 (331) [Abb.]: Abb. 11 (332) [Abb.]: Abb. 12 (333) Der Kleiderverschuß Arm-Amputierter und Arm-Beschädigter. (334) [3 Abb.]: Abbildungen 13 (1)Hosenverschluß (2)Kragenverschluß (3)Prothesenträger: angekleidet, teilweise mit Hilfe von besonderen Kleiderverschlüssen (334) [4 Abb.]: (1),(2)Abb. 13 Schuhverschluß (3),(4)Abb. 13 Westenverschluß (335) [2 Abb.]: (1)Abb. 14 (2)Abb. 14 (336) [4 Abb.]: Abb. 15 Federhalter zum Schreiben für Linkshänder und Handbeschädigte von F. Soennecken - Bonn (337) [Abb.]: Abb. 16 (338) [6 Abb.]: Abbildungen 17 Die Nitralampe und der Elektromagnet in der Heilkunde. (1)Armstütze für Augenoperationen mit Handmagnet. (2)Mattierte Nitralampe von etwa 100 Watt in Stehlampe zum Gebrauch mit Stirnreflektor (3)Elektrische Beleuchtungslampe für Magnetoperationen (4)Magnetachse, horizontal, tiefe Stellung (großer fahrbarer Elektromagnet zur Extraktion von Geschoßsplittern usw.) (5)Stirnlampe (kleine Niederspannungs-Nitralampe) mit Metallreflektor (6)Magnetachse, vertikal geneigt, Veränderung der Höheneinstellung im Handrad ([339]) [7 Abb.]: Abbildungen 18 Die Röntgentechnik im Kriege a - c Feldröntgenautomobil d - g Feldröntgenapparat ([340]) [7 Abb.]: Abb. 19 (341) [Abb.]: Abb. 20 (342) [5 Abb.]: Abbildungen 21 Zur Elektrolyse des (1)a) Blei aus Bleiacetat (2)b) Blei aus Bleiacetat (3)c) Zinn aus Zinnchlorid (4)d) Zinn aus Zinnchlorid (5)e) Zink aus Zinkchlorid ([343]) [Abb.]: Abb. 22 (344) [Abb.]: Abb. 23 Elektrische Stumpfschweißmaschine (345) [Abb.]: Abb. 24 (347) [Abb.]: Abb. 25 (348) II. (349) Die Industrie der Ersatzstoffe. (353) Verkehrs- und Nachrichtenmittel. ([359]) Allgemeines. ([361]) I. Bahnverkehr. (364) Vollbahnen. (366) [Abb.]: Eisenbahntransport von Kriegsfahrzeugen (367) [6 Abb.]: Einrichtungen eines Lazarettzuges. (1)Wagen für Pflegepersonal (2)Krankenwagen (3)Küchenwagen (4)Vorratswagen (5)Operationsraum (6)Chefarztwagen ([369]) [Abb.]: Krankenzug (370) [Abb.]: Badezug (Inneres eines Badewagens) (371) Feldbahnen. (372) [Abb.]: Feldbahnzug mit Leichtverwundeten (372) Förder- u. Seilbahnen. (373) [Abb.]: Verwundetentransport durch Seilbahn (373) [2 Abb.]: (1)Gesprengter und wiederhergestellter Tunnel (2)Neubau einer zerstörten Eisenbahnbrücke (374) [2 Abb.]: (1)Gesprengte Eisenbahnbrücke (2)Zerstörte Eisenbahn- und Fußgängerbrücke (375) II. Schiffsverkehr. (376) Schiffbare Wasserstraßen. (376) [Abb.]: Schleppzug aus Lastkähnen (377) [Abb.]: Lazarettschiffe (378) [Abb.]: Kriegsbrückengerät (Pontonpark) (379) [2 Abb.]: (1)Kriegsbrücke (2)Große Kriegsbrücke über die Weichsel (380) [Abb.]: Pionierbrücke aus Behelfsmaterial (381) Seeweg. (381) [Abb.]: Fähre aus Kriegsgerät (381) [Abb.]: Handels U-Boot "Deutschland" (382) III. Verkehr auf Landstraßen und im Gelände. (384) [Abb.]: Pionierbrücke über Weichland (384) Straßen und Wege (384) [2 Abb.]: (1)Neubau einer festen Brücke (2)Straßenbarrikade (385) Fahrzeuge mit Pferdebespannung. (386) [Abb.]: Verwundetentransport auf Schlitten (386) [Abb.]: Fahrbarer Trinkwasserbereiter (387) [Abb.]: Fahrbarer Ofen zur Kleiderreinigung (388) Tragetiere. (388) [Abb.]: Entlausungsmaschine (388) [Abb.]: Tragetiere (389) Kraftwagen. (389) [8 Abb.]: Personen- und Krankenkraftwagen. (1)Offener Personenwagen (2)Geschlossener Personenwagen (3)Mannschafts-Omnibus (4)Feldapothekenwagen m. Drahtseil-Fangvorrichtg. (5)Geschlossener Krankenwagen (6)Offener Krankenwagen (7)Krankenzug (8)Badewagen im Betrieb ([391]) [7 Abb.]: Lastkraftwagen und Kraftzug. (1)Schwerer Lastkraftwagen (2)Leichter Lastkraftwagen (3)Ganz leichter Lastwagen (4)Postkraftwagen (5)Motorlastzug (6)Heißdampflokomotive (7)Flugzeugtransport auf Kraftwagen ([393]) [Abb.]: Lastkraftwagenkolonne (394) [Abb.]: Kraftfahrerabteilung (396) Krafträder. (396) Der Kraftzug. (397) [Abb.]: Transport schwerer Geschütze durch Dampflokomotiven (398) Fahrräder. (398) [Abb.]: Radfahrerabteilung. (399) Schneeschuh. (399) [2 Abb.]: (1)Schneeschuhabteilung (2)Schneeschuhpatrouille in Schneeanzügen (400) Lastenträger. (400) IV. Luftverkehr. (401) Luftschiffe. (402) [Abb.]: Deutsches Luftschiff (403) Flugzeuge. (405) [Abb.]: Deutscher Doppeldecker (407) [3 Abb.]: (1)1. Fliegeraufnahme von Epinal (2)2. Fliegeraufnahme von Epinal (3)Deutsches Wasserflugzeug (408) [Abb.]: Deutscher Fesselballon (409) V. Nachrichtenmittel. (410) [2 Abb.]: (1)Legen der Feldleitung von der Trage aus (2)Legen der Feldleitung vom Wagen aus (412) [Abb.]: Bombensicherer Fernsprech-Unterstand (413) [Abb.]: Meldehund (Zurückbringen einer Meldung) (420) [2 Abb.]: (1)Sanitätshund (2)Sanitätshund auf der Suche (421) VI. Beleuchtungsmittel. (422) [Abb.]: Fahrbarer Scheinwerfer (423) VII. Postverkehr. (424) Die Geologie in der Kriegs-Literatur bei Beschaffung von Rohstoffen des Bodens und Wasserversorgung für Truppen. ([427]) I. Einleitung. ([429]) II. Beschaffung von Rohstoffen des Bodens. (430) III. Wasserversorgung. (435) [Abb.]: Fig. 1. Neufassungen für einen durch Latrinenabwässer verseuchten Brunnen. Durch die Absperrvorrichtungen kann nötigenfalls jede der Quellen a-c ausgeschaltet werden; die bisherige Mitbenutzung der verseuchten Wasseraustritte dicht hinter der Küche und unterhalb der Vorratskammer hört durch Abbruch ihrer (ungenügenden) Fassungen auf (436) [Abb.]: Fig. 2. Verunreinigung einer Stauquelle durch ein Dorf. (437) [Abb.]: Fig. 3. Vermeintliche "Quellfassung" auf dem Land im besetzten Frankreich (439) [Abb.]: Fig. 4. Entwurf eines behelfsmäßigen Schacht- und Bohrbrunnens (440) [Abb.]: Fig. 5. Bauzeichnung des in Fig. 4 entworfenen Brunnens (441) [2 Abb.]: (1)Fig. 6a. Absenkung eines Wasserspiegels in einen tieferen (2)Fig. 6b (444) [Abb.]: Fig. 7 Gebohrter Abessinierbrunnen. (448) [2 Abb.]: Fig. 8. Quellfassung (1)Schnitt. (2)Grundriss. (450) [2 Abb.]: (1)Fig. 9a. Mangelhafte Fassung einer (Schicht- und) Schuttquelle. Quellkammer überfüllt, weil Überlauf fehlt; durchdrückendes Wasser (←) beschädigt sie. Bedeckung der Kammer zum Schutz gegen Tagewasser ungenügend. Nach Angaben von Herrn F. Bernauer. Die Mauer am Trog ist architektonisch verziert. Statt dessen muß die Quellkammer gemauert (oder betoniert) werden, Fig. 9b (2)Fig. 9b. Bessere Fassung derselben Quelle (451) Der Krieg und die erdkundliche Wissenschaft. ([455]) 1. Die geographische Karte im Kriege. (459) [Karte]: Abb. 1. Reliefkarte der deutsch-französischen Grenzgebiete ([462-463]) [Abb.]: Abb. 2. Der Hafen von Dünkirchen (von einem deutschen Flugzeug aufgenommen). Man beachte die Wirkung der Sonnenbestrahlung im Spiegeln der Schuppendächer und in den Schattenbildern der Schiffe (464) 2. Die geographische Lage im Kriege. (465) [Abb.]: Abb. 3. Vor Bombenwurf flüchtende russische Torpedoboote (von einem deutschen Flugzeug aufgenommen). Die rasende Fahrt im ausweichenden Zickzack veranlaßt sich überschneidende Wellenstreifen, die scharfe Licht- und Schattenwirkungen aufweisen (465) [Abb.]: Abb. 4. Vorder., Zwisch.- u. Hint.-Europa (466) [Karte]: Abb. 5 Skizze der Karpathenpässe (475) 3. Der geographische Raum im Kriege. (476) [Tabelle]: Übersicht über die Raum- und Volksgröße der um Mitte Juli 1917 nicht mehr neutralen Staaten: (478) [Abb.]: Abbildung 6. und 7. Schematische Veranschaulichung der Größenverhältnisse der vom Kriege betroffenen Staaten. Zeit: Mitte Juli 1917. (479) [2 Karten]: Abb. 8 und 9. Verkehrsbedeutung des norditalienischen, serbischen und rumänischen Kriegsschauplatzes (September 1917; inzwischen verschoben die Mittelmächte ihren Einflußbereich viel weiter ostwärts) (1)Was die Entente wollte. (2)Was wir erreicht haben. (485) 4. Die Landeseigenart im Kriege. (487) [Tabelle]: Doch Frankreich vermochte seinen hauptsächlich im Nordosten lagernden Schatz nicht annähernd selbst zu verhütten, während Deutschland, das kohlenreiche, erhebliche Erzmengen einführte. Diese Einfuhr hat sich sehr merkwürdig entwickelt. Langsam hob sich die spanische, rasch die schwedische, reißend die nordfranzösische Zufuhr. (490) [2 Abb.]: Abb. 10 und 11. Posières bei Albert vor und nach der Somme-Schlacht 1916. (Fliegeraufnahme) ([492]) [Abb.]: Abb. 12. Verwüstungen im Rabenwald östlich vom Toten Mann (493) Zum Schrifttum über Kriegsgeographie. (497) Krieg und Völkerkunde. ([499]) Erster Teil. Geschichte der Völkerkunde. ([501]) Zweiter Teil. Arbeiten und Ergebnisse der Völkerkunde im Kriege. (508) Allgemeine Einleitung. (508) 1. Anthropologische Arbeiten. (510) 2. Der Krieg als Erscheinung der primitiven Kultur. (510) 3. Die primitiven Völker auf den Kriegsschauplätzen. (511) 4. Die europäischen Völker im allgemeinen. (513) 5. Vom deutschen Wesen. (514) 6. Die Völker in Österreich-Ungarn. (515) 7. Die Nordgermanen. Belgier. Holländer. Buren. Luxemburger. Schweizer. (516) 8. Engländer und Iren. (518) 9. Die romanischen Völker. (520) 10. Die Russen. (522) Die Fremdvölker des russischen Reiches. (526) 1. Allgemeine Übersicht. (526) 2. Die Polen. (527) 3. Die Ukrainer. (529) 4. Litauer und Letten. Die Finnen. (530) 5. Die türkischen und mongolischen Völker. Lappen. Samojeden. (531) 6. Die Kaukasusvölker. (533) 7. Die Ostjuden. (534) Die Balkanvölker. (536) Die Völker des türkischen Reiches und der Islam. (541) Der Orient. (544) 1. Allgemeines. (544) 2. Armenier. Perser. Inder. (545) 3. Ostasien. (549) Die Amerikaner. (551) Die Botanik im Kriege. (553) Öle und Fette. (557) 1. Gesteigerter Anbau vor dem Krieg als Öllieferanten in Deutschland angebauter Pflanzen. (557) 2. Anbau von vor dem Krieg nicht oder nur in beschränktem Maße in Deutschland kultivierten Ölpflanzen. (557) [Abb.]: Abb. 1 (558) [Abb.]: Abb. 2. Sonnenblumenmassenkultur Anfang August 1916 (559) [Abb.]: Abb. 3. Sonnenblumenmassenkultur nach dem Unwetter Anfang Oktober 1916 (560) 3. Nutzung der bei uns wildwachsenden oder zu anderen Zwecken kultivierten, ölhaltigen Pflanzen. (561) Walnuß (561) Bucheckern. Weinrebe. (562) Steinobstkerne. (562) Mehle und Stärke. (563) [Abb.]: Abb. 4 (564) Reismelde. (564) [Abb.]: Abb. 5. Reismeldenkultur (565) Flechten (565) [Abb.]: Abb. 6. Isländisch Moos. Renntierflechte (565) [Abb.]: Abb. 7. Flechtenbestandenes Moor im württembergischen Algäu. (566) Salate und Gemüse. (566) Pilze. (567) Hefe. (569) Genußmittel (Kaffee- und Tee-Ersatz). (570) Kaffee. (570) [2 Abb.]: (1)Abb. 8. Zichorienpflanze (2)Abb. 9. Zichorienwurzel (571) [Abb.]: Abb. 10. Zichorienlieferung Frank-Ludwigsburg (572) Tee-Ersatz. (572) Arzneipflanzen. (573) Faserersatz. (575) Die Brennessel. (577) [Abb.]: Abb. 11. Brennessel (577) [Abb.]: Abb. 12 (578) Der Ginster (Sarothamnus scoparius). Hopfen (579) Lupine (579) Weide. Torffasern. (580) Ersatz für technisch wichtige Artikel. (580) Seife. (580) Kautschuk. Klebstoffe. (581) Mikroskopisch-anatomische Untersuchungen. (582) Die Zoologie im Kriege. ([585]) [Tabelle]: In der bestehenden Übersicht sind die wichtigsten hierhergehörenden Insekten und die von ihnen übertragenen Krankheiten zusammengestellt; (599) [Abb:]: Abb. 1. Lage des Verdauungstraktes der Kleiderlaus, schematisch (Nach H. Sikora 1916) (602) [Abb:]: Abb. 2. Kopf der Kleiderlaus (Mikrophotogramm nach Frickinger 1916) (603) [7 Abb:]: Abb. 3a - g. Entwicklung des Läuseeies (nach Hase 1916): (1)a)Ei nach der Ablage (2)B) am Ende des 1. Tages. (3)c) am Ende des 2. Tages (4)d) am 3. Tage (5)e) am 4. Tage (6)f) am 5. Tage (7)g) unmittelbar vor dem Ausschlüpfen der Larve (604) [Abb:]: Abb. 4. Deckel des Läuseeies mit Mikrophylapparat (Nach Hase 1916) (605) [2 Abb:]: (1)Abb. 5. An Fasern und Haaren abgelegte Läuseeier (Nach Hase 1916) (2)Abb. 6. Ungewöhnliche Anheftung von Läuseeiern am Kopf bzw. Bein einer andern Laus (nach Hase 1916) (606) [Abb:]: Abb. 7. Stellung der Laus beim Blutsaugen (nach Hase 1916) (607) Die Bakteriologie im Kriege. ([629]) [Tabelle]: Einen Überblick über diese und die Zeit ihrer Entdeckung soll folgende Tabelle geben: (633) Grundlegende Methoden. (633) Gestaltung, Organisation und chemisch-physikalische Beschaffenheit der Bakterien. (634) Die Lebenserscheinungen der Bakterien. (636) Die äußeren Lebensbedingungen. (636) Die Feuchtigkeit. (636) Die Temperatur. (636) Der Stoffwechsel. (637) Der Tierversuch. (639) Das wechselweise Verhalten von Bakterium und infiziertem Organismus. (640) Toxine. (640) Bakteriolysine. (641) Agglutination. (641) Herstellung von Impfstoff. (642) Die im Kriege wichtigsten Bakterien. (643) Coccaceen. (644) Streptococcen. (644) Micrococcus. Micrococcus gonorrhoeae. (645) Micrococcus intracellularis. (645) Micrococcus pyogenes. (646) Bacteriaceen. (646) Sporenlose Bakterien. (647) Die Typhus-Coli-Ruhr-Gruppe. (647) Die Typhusgruppe. (648) B. typhi. (651) B. Paratyphi A. (652) B. Paratyphi B. (652) B. dysenteriae und pseudodysenteriae. (653) B. proteus. (654) Sporenbildende Stäbchen. (655) Aerobe sporenbildende Bakterien. (655) Bacilius subtilis. (655) B. anthracis. (655) Anaerobe sporenbildende Bakterien. (656) B. Tetani. (656) Anaerobe Gasbazillen. (657) Spirillaceen. (658) Vibrio Cholerae. (658) Mycobacteriaceen. (659) C. Corynebacterium diphtheriae. Corynebacterium Mallei. (660) Mycobacterium tuberculosis. (661) Kriegsmethoden. (661) [Abb:]: Abb. 1 (662) Massenuntersuchungen. (663) [Abb:]: Abb. 2 (664) Die Hygiene im Kriege. ([665]) [Tabelle]: Der Jahreszugang an Kriegsseuchen oder sonstigen bemerkenswerten Krankheiten betrug, gleichfalls berechnet auf je tausend der Kopfstärke: (695) [Tabelle]: An Krankheiten, welche für die Beurteilung des Gesundheitszustandes der Flotte von Bedeutung sind, gingen zu: (696) [Tabelle]: Die Erkrankungen und Sterbefälle infolge der wichtigsten Infektionskrankheiten in Cöln von 1907 - 1915: (697) Die Medizin im Kriege. ([699]) Krieg und Heilkunst. ([701]) Die Chirurgie im Kriege. ([713]) [Abb.]: Fig. 1 (718) [Abb.]: Fig. 2 (720) [Abb.]: Fig. 3a -c (722) [Abb.]: Fig. 4 (728) [Abb.]: Fig. 5 (730) [2 Abb.]: (1)Fig. 6a (2)Fig. 6b (731) Die Orthopädie im Kriege. ([739]) [Abb.]: Abb. 1. Geh-Gipsverbände bei Oberschenkelbrüchen (von Lange-München) (743) [3 Abb.]: (1)Abb. 2a (2)Abb. 2b. Streckverbandapparat nach Ansinn-Bromberg zur selbsttätigen Bewegung des Knie- u. Hüftgelenkes bei Oberschenkelbrüchen (3)Abb. 2c. Lagerung zur selbsttätigen Gelenkbewegung bei Schußbrüchen nach Böhler-Bozen (744) [2 Abb.]: (1)Abb. 3. Mechanotherapie und Gymnastik. (Aus dem Wiener orthopäd. Spital und Invalidenschulen) (2)Abb. 4. Kniestreckschiene nach Schede-München (745) [2 Abb.]: (1)Abb. 5 Schiene für Schulterversteifungen nach Erlacher-Wien-Graz (2)Abb. 6. Behandlungsapparat nach Fischer-Preßburg bei Ellbogenversteifungen (746) [Abb.]: 7. Erhöhungsschuh mit Kniekappe bei Oberschenkelverkürzung und Knieschlottern (747) [5 Abb.]: (1)Abb. 8. Radialschiene nach Spitzy-Wien zur Behebung der Fallhand (2)Abb. 9a. Ulnarisspange zur Behinderung der Krallenhand bei Ellnervenverletzung (3)Abb. 9b. Ulnarisspange angelegt (4)Abb. 10. Apparat bei Lähmung der Oberarmheber nach Stracker-Wien (5)Abb. 11. Schuh mit Hebezug bei Lähmung der Fußheber. Alte Form. (Wiener orthop. Spital) (748) [5 Abb.]: (1)Abb. 12. a Fallhand links bei Radialislähmung; (2)b. durch Sehnenplastik geheilt. Von Fischer-Stuttgart. (Aus der Münch. med. Wochenschr. 1915) (3)-(5)Abb. c-e Lähmungen von Arm- und Beinnerven, durch Nervenoperation (Naht des durchtrennten Nerven) wieder geheilt. (Aus dem Wiener orthopädischen Spital und Invalidenschulen) (749) [3 Abb.]: (1)Abb. 13. Gipsprothesen nach Spitzy-Wien (2)Abb. 14a. Lederbehelfsprothesen für doppelseitig Unterschenkelamputierten, ohne Schuh und Verkleidung (3)Abb. 14b. Lederbehelfsbein bei sehr kurzem Oberschenkelstumpf, verkleidet. (Aus dem Wiener orthopädischen Spital) (750) [Abb.]: 15 Kunstbein bei Verlust des ganzen rechten Beines (ausgelöst in der Hüfte). (Aus dem Wiener orthopädischen Spital) (751) [3 Abb.]: Abb. 16. Doppelseitig Oberschenkelamputierter mit seinen Prothesen, mit denen er stundenlang gehen kann. (Aus dem Wiener orthopädischen Spital) (752) [6 Abb.]: Tafel I (1)-(4)Doppelseitig Verstümmelter mit sehr kurzem Stumpf rechts. (5)-(6)Muskelanschlußprothese links. Beide können vom Stumpf aus Ellbogen und Finger willkührlich bewegen (Wiener orthopädisches Spital) ([755]) [6 Abb.]: Tafel II Doppelseitig Armamputierte bei den Verrichtungen des täglichen Lebens. (Aus dem Wiener erthopädischen Spital und Invalidenschulen) ([756]) [7 Abb.]: Tafel III a-d Verschiedene Arbeitsbehelfe. (1)a. Wienerarm (2)b. Bauernarm (3)c. Kellerhand (4)d. Rotaarm (5)-(7)e-g Muskelanschlußprothesen. (Aus dem Wiener orthopädischen Spital und Invalidenschulen) ([757]) Die Lichttherapie im Kriege. ([763]) Einleitung. ([763]) Das Licht. ([763]) Die Lichtquellen für die Lichttherapie. (764) [2 Abb.]: (1)Abb. 1. Kromayerlampe (2)Abb. 2. Bachs künstliche Höhensonne (766) Wirkung der ultravioletten Strahlung. (767) [Abb.]: Abb. 3. Jesionek-Quarzlampe (767) [2 Abb.]: (1)Abb. 4. Lichtfilter (2)Abb. 5. Hagemanns Glühlampenring (768) [Abb.]: Abb. 6. Sollux-Ergänzungs-Höhensonne (769) Die Lichttherapie im Kriege. (770) [2 Abb.]: Abb. (1)7a und (2)b. Wundheilung (774) [Abb.]: Abb. 8. Gruppenbestrahlung (775) Die Röntgentechnik im Kriege. ([777]) I. Physikalische Grundlagen. ([777]) II. Erzeugung der Röntgenstrahlen. (780) [Abb.]: Fig. 1. Röntgenröhre (780) [Abb.]: Fig. 2. Glühkathoden-Röntgenröhre (782) III. Die Erzeugung der hohen Spannung. (782) IV. Die Erkennung von Krankheiten mit Röntgenstrahlen. (783) [2 Abb.]: (1)Fig. 3 (2)Fig. 4 (784) [Abb.]: Fig. 5 (785) V. Kriegs-Röntgenapparate. (786) [Abb.]: Fig. 6. Feldröntgenauto, gebaut von den Veifawerken in Frankfurt a. M. (787) [2 Abb.]: (1)Fig. 7 (2)Fig. 8 (788) [2 Abb.]: (1)Fig. 9 (2)Fig. 10 (789) VI. Röntgenbilder aus dem Kriege mit Erklärungen. (791) Aus der überaus großen Zahl von Anwendungen, die das Röntgenverfahren im Kriege gefunden hat, können wir nur einige Beispiele in den nachfolgenden Tafeln bringen: (791) [3 Abb.]: (1)Fig. 11 (2)Fig. 12 (3)Fig. 13. Großer Präzisionsapparat für Fremdkörper-Lagebestimmung (792) [2 Abb.]: (1)Fig. 14. Röntgenkinematograph. Aufnahme eines Geschosses im Herzen. (2)Fig. 15. Ausmessungsaufnahme eines Geschosses im Herzen mittels des Präzisionsmeßapparates und des Telekardiographen nach Huismanns in einem Reservelazarett (793) [Abb.]: Tafel I ([795]) [Abb.]: Tafel II ([796]) [Abb.]: Tafel III ([797]) [Abb.]: Tafel IV ([798]) [Abb.]: Tafel V ([799]) Psychiatrie und Nervenkrankheiten. ([801]) Die Einwirkung des Krieges auf das Nervensystem geschieht in vielerlei Arten. (802) I. Die mechanischen Schädigungen des Nervensystems. (802) 1. Peripherische Nerven. (802) 2. Rückenmark. (808) 3. Gehirn. (809) II. Infektions- und Intoxikationskrankheiten. (810) III. Erschöpfende Einflüsse. (813) IV. Psychische Einwirkungen. (815) Die Augenheilkunde. ([821]) [Abb.]: Abb. 1. Veränderungen des Augenhintergrundes nach einem Schuß, welcher die umgebenden Knochen des Auges getroffen hat (822) [2 Abb.]: (1)Abb. 2a a) Nach Verbrennung ist eine Verwachsung der Haut des oberen Lides mit der Hornhaut und der Bindehaut des Augapfels entstanden. (2)Abb. 2b b) Das Auge nach Abtragung der Hautbrücke. Das Hautläppchen a) ist zur Herstellung des unteren Bindehautsackes verwandt, außerdem ist noch Lippenschleimhaut eingesetzt. Ein Teil der oberen Hautbrücke wurde zur Bildung des oberen Bindehautsackes verwandt (823) [Abb.]: Abb. 3. Wagrechter Schnitt durch Augen und Gehirn. Beide Augen fixieren Punkt F. Sein Bild fällt auf den gelben Fleck. (M und M`). cM und g`M` werden von der linken Gehirnseite mit Nerven versorgt, Mg und M`c`von der rechten. M und M`gelber Fleck. aFb Gesichtsfeld des linken Auges. a`F``des rechten Auges. Aus Dr. Klingelhöffer, Das Auge und seine Erkrankungen. Thomas`Volksbücher 113 und 114 (826) [Abb.]: Abb. 4. Blick in gerader und schräger Richtung durch ein doppelgehöhltes und ein Meniskenglas (829) Die Zahnheilkunde. ([833]) [2 Abb.]: (1)Abb. 1. Bügel und sog. "Band". Dieses wird an den Zahn angeschraubt. In der seitlich angelöteten Röhre kann der Bügel mit Hilfe der beiden Muttern befestigt werden (2)Abb. 2. Der Bügel ist so eingestellt, daß er freigelassen, wie dies die gestrichelte Linie andeutet, nach außen federn würde. Er wird durch die Röhrchen festgehalten und nimmt, seiner Ruhelage zustrebend, die ihn festhaltenden Zähne allmählich nach außen mit. Der Erfolg ist eine "Kieferdehnung" (834) [3 Abb.]: (1)Abb. 3. Der Bügel dient hier als einfache Kieferschiene. Die Zähne und mit ihnen die Bruchstücke des Knochens werden an dem Bügel durch Draht festgebunden und bis zur Heilung fixiert. (2)Abb. 4. Der Bügel überbrückt den Defekt und hält die beiden Bruchstücke in ihrer gegenseitigen Lage fest (3)Abb. 5, oben. Definitives Ersatzstück bei Fehlen des Mittelteiles des Unterkiefers. Es findet an den durch Kronen miteinander befestigten Backenzähnen beider Stümpfe seinen Halt durch Klammern (835) [2 Abb.]: (1)Abb. 6. Fehlen des Mittelteiles des Unterkiefers. Da nicht geschient wurde, näherten sich beide Stümpfe, um in dieser ungünstigen Stellung miteinander zu verwachsen (2)Abb. 7. Die links am Bügel angebrachte "schiefe Ebene" zwingt bei jedem Kieferschluß die Fragmente in die richtige Stellung (836) [3 Abb.]: (1)Abb. 8. Schwere Zerreißung der Wangenweichteile durch die Splitterwirkung des zertrümmerten Unterkiefers (2)Abb. 9. Abschuß des ganzen Mittelteiles des Unterkiefers. Untelippenweichteile teilweise noch erhalten (3)Abb. 10. Großer Wangendefekt bei Schußbruch des Oberkiefers (837) [2 Abb.]: Abb. 11 Abb. 12 Ober- und Unterkieferdefekt nach Heilung der Wunden. - Der verlorene Knochen wird durch "Kautschukschilder" ersetzt, die an den Kieferresten ihren Halt finden und die Unterlage für die Deckung des Defektes mit Weichteillappen bilden (838) [Abb.]: Abb. 13. Der gleiche Patient nach Deckung des Defektes. Die Kautschukschilder werden später gegen zahntragende Kautschukgebisse ausgetauscht. Gegebenenfalls wird vorher noch der Unterkieferknochen durch Knochenverpflanzung ersetzt (839) [2 Abb.]: (1)Abb. 14. Narbe nach der Heilung der Weichteilwunde der Abb. 8 (2)Abb. 15. Zustand nach Ausschneidung der Narbe und exakter Wundnaht (840) [Abb.]: Abb. 16. Durch einen "Nagel" wird das linke Unterkieferfragment mit Hilfe einer Kopfkappe in richtiger Lage gehalten. Das rechte Fragment ist auf die gleiche Weise geschient. (841) [3 Abb.]: (1)Abb. 17. Die beiden Kiefermodelle sind in einen anatomischen Artikulator eingegipst, der die genaue Wiederholung der sehr komplizierten Kieferbewegungen erlaubt. Die Gleitschiene wird hier erst in die richtige Lage gebracht und mit dem Bügel verlötet (2), Abb. 18a (3)Abb. 18b Freilegung und Anbohrung der beiden Knochenstümpfe, oben das dem Schienbein entnommene entsprechend vorbereitete Knochenstück. - Das "Transplantat" ist in die Kieferstümpfe eingefügt. Es folgt Weichteil- und Hautnaht (842) [2 Abb.]: (1)Abb. 19. Großer Unterkieferdefekt mit großen Weichteilwunden (2)Abb. 20. Der gleiche Patient, mit verheilten Wunden. Unterkiefermittelteil nebst Kinn und Lippe fehlt (843) [2 Abb.]: (1)Abb. 21. Am Oberkiefer wird ein Kautschukkiefer befestigt, als Unterlage für den plastischen Ersatz der Kinnweichteile (2)Abb. 22. Der Weichteildefekt ist gedeckt. Der Narbenschrumpfung wird durch Kopfkappenzugverband vorgebeugt ([844]) [Abb.]: Abb. 23. Der gleiche Patient siehe Abb. 19, nach Weichteil- und Knochenplastik (845) [2 Abb.]: Abb. 24 Abb. 25 Sattelnase wird durch Pelotten- und Gummizug gehoben, die an einer Kopfkape ihren Halt finden. - Apparat zur Formung neugebildeter oder deformierter Nasen. Die Pelotten sind in jeder Lage feststellbar. Halt an Kopfkappe (846) Die Tiermedizin. ([849]) [Abb.]: Fig. 1. Positives Ergebnis der Mallein-Augenprobe bei einem rotzkranken Pferde. - Die Einträufelung einiger Tropfen Mallein- (Rotzbazillenextrakt-) Lösung in den Lidbindehautsack erzeugt bei rotzkranken Pferden nach 4-6 Stunden einen mehrere Stunden anhaltenden Ausfluß eiterflockenhaltigen Sekretes. (852) [Abb.]: Fig. 2. Ein von der Räudekrankheit befallenes und dadurch an zahlreichen Körperteilen, besonders an der Schulter, der Flanke und am Gesäß, des Haarkleides beraubten Pferd. (854) Die Landwirtschaft und der Krieg. ([873]) [Abb.]: Bild 1. Unser täglich Brot. Herr v. Lochow-Petkus bei seinen Elitepflanzen des Petkuser Roggens (879) [2 Tabellen]: (1)Dagegen mehrte sich die Zahl der Menschen, die nebenberuflich in der Landwirtschaft tätig sind, und es bleibt auch wohl zu beachten, daß es viele kleine Leute gibt, die "gewerblich" und "landwirtschaftlich" arbeiten, sich aber bei der Berufszählung nicht als Bauern bekennen. (2)Ernteerträge im ganzen in 1000 Tonnen pro Hektar in Doppelzentnern: (882) [Abb.]: Bild 2. Getreideselektionsraum. Aus der Saaatzucht von Fr. Strube in Schlanstedt (883) [Abb.]: Bild 3. Hohenheim bei Stuttgart, die älteste landwirtschaftliche Hochschule die 1918 ihr hundertjähriges Jubiläum feierte (885) [Abb.]: Bild 4. Tiere des Rassenstalls der landwirtschaftlichen Hochschule Hohenheim (890) [2 Tabellen]: (1)Von den Jahren 1882 auf 1895 auf 1907 war die Zahl der Betriebe: (2)Bei den Zwergbetrieben, die in Friedenszeiten weniger Bedeutung für die Landwirtschaft besitzen, ist allerdings ein Verlust von 129000 Landwirten zu buchen, die durch andere Leute ersetzt worden sind. (891) [Tabelle]: Verteilung der Tierbestände auf die einzelnen Betriebsgrößen im Deutschen Reich nach der Zählung vom 2. Dezember 1907: (892) [2 Tabellen.]: (1)Anbauflächen (2)Gesamterträge: (894) [Abb.]: Bild 5. Weinlese auf einer hessischen Domäne (895) [Tabelle]: Von den Hauptzuckerländern waren die Zahlen 1912/13 für den Zuckerrübenbau: (895) [Abb.]: Bild 6. Vollblut-Shorthorns auf Sürwürden, Oldenburg. Aus Dade, "Die deutsche Landwirtschaft unter Kaiser Wilhelm II." (898) [Tabelle]: Danach verlief die Zunahme folgendermaßen: (898) [Tabelle]: Fügen wir Pferde und Ziegen hinzu und betrachten wir die Zahl seit 1873 noch etwas genauer, so erkennen wir den weiteren Aufstieg und zugleich die Schwankungen, denen naturgemäß die Viehbestände ausgesetzt sind (Futterernten und dergleichen). (899) [Abb.]: Bild 7. Württemberger Bastardschafe auf der Domäne Ochsenhausen bei Biberbach, Oberschwaben (900) [Abb.]: Bild 8. Aus "Kriegsbilder", Nr. 15, 13. April 1918, Illustrierte Wochenbeilage der Deutschen Tageszeitung (901) [3 Tabellen]: (1)Es betrug das durchschnittliche Schlachtgewicht in Kilogramm: (2)Die Zunahme des Schlachtgewichts betrug in Prozenten: (3)Im selben Sinne sprechen die Erhebungen durch das Großherzogliche Statistische Landesamt in Baden (1913), wonach die Lebendgewichte der Rinder, Schweine und Schafe und deren Verkaufswert fortgesetzt stiegen. (902) [Abb.]: Bild 9. Herde auf Friedrichswerth bei Gotha von Domänenrat Meyer (903) [Tabelle]: Es kamen auf 100 Einwohner: (903) [Abb.]: Bild 10. Aus der Forellenzucht von Wüsten-Jerichow, Bezirk Magdeburg (904) [Tabelle]: Die Zahl der landwirtschaftlichen Betriebe, die überhaupt Maschinen benutzten hat sich erheblich vermehrt. (906) [Abb.]: Bild 11. Landbaumotor Lanz mit angehängten Mähmaschinen (907) Die Forstwirtschaft im Kriege. ([913]) I. Die technischen Hilfsstoffe des Waldes. (916) [Tabelle.]: Vielmehr stellt sich der Besitzstand in den Forsten des Deutschen Reiches wie folgt: (917) II. Die Nährstoffe des Waldes. (930) Der naturwissenschaftliche Unterricht und der Krieg. ([945]) Die Schulmathematik und der Krieg. ([961]) Krieg und Wirtschaftsleben. ([975]) Werbung ( - ) Einband ( - ) Einband ( - )
DER WELTBRAND BAND 1 Der Weltbrand (-) Der Weltbrand Band 1 (1; 1915) ( - ) Einband ( - ) Titelseite ( - ) Impressum ( - ) [Abb.]: Deutschlands Oberster Kriegsherr: Kaiser Wilhelm II. in Felduniform. ( - ) Einleitung. "Es geht um Alles!" (1) [Abb.]: Kaiser Franz Joseph I. und Erzherzog Friedrich von Österreich, der Oberbefehlshaber der österr.-ungar. Armee. (1) [4 Abb.]: (1)Leopold Graf Berchtold, österr.-ungar. Minister des Äußeren. (2)K. Graf Stürgkh, österr. Ministerpräsident. (3)Freiherr Conrad v. Hötzendorf, österr.-ungar. Generalstabschef. (4)A. Ritter v. Krobatin, österr.-ungar. Kriegsminister. (3) [2 Abb.]: (1)das Attentat auf den Erzherzog-Thronfolger Franz Ferdinand von Österreich und seine Gemahlin in Sarajewo am 28. Juni 1914. (2)Blick auf Sarajewo, die Hauptstadt Bosniens, von Nordost. (4) [Abb.]: Zum Krieg zwischen Österreich-Ungarn und Serbien: Abfahrt einberufener österreichischer Reservisten von einem niederösterreichischen Bahnhof. (5) [4 Abb.]: (1)Zar Nikolaus II. (2)Kronprinz Alexander von Serbien, Oberbefehlshaber der serbischen Streitkräfte im Kampfe gegen Österreich-Ungarn. (3)Großfürst Nikolai Nikolajewitsch, der Generalissimus der russischen Armee. (4)Nikola Pasitsch, serbischer Ministerpräsident. (6) [3 Abb.]: (1)Serbische Infanterie. (2)Uniformtypen der österreichisch-ungarischen Armee: (3)Serbische Artillerie. (7) Die Vorgeschichte des Krieges. (8) [Abb.]: Franz Joseph I., Kaiser von Österreich, apostolischer König von Ungarn. ( - ) [Karte]: Karte vom Schauplatze des Krieges zwischen Österreich-Ungarn und Serbien. (9) [3 Abb.]: (1)Reichskanzler von Bethmann Hollweg. (2)Generalleutnant Erich von Falkenhayn, preußischer Kriegsminister. (3)Großadmiral von Tirpitz, Staatssekretär des deutschen Reichsmarineamtes (10) [2 Abb.]: (1)Heinrich, Prinz von Preußen. Großadmiral, Generalinspekteur der Marine (2)Die Mobilmachung an der deutschen Küste: Einbootung von Marinereservisten. (11) [Abb.]: Die offizielle Verkündung des Kriegszustandes auf der Straße Unter den Linden in Berlin durch einen Offizier am 31. Juli. (12) [Abb.]: Huldigung der Berliner Bevölkerung vor dem Kronprinzlichen Palais zu Berlin am Abend des 1. August. Kronprinz Wilhelm, mit seinem ältesten Sohn, dem Prinzen Wilhelm, auf dem Arme, dankt für die Ovation. ( - ) [2 Abb.]: (1)Ein Bauernhaus in Großgörschen. (Provinz Sachsen.) (2)Deutsche Soldaten auf dem Weg zur Grenze. (13) [Abb.]: Der Humor der ausziehenden deutschen Krieger. (14) [Abb.]: Abschied Kaiser Wilhelms II. vom Oberbürgermeister von Berlin, Exzellenz Wermuth, und vom Stadtverordnetenvorsteher Michelet vor dem Auszug ins Feld am 16. August. (15) [Abb.]: Abfangen zweier als Damen verkleideter russischer Spione durch österreichisch-ungarische Grenztruppen. (16) [Abb.]: Jubelnde Begrüßung einrückender Reservisten auf dem Potsdamer Platz in Berlin. (17) Die Mobilmachung in Deutschland und Österreich. Ausmarsch der Truppen. (17) [Abb.]: Torpedobootangriff. ([18 - 19]) [Abb.]: Bittgottesdienst am Fuße des Völkerschlachtendenkmals in Leipzig. (20) [Karte]: Karte vom österreichisch-russischen Kriegsschauplatz. ( - ) [Abb.]: Verpflegung durchfahrender Soldaten auf einem Leipziger Vorortbahnhof. (21) [2 Abb.]: (1)Patriotische Opferwilligkeit. (2)Vom Kriege zwischen Österreich-Ungarn und Serbien: Die Erstürmung der stark besetzten Uferhöhen der Drina nächst Loznica und Ljesnica durch das ungarisch-kroatische Warasdiner Infanterie-Regiment Nr. 16 am 14. August. (22) [Abb.]: Der Panzerkreuzer "Goeben" und der kleine Kreuzer "Breslau" gefechtsklar im Hafen von Messina, von wo den beiden Schiffen am 6. August der Durchbruch durch die ihnen auflauernden englische und französische Mittelmeerflotte gelang. (23) [3 Abb.]: (1)Georg V. König von Großbritannien und Irland. (2)Sir Edward Grey britischer Minister des Auswärtigen. (3)H . H. Asquith britischer Premierminister. (24) [Karte]: Karte vom deutsch-russischen Kriegsschauplatz. ( - ) [Abb.]: Vom deutsch-russischen Kriege: Drei deutsche Infanteristen, in einem Kartoffelacker in Deckung liegend, schlagen eine russische Kavallerie-Patrouille in die Flucht. (25) [Abb.]: Das Eingreifen des Militärluftschiffes "Z VI" in den Kampf um die belgische Festung Lüttich am 6. August 1914. (27) [2 Abb.]: (1)Typen vom belgischen Heer: Feldartillerie. Infanterie (Feldanzug). Regiment Chasseurs. Grenadier-Rgt. (Tamboux). Regiment des Guildes (Trompeter) Lancier-Rgt. Genietruppe (mineux). Carabiner-Rgt. Train-Rgt. (Feldanzug). Im Hintergrund: Reitende Artillerie (Offiziere). General (kleiner Anzug). Jäger zu Pferde (Offizier), 2. Lancier-Regt. (Offizier, Feldanzug). (2)Zur Wirkung des deutschen 42 cm-Belagerungsmörsers: Bild aus dem Panzerfort Loucin der Festung Lüttich. (28) [Abb.]: Die deutsche Felduniform ( - ) Vom Ausbruch des Krieges bis zur englischen Kriegserklärung. (29) [Abb.]: Zu dem Kampf bei Lagarde in Lothringen am 11. August: Die Eroberung der ersten französischen Fahne. (29) [Abb.]: Vom belgischen Kriegsschauplatz: Franktireurüberfall. (31) [Abb.]: Wachen zur Beobachtungen feindlicher Flieger auf den Höhen des Schwarzwaldes. (32) Deutsche Schiffe in der Nordsee - Der Fall von Lüttich. - Belgische Greuel. - Gefechte an der Ostgrenze. - Die Franzosen im Elsaß. - Mühlhausen und Lagarde. (32) [Abb.]: Nachtgefecht in Mühlhausen. ( - ) [Abb.]: Eine Dorfstraße in Lagarde. (33) [Abb.]: Offiziersgräber in Lagarde. (34) [Abb.]: Französische Truppen in den Vogesen. (35) [7 Abb.]: Deutsche Heerführer vom westlichen Kriegsschauplatz. (1)Herzog Albrecht von Württemberg. (2)Kronprinz Rupprecht von Bayern. (3)Generaloberst v. Bülow. (4)Der Deutsche Kronprinz Wilhelm. (5)Generaloberst v. Heeringen. (6)Generaloberst v. Kluck. (7)Generaloberst Frhr. v. Hausen. (37) Östliche Grenzkämpfe. - Haltung der Polen. - Proklamation des Zaren an die Polen und Juden. - Der Pöbel in Petersburg demoliert das deutsche Botschaftsgebäude. - Note der Deutschen an die Belgische und Französische Regierung. (38) [3 Abb.]: (1)General der Infanterie v. Emmich, der den Sturm auf Lüttich befehligte. (2)Generalfeldmarschall Colmar Frhr. v. d. Goltz, der zum Generalgouverneur von Belgien ernannt wurde. (3)Vom westlichen Kriegsschauplatz: Eine Batterie der Fußartillerie im Gefecht. (39) [Abb.]: Eine Szene aus der Schlacht bei Longwy am 22. August, in der die Armee des Deutschen Kronprinzen den Feind in die Flucht schlug. (40) [3 Abb.]: (1)Raymond Poincaré, Präsident der französischen Republik. (2)General Pau, bekannter französischer Heerführer. (3)Marschall Joffre, Generalissimus der französischen Armee. (41) Aufruf des Landsturms. - Der Kaiser zieht ins Feld. - Gefechte im Westen. - Friedensangebot an die Belgier. - Besetzung von Brüssel. - Schlachten bei Metz, bei Longway, am Semois. - Kapitulation von Namur und Longwy. - Die Deutschen rücken überall siegreich vor. - Schlacht bei St. Quentin. - Folgen der deutschen Siege. (43) [2 Abb.]: (1)Zu den Ausschreitungen der Volksmenge gegen die deutsche Botschaft in St. Petersburg: Die Fassade des von Peter Behrens erbauten Gebäudes mit den Giebelfiguren von Eberhard Encke. (2)Von den Verwüstungen und Zerstörungen im Dienstgebäude der Reichsbankstelle in Saarburg i. Lothr. durch französisches Militär in den Tagen des 18. bis 20. August: Die Wohnung des Kassendieners. (43) [2 Abb.]: (1)Vom westlichen Kriegsschauplatz: Rast. (2)Von den Kämpfen in Lothringen: Deutsche Dragoner in der Stadt Dieuze. (44) [Karte]: Karte vom deutsch-französisch-belgischen Kriegsschauplatz. ( - ) [2 Abb.]: (1)Albert, König der Belgier. (2)Deutsche Truppen auf der Grande Place in Brüssel. (45) [Abb.]: In Brand gestecktes Frankireurdorf bei Luneville (47) [Abb.]: Die Begeisterung in München über den Sieg des Kronprinzen Rupprecht von Bayern in der Schlacht bei Metz. (48) [2 Abb.]: (1)Zur völkerrechtswidrigen Kriegsführung Frankreichs und Englands: Die Dum-Dum-Geschosse. (2)Hinter dem Schlachtfeld: Die Tätigkeit des Sanitätskorps während einer Schlacht. (49) Japans Ultimatum. - Der Krieg mit England zur See und über See. (50) [3 Abb.]: (1)Carl Kitchener, der englische Kriegsminister. (2)Transport verwundeter deutscher Soldaten, die an den Kämpfen bei Nancy teilgenommen haben, auf der Landstraße bei Dieuze im Regenwetter. (3)Generalfeldmarschall Sir John French, Oberbefehlshaber der englischen Expeditionstruppen. (51) [Abb.]: Zu dem Siege der Armee des Generalobersten v. Kluck über die Engländer in der Schlacht bei St. Quentin am 28. August: Die Eroberung englischer Geschütze durch die stürmenden deutschen Truppen. ([52 - 53]) [2 Abb.]: (1)Schützengräben vor der Ortschaft Champien bei Roye mit Leichen deutscher und französischer Soldaten. Das Kreuz steht auf einem bereits geschlossenem Grabe. (2)Die Hauptwache im Laubengang des alten gotischen Rathauses in St. Quentin. (55) [2 Abb.]: (1)Im Geschäftszimmer des Generalstabes des 19. Armeekorps. (2)Typen aus dem Gefangenenlager in Königsbrück bei Dresden: Gefangene verwundete Franzosen werden verbunden. (56) [Abb.]: Uniformen österreichisch-ungarischer Truppen. ([57]) Die Russen in Ostpreußen. - Große Siege Hindenburgs. (59) [Abb.]: Generaloberst von Hindenburg. (59) [Abb.]: Die Erstürmung der serbischen Stellung auf Höhe 954 bei Visegrad durch das deutsche Skutari-Detachement im Verein mit den österreichisch-ungarischen Truppen am 20. August. (60) [Abb.]: Eine heldenhafte Tat der österreichisch-ungarischen Marine: Der kleine Kreuzer "Zenta" im Kampf mit der gesamten französischen Mittelmeerflotte am 16. August. (Links von dem Kreuzer der österreichisch-ungarische Torpedobootszerstörer "Ulan".) (61) [2 Abb.]: (1)Ein von den Russen in Ostpreußen zerstörter Kolonialwarenladen. (2)Blick vom Kirchturm in Gerdauen auf die zerstörte Stadt. (62) [Abb.]: Die Vernichtung der russischen Narew-Armeen in der Schlacht bei Tannenberg in Ostpreußen vom 26. bis zum 28. August: Die Flucht der Russen über eine nachts von ihnen geschlagene Notbrücke. (63) [2 Abb.]: (1)Bei den Kämpfen in Ostpreußen gefangenen Russen auf der Fahrt durch Hohensalza. (2)Ostpreußische Landsturmleute beim Sortieren von eroberten russischen Munitions- und Uniformstücken in Hohenstein. (64) [Abb.]: Ostpreußische Flüchtlinge bei ihrer Ankunft in Elbing. (65) [2 Abb.]: (1)General der Kavallerie von Rennenkampf x im Kreise seines Stabes in Insterburg. (2)Teilansicht der Stadt Lublin in Russisch-Polen. (66) [2 Abb.]: (1)Vom Kriegsschauplatz in Russisch-Polen: Lagerleben österreichisch-ungarischer Truppen in Feindesland. (2)Österreichisch-ungarische Truppen in den Schützengräben vor Lublin während einer zum Schlafen benutzten Feuerpause. (67) [Abb.]: Plündernde Kosaken werden in einem ungarischen Karpathendorfe von ungarischer Landwehr (Honvéd) überrascht und in die Flucht geschlagen. ([68 - 69]) [2 Abb.]: (1)Blick auf Lemberg, die Hauptstadt Galiziens. (2)Der ungarische Ministerpräsident Graf Stefan Tisza (70) [Abb.]: Straßenkampf der österreichisch-ungarischen Truppen mit den Einwohnern einer erstürmten serbischen Ortschaft. (71) Die galizischen Kämpfe. - Grenzgefechte gegen die Serben. (72) [Abb.]: Die in den Schlachten bei Krasnik und Komarow von den österreichisch-ungarischen Truppen erbeuteten russischen Geschütze vor dem Arsenal in Wien. (72) [Abb.]: Episode von der Erstürmung der serbischen Stadt Schabatz durch die österreichisch-ungarischen Truppen am 14. August. (73) [Abb.]: Eine österreichisch-ungarische Schleichpatrouille überrascht im Gebiet von Lublin eine Abteilung Russen, die zu Gefangenen gemacht werden. (75) [2 Abb.]: (1)Gefangengenommene Russen bei Neidenburg. (2)Ein Gruß in die Heimat. (76) [Abb.]: Vernichtung der serbischen Timokdivision durch österreichisch-ungarische Truppen. Im Vordergrunde Munitionswagen der zusammengeschossenen serbischen Batterien, rückwärts Sturm österreichisch-ungarischer Truppen auf die Komitatschis und serbische Infanterie am 6. September. ( - ) [3 Abb.]: (1)Typen des französischen Heeres. (2)Typen des russischen Heeres. (3)Typen des englischen Heeres. ([77]) [2 Abb.]: (1)General der Infanterie Moritz v. Auffenberg. (2)General der Kavallerie Victor Dankl. (78) Das deutsche Heer in Frankreich und Belgien während des zweiten Kriegsmonats. (78) [Abb.]: General Samsonow, der russische Oberkommandierende, der in der Schlacht bei Tannenberg fiel. (78) [2 Abb.]: Die österreichischen Motorbatterien, 30,5 cm-Geschütze, die uns ausgezeichnete Dienste leisteten. (79) [Abb.]: Die Liebestätigkeit des Roten Kreuzes: Verbinden und Verpflegen von Verwundeten nach Eintreffen des Eisenbahnzuges auf einem Bahnhof. (80) [2 Abb.]: (1)Vernehmung eines gefangenen französischen Husaren in Chateau-Salins. (2)Aufnahme der Verlustliste. (81) [Abb.]: Ein Feldpostamt des Gardekorps in Nordfrankreich. (83) [Abb.]: Aus den Oktoberkämpfen auf dem westlichen Kriegsschauplatz: Erstürmung eines von Zuaven und Turkos besetzten Hohlweges an der sogenannten Telegraphenhöhe durch zwei bayerische Reserveregimenter. (85) [Abb.]: Blick auf die französische Grenzfestung Belfort. (86) [Karte]: Zu den Kämpfen in den Vogesen und im Sundgau: Vogelschaukarte des Vogesengebietes. (87) [Abb.]: Vom westlichen Kriegsschauplatz: Deutsche Patrouillenfahrt im Automobil durch ein von Franzosen besetztes Dorf. ([88 - 89]) [5 Abb.]: (1)Generalleutnant v. Stein, Führer eines Reservearmeekorps, der ursprüngliche Generalquartiermeister. (2)Prinz Friedrich von Sachsen-Meiningen †. (3)General v. Einem, Führer einer Armee im Westen. (4)Friedrich Wilhelm, Prinz zur Lippe †. (5)Prinz Ernst von Sachsen-Meiningen †. (90) [Abb.]: Die erbitterten Kämpfe im Argonner Wald. (91) [2 Abb.]: (1)Morgenmärsche. (2)Eine Fuhrparkkolonne. (92) Der Lügenkrieg gegen Deutschland und Österreich-Ungarn und seine Abwehr. (93) [2 Abb.]: (1)Lagerleben. (2)Zur Mittagszeit. (93) [Abb.]:Im Schützengraben während eines Nachtgefechtes an der Aisne. (95) [Abb.]: Vor dem Stadthaus in Antwerpen nach der Besetzung der Stadt durch die deutschen Truppen. (97) [Abb.]: Genereal der Infanterie v. Beseler, der Eroberer des "uneinnehmbaren" Antwerpen. (98) [2 Abb.]: (1)Ein mit Maschinengewehr ausgerüstetes deutsches Motorboot kurz vor der Abfahrt zum Aufklärungsdienst im Englischen Kanal. (2)Nach der Eroberung Antwerpens: Das zerstörte Außenfort Ertbrand. Das Geschütz links wurde durch den Luftdruck eines 42-cm-Geschosses über den Festungsgraben vor den Eingang des Forts geschleudert. (99) [Abb.]: Blick auf Antwerpen mit der Kathedrale von der Reede aus. (100) [Karte]: Karte der Festung Antwerpen und ihres doppelten Fortsgürtels. (100) [8 Abb.]: Ansichten aus Belgien. (1)1. Blick auf die Stadt Lüttich. (2)2. Blick auf die Stadt Dinant mit der Zitadelle. (3)3. Gesprengte Brücke bei Andenne. (4)4. Namur mit zerstörter Brücke. (5)5. Das Rathaus in Löwen. (6)6. Das größte Kirchenfenster Europas, das sich in der Kathedrale zu Dinant befindet und unversehrt blieb. (7)7. Die Grande Place in Brüssel, links das Königshaus. (8)8. Der Marktplatz in Mecheln mit Lager von Seesoldaten. (101) Der Seekrieg mit England. (102) [Abb.]: Die Besatzung des deutschen Unterseebootes "U 9". X Kapitänleutnant Weddigen. (102) [Abb.]: Die Vernichtung der drei Panzerkreuzer "Aboukir", "Hogue" und Cressy" durch das deutsche Unterseeboot "U 9" unter dem Kommando des Kapitänleutnants Otto Weddigen am Morgen des 22. September 20 Seemeilen nordwestlich von Hoek van Holland. (103) [Abb.]: Fregattenkapitän Karl v. Müller, der ruhmgekrönte Kapitän des kleinen Kreuzers "Emden". (104) [Abb.]: Die Rückkehr des sieggekrönten Unterseebootes "U 9" nach Wilhelmshaven am 23. September: Jubelnde Begrüßung des Unterseebootes und seiner heldenmütigen Besatzung durch die Mannschaften der Kriegsschiffe. (105) [Abb.]: Vom westlichen Kriegsschauplatz: Das Gefecht an einem Eisenbahndamm bei Chaulnes am 23. Oktober. (106) [2 Abb.]: (1)Feldbäckerei. (2)Ein improvisierter Pferdestall. (107) [Abb.]: Deutsche Brückenwache an der Maas. ([108 - 109]) Eroberung Belgiens. Antwerpens Fall. (110) [2 Abb.]: (1)Die Kiautschoe-Bucht. (2)Kapitän zur See Meyer-Waldeck, Gouverneur des deutschen Schutzgebietes Kiautschou, der heldenmütige Verteidiger von Tsingtau. (111) [2 Karten]: (1)Das deutsche Schutzgebiet Kiautschou aus der Vogelschau. (2)Tsingtau (111) [2 Abb.]: (1)Feldmarschalleutnant v. Kusmanek, der tapfere Kommandant der Festung Przemysl. (2)Mörderischer Kampf in einem Graben der Festung Przemysl. (112) [Abb.]: General d. Infanterie Svetozar Boroevic v. Bojna, der erfolgreiche Führer der bei Przemysl gegen die Russen kämpfenden österreichisch-ungarischen Armee. (113) Die Kämpfe Österreich-Ungarns im Oktober. (113) [2 Abb.]: (1)Feldzeugmeister Potiorek, der Führer der österreichisch-ungar. Armee gegen Serbien. (2)Das Gebetbuch als Lebensretter: Die durchgeschlagenen Seiten des Gebetbuches mit der steckengebliebenen Schrapnellkugel. (114) [Abb.]: Die Niederlage der aus Galizien über die Karpathenpässe in Ungarn eingefallenen Russen bei Maramaros-Sziget. Im Vordergrunde polnische Legionäre, die mit dem ungarischen Landsturm an Tapferkeit wettstreiten. (115) [Abb.]: Vormarsch bosnisch-herzegowinischer Infanterie sowie einer Maschinengewehrabteilung im Gebiete des oberen Drina während der Kämpfe im östlichen Bosnien gegen die Serben und Montenegriner. ( - ) [Abb.]: Verhör russischer Spione an der deutschen Ostgrenze. (117) [Abb.]: Vom westlichen Kriegsschauplatz: Eine Episode aus der Schlacht bei Noyon in Nordfrankreich am 16. und 17. September; der erfolgreiche Angriff hanseatischer Reserveregimenter bei Chiry und Ribécourt. ([118 - 119]) [Abb.]: Die Säuberung eines Karpathenpasses von den aus Galizien eingedrungenen Russen durch österreichisch-ungarische Truppen. (121) [Abb.]: "Zierden" der russischen Armee: Kalmücken, die nach Aussagen sowohl der Russen als auch unserer Ostpreußen die schlimmsten Mordbrenner unter den Kosaken sind. (122) Deutsch-russische Kämpfe bis Ende Oktober. (122) [Abb.]: In Galizien gefangengenommene Russen. (122) [Abb.]: Trag- und fahrbare Feldküchen der russischen Armee, wie sie vielfach von unseren Truppen in Ostpreußen erbeutet wurden. (123) [2 Abb.]: (1)Serbische Komitatschis, die in Kreka bei Tuzla gefangen genommen wurden. (2)Belgrad von der Donauseite. (125) Die neutralen Mächte. - Die Kämpfe auf dem Balkan. - Der Eintritt der Türkei in den Weltkrieg. (126) [Abb.]: Von den österreichisch-ungarischen Truppen eroberte serbische Geschütze. (126) [Karte]: Karte des türkisch-ägyptischen Grenzgebietes. (127) [Abb.]: Ein Besuch des Kaisers Franz Joseph von Österreich in einem Verwundetenspital zu Wien. ([128 - 129]) [4 Abb.]: (1)Sultan Muhammed V. Kaiser der Osmanen seit dem 27. April 1909. (2)Abbas II. Khedive (Vizekönig) von Ägypten (x). (3)Generalleutnant Liman v. Sanders, Chef der deutschen Militärmission für die Türkei. (4)General Enver-Pascha, Generalissimus der türkischen Streitkräfte und Kriegsminister. (131) [Karte]: Die Dardanellenstraße und ihre Umgebung aus der Vogelschau. (132) [2 Abb.]: (1)Türkische Kavallerie. (2)Persische Offiziere. (133) [2 Abb.]: (1)Der Bosporus. (2)Zur Erklärung des heiligen Krieges in Konstantinopel am 14. November: Die Kundgebung des türkischen Volkes vor dem ottomanischen Kriegsministerium. (134) [Abb.]: Kampf der türkischer Dardanellenforts gegen die vereinigte englische und französische Flotte. (135) [2 Abb.]: (1)Der Suezkanal in der Nähe von Ismailia, der in der Mitte des Kanals gelegenen ägyptischen Stadt. (2)Der Suezkanal bei Port Said (Hafen und Leuchtturm). (136) [2 Abb.]: (1)Beduinen. (2)Eine Gruppe Kaschkai-Nomaden. Dieser Volksstamm gilt in Persien als besonders kriegstüchtig. (137) [Abb.]: Vom westlichen Kriegsschauplatz: Das siegreiche Vorgehen von Truppen der I. Armee bei Nampcel südlich von Noyon während der Oktoberkämpfe. ([138 - 139]) Die deutschen Veröffentlichungen über die Vorgeschichte des Krieges. (140) [2 Abb.]: (1)Flüchtlinge vor dem Kloster Dinant. (2)Das Rathaus in St. Quentin. (141) [2 Abb.]: (1)Das Rathaus in Lille, von deutschen Granaten getroffen. (2)Rasttag in Sillery in Frankreich. (142) [3 Abb.]: (1)Ein Unterstand bei Moronvillers. (2)Schottischer Dudelsackbläser. (3)Schottische Soldaten. (143) [Abb.]: Feuerüberfall auf eine in die Infanterielinie vorgeschobene Feldartillerie-Beobachtungsstelle in der Gegend von Antilly bei Betz (Departement Oise). (145) [Abb.]: Die Post passiert die Vorposten. (146) [Abb.]: Deutsche Minenwerfer zerstören französische Schützengräben als Vorbereitung eines Sturmangriffs. (147) [Abb.]: Im Überschwemmungsgebiet bei Dixmuiden. ([148 - 149]) [2 Abb.]: (1)Ein Rasttag in Sillery in Frankreich. (2)Apell der Etappentruppen - in der Mitte Landsturmbataillon I München - auf dem Marktplatz in Cambrai. (150) [2 Abb.]: (1)Ein Kampf in den Lüften: Angriff eines von zwei Offizieren der Fliegerabteilung 30 des II. Armeekorps geführten Doppeldeckers auf einen der Beobachtung der Artilleriewirkung dienenden französischen Fesselballon. (2)Auch eine Ballonabwehrkanone. (151) Die Ereignisse im Westen bis Ende November. (152) [Abb.]: Ein englischer Schützengraben mit Leichen vor dem Ennetières westlich von Lille am Tage nach der Erstürmung. Im Hintergrund ein zerschossenes Fabriksgebäude. (153) [Abb.]: Phantastische Brandruinen in Lille. (154) [Abb.]: Die Flucht der französischen Besatzung und der Einwohner von Lille aus dem brennenden Stadtviertel bei der Porte de Douai kurz vor der Übergabe der Stadt. (155) [Abb.]: Der Sturm des Königlich Sächsischen 15. Infanterie-Regiments Nr. 181 auf die Porte de Douai in Lille am 12. Oktober 1914. ( - ) [Abb.]: Der Kaiser während des Besuchs in einer Artilleriestellung auf dem westlichen Kriegsschauplatz. (157) [4 Abb.]: (1)An den Kämpfen in Frankreich teilnehmende indische Sikhs. (2), (3)Die Bilder zeigen zwei verwundete französische Kriegsgefangene, die im Kriegslazarett I in Brüssel photographiert worden sind. Der aus Guinea (Afrika) stammende Gefangene auf dem Bilde links hat laut vorliegender amtlicher Meldung bei seiner Vernehmung durch einen Feldkriegsgerichtsrat erklärt, daß es in seinem Heimatsdorf Menschenfresser gäbe. Er bestreitet allerdings - vielleicht aus naheliegenden Gründen - selbst jemals Menschenfleisch gegessen zu haben. Der Gefangene auf dem Bilde rechts stammt aus Senegal. (4)Typen aus dem Zossener Gefangenenlager. (159) [2 Abb.]: (1)Nieuport, die Hafenstraße. (2)Ypern mit der Haupstraße. (160) [Abb.]: Ein Artilleriebeobachtungsstand vor Ypern. Mittels des Scherenfernglases beobachten die Offiziere das Einschlagen der im Hintergrund feuerenden Geschütze und geben durch Telephon entsprechende Befehle an die Batterie. (161) [3 Abb.]: (1)Verwundete Franzosen in Mariembourg in Belgien. (2)Die Apothekenwagen. (3)Gefangenenlager in Mariembourg in Belgien. (162) [Abb.]: Eine Episode aus den Kämpfen an der Marne; die Heldentat eines todesmutigen deutschen Pionieroffiziers, der bei der Kontrolle der Minenlegung auf einer Marnebrücke von heranschleichenden Zuaven überrascht wurde und den Befehl zur Brückensprengung gab. Hierbei flog er selbst mit den Feinden in die Luft. (163) Der Krieg zur See bis Ende November. (163) [3 Abb.]: Drei Skizzen vom westlichen Kriegsschauplatz von dem im Felde weilenden Mitarbeiter der "Illustrirten Zeitung" O. J. Olbertz. (164) [Abb.]: Die Erstürmung einer englischen Batterie bei Ypern. (165) [Abb.]: Das gute Einvernehmen zwischen den deutschen Besatzungstruppen in Belgien und der einheimischen Bevölkerung: Deutsche Matrosen während des Aufenthaltes in einem Küstenort an der belgisch-holländischen Grenze. (166) [3 Abb.]: (1)General der Infanterie Freiherr v. Scheffer-Boyadel. (2)General der Infanterie v. Woyrsch. (3)Generalleutnant v. Litzmann. (167) [Abb.]: Die Vernichtung des englischen Südamerika-Geschwaders bei der Insel Santa Maria auf der Höhe von Coronel an der chilenischen Küste durch das unter dem Kommando des Vizeadmirals Grafen v. Spee stehende deutsche Kreuzergeschwader am 1. November. ([168 - 169]) [Abb.]: Ein schwerer Verlust der englischen Marine: Der Untergang des Großkampfschiffes "Audacious" an der irischen Küste. (171) [3 Abb.]: (1)Generaloberst v. Mackensen. (2)Generalleutnant v. Morgen. (3)Generalfeldmarschall v. Hindenburg mit seinem Stabe. Links von Generalfeldmarschall v. Hindenburg sein Generalstabschef Generalleutnant Ludendorff, rechts der erste Gehilfe des Generalstabschef Oberleutnant Hoffmann. (173) [2 Abb.]: (1)Eine Schlafstelle der Kraftwagenoffiziere des Generalkommandos des XIX. Armeekorps. (2)Die Uhr als Lebensretter. (174) [Karte]: Karte von Russisch-Polen. (175) Deutsche Kämpfe im Osten. (176) Die Ereignisse auf dem östlichen Kriegsschauplatz seit Mitte September. (176) [Abb.]: Von den entscheideneden Kämpfen in Nordpolen, die zum Zusammenbruch der russischen Offensive gegen Schlesien und Polen und zum Rückzug der russischen Hauptkräfte nach der Weichsel führten: Der heldenmütige Nachtangriff westpreußischer und hesischer Regimenter auf eine beherrschende russische Stellung unter heftigem feindlichen Artilleriefeuer in der Nacht vom 16. zum 17. Dezember. (177) [Abb.]: Mit Maschinengewehren augerüstete Motorboote des Freiwilligen Motorbootkorps auf der Weichsel bei Wlozlawek während der Beschießung eines russischen Fliegers, der zur Landung gezwungen wird. (179) [Abb.]: Die Piotrkowskaja (Hauptstraße) in Lodz nach der Besetzung der Stadt durch die deutschen Truppen am 6. Dezember. (180) [2 Abb.]: (1)Erzherzog-Thronfolger Karl Franz Joseph von Österreich im Hauptquartier des österreichisch-ungarischen Heeres. (2)Dekorierung österreichisch-ungarischer Soldaten mit der Tapferkeitsmedaille durch Erzherzog Peter Ferdinand von Österreich. (181) [Abb.]: Eine interssante photographische Aufnahme: Das Einschlagen und Krepieren einer 30,5-cm-Granate. (182) [Abb.]: Eine ruhmvolle Waffentat der österreichisch-ungarischen Truppen in Russisch-Polen: Die Erstürmung von Petrikau durch das k. und k. Infanterieregiment Wilhelm I. Deutscher Kaiser und König von Preußen Nr. 34 am 16. Dezember 1915. (183) Die Kämpfe der Österreicher und Ungarn mit den Russen und Serben bis Ende des Jahres 1914. (184) [Karte]: Zu den Kämpfen in Galizien und in der Bukowina: Reliefkarte des heißumstrittenen Karpathengebietes. (185) [Abb.]: Eine österreichisch-ungarische Verwundeten-Transportkolonne. (186) [Abb.]: Ein während des Marsches an den Nordhängen des Duklapasses von Tscherkessen und Kosaken überfallener österreichisch-ungarischer Train wird durch eine Abteilung ungarischer Husaren wieder befreit. (187) [Abb.]: Der erbitterte Nahkampf der ungarischen Nádasdy-Husaren mit den Russen im Birkenwalde bei Limanowa, durch den die Schlacht vom 10. bis zum 12. Dezember zugunsten der österreichisch-ungarischen Waffen entschieden wurde. (189) Der Islam im Weltkrieg bis Ende 1914. (190) [2 Abb.]: (1)Gräber der bei Limanowa Gefallenen . (2)Die deutsch-österreichisch-ungarische Waffenbrüderschaft. (190) [2 Abb.]: (1)Vom galizischen Kriegsschauplatz: Im Schützengraben bei Trabki: "Freund oder Fein?" (2)Grundlos (Schwere Haubitzen). (191) [Abb.]: Ein Überfall auf eine Kalmücken-Kavalleriepatrouille, die zum Zweck der Aufklärung die Karpathenhänge nördlich von Mezö-Laborcz durchstreifte, durch eine ungarische Landsturmabteilung. ([192 - 193]) [2 Abb.]: (1)Hussein Kiamil, der von England mit dem Titel eines Sultans eingesetzte Gegenkhedive von Ägypten, ein Onkel des rechtmäßigen Khediven Abbas II. Hilmi. (2)Die Türkei im Kriege: Eine deutschfreundliche Kundgebung der türkischen Bevölkerung von Jaffa in Palästina vor dem Gebäude der Deutschen Palästinabank. Die Menge trägt schwarz-weiß-rote Fahnen. (195) Ereignisse in den überseeischen Ländern während des November und Dezember. - Der Krieg zur See im Dezember 1914. (196) [Abb.]: Mittagsrast türkischer Truppen beim Bahnhof von Jerusalem. (196) [2 Abb.]: (1)Die Ausbildung türkischer Reservetruppen in Gallipoli: Türkische Infanterie beim Vorgehen zur Schützenlinie. (2)Zu der ruhmreichen Tätigkeit der türkischen Flotte im Schwarzen Meer: Konteradmiral Souchon mit seinem Stabe. Von links nach rechts: Türkischer Chef des Admiralstabes Fregattenkapitän Enver-Bei (nicht zu verwechseln mit dem gleichnamigen türkischen Kriegsminister), I. Admiralstabsoffizier Korvettenkapitän Busse, Konteradmiral Souchon, II. Admiralstabsoffizier Korvettenkapitän Büchsel, Flaggleutnant Oberleutnant z. S. Wichelhausen, türkischer Flaggleutnant Oberleutnant z. S. Hakki. (197) [Abb.]: Beduinenattacke gegen englische Truppen in der Nähe des Suezkanals. (198) [Abb.]: Abmarsch türkischer Truppen zur Front vom Davidstor in Jerusalem auf dem Weg nach Bethlehem. (199) [Abb.]: Heimatlieder. ( - ) [Abb.]: Zu dem Vorstoß von Teilen der deutschen Hochseestreitkräfte nach der englischen Ostküste: Die Beschießung befestigter Küstenplätze am Morgen des 16. Dezember. (201) [Abb.]: Vizeadmiral Graf von Spee. (202) [Abb.]: Ein Stellungswechsel der deutschen Truppen im Überschwemmungsgebiet. (203) [Abb.]: Der Hafen von Nieuport. (204) [Abb.]: Lombartzyde mit der Yser. (205) Der Krieg im Westen vom 1. Dezember 1914 bis Ende Februar 1915. (205) [2 Abb.]: (1)Schützenlinie. (2)Zu den Kämpfen bei Soissons: Eine Maschinengewehrabteilung in Deckung gegen Artilleriefeuer in Erwartung des Befehls zum Vorgehen. (207) [Abb.]: Am Ufer der Aisne. (208) [4 Abb.]: (1)General der Infanterie v. Lochow. (2)General v. Mudra. (3)Generalleutnant Wichura. (4)Generalleutnant Wild v. Hohenborn, der neuernannte preußische Kriegsminister, der seit 27. November 1914 Generalquartiermeister war. (209) [Abb.]: Das Gefechtsfeld südwestlich La Bassée am Abend des 7. Februar 1915. (210) [Abb.]: Aus den Kämpfen bei Soissons: Die Deutschen gehen aus den Schützengräben zum Sturm vor. (211) [2 Abb.]: Bilder vom westlichen Kriegsschauplatz: ( - ) Der Krieg zur See und in der Luft vom 1. Januar bis 18. Februar 1915. (213) [3 Abb.]: (1)General der Infanterie d'Elsa. (2)General v. Gersdorff. (3)General von der Planitz. (213) [Abb.]: Die sich täglich noch immer mehrenden Säcke der Feldpost in einem Städtchen an der Aisne. (214) [Abb.]: Vom westlichen Kriegsschauplatz: Nach der Schlacht. (215) [Karte]: Übersichtskarte zu den Kämpfen im Oberelsaß. (217) [Abb.]: Eine deutsche Skiläuferpatrouille in den Vogesen. (218) [2 Abb.]: (1)Aus den Kämpfen um die Höhe 425 bei Sennheim. (2)Eine von den Franzosen zum Schutz gegen das Vordringen der Deutschen auf einer Waldstraße in den Vogesen errichtete Barrikade. (219) [Abb.]: Admiral v. Pohl, Chef des Admiralstabes der Marine. (220) [Karte]: Karte vom westlichen Kriegsschauplatz. ( - ) [2 Abb.]: (1)Abwehr eines englischen Fliegerangriffs durch die Besatzung eines deutschen Unterseebootes. (2)Getauchtes Unterseeboot in englischen Gewässern. (221) [Abb.]: Ein deutsches Unterseeboot kapert einen englischen Handelsdampfer, um ihn zu versenken. (223) Die Kämpfe des deutschen Ostheeres im Januar und Februar. (224) [Abb.]: Von der Rekrutierung in Rußland: Das letzte Aufgebot. (225) [4 Abb.]: (1)General der Infanterie v. Below. (2)Generaloberst v. Eichhorn. (3)Generalleutnant v. Kosch. (4)Generalleut. Freih. v. Freytag-Loringhoven, der neuernannte Generalquartiermeister. (227) [Abb.]: Am Grabe des Kameraden. (228) [2 Abb.]: (1)Ein Zeugnis russischer "Kultur" in Ostpreußen: Die von den Russen vor ihrem Rückzug zerstörte Bank in Pillkallen. Im Hintergrunde der gesprengte Kassenschrank. (2)Ein nicht abzuleugnendes Beweisstück der russischen Plünderungssucht: Blick in den Güterwagen eines erbeuteten "Raub"-Zuges mit von Russen gestohlenen Gegenständen aus ostpreußischen Städten und Ortschaften. (229) [Abb.]: Brückenbau über die Weichsel durch deutsche Pioniere. (230) [Abb.]: deutscher Sturmangriff in Russisch-Polen. (231) [Abb.]: Nach der Winterschlacht in Masuren: Verfolgung der geschlagenen Russen. (232) [Karte]: Übersichtskarte über das Gebiet der neuntägigen Schlacht in Masuren, in der die russische X. Armee in harten Kämpfen vom 7. bis zum 15. Februar über die Grenze geworfen und schließlich in nahezu völliger Einkreisung vernichtend geschlagen wurde. (233) [Abb.]: In einem Unterstand an der Rawka, wo die Russen starke Verteidigungsstellungen zum Schutze Warschaus eingenommen haben. (235) [2 Abb.]: (1)Ein Bismarck-Denkmal in Russisch-Polen: Das am 1. April, dem hundertsten Geburtstag des Altreichskanzlers, in Swienta Anna bei Koniecpol im Kreise Kalisch enthüllte Bismarck-Denkmal mit den Offizieren, die der Einweihung beiwohnen. (2)Eine deutsche Feldbäckerei in Pillkallen vor dem Ausmarsch nach Rußland. (236) [Abb.]: Hinter der Front auf dem östlichen Kriegsschauplatz: Löhnungsappell. (237) Wirkung des Krieges auf das wirtschaftliche Leben der Völker bis Frühlingsanfang 1915. (238) [Abb.]: Der Kaiser unter seinen siegreichen Truppen auf dem Marktplatz in Lyck am 14. Februar nach der Vertreibung der Russen aus ihren um die Stadt angelegten Stellungen. (239) [Abb.]: In der zerstörten Stadt Lyck, deren Einwohner durch die siegreichen deutschen Truppen am 14. Februar einen Teil der gewaltigen Winterschlacht in den Masuren bildete. Rechts russische Gefangene. (240) [2 Abb.]: (1)Dr. Karl Helfferich, der neuernannte Staatssekretär des Reichsschatzamtes. (2)Liebestätigkeit unserer Eisenbahner in Feindesland: Verteilung von Kohlen beim Aufenthalt auf einer Station in Nordfrankreich. (241) [Abb.]: General der Infanterie v. Linsingen (x), Führer der deutschen Südarmee in den Karpathen mit seinem Stabe. (243) [Abb.]: Sanitätswagen. (244) [Abb.]: Weihnachtsfeier 1914 des Generalkommandos des XIX. Armeekorps in einer flandrischen Kirche. ( - ) [Abb.]: Bei den österreichisch-ungarischen Truppen in Galizien: Ein aus primitiven Mitteln hergestellter Desinfektionsapparat zur Bekämpfung der Läuseplage für die im Felde stehenden Mannschaften in Galizien. (245) [2 Abb.]: (1)Abendstimmung bei Haidar Pascha. Im Hintergrund Konstantinopel. (2)Das Gebet beim feierlichen Abschied des Oberbefehlshabers der gegen den Suezkanal operierenden Truppen, Dschemal-Pascha (vorn in der Mitte), von Damaskus. Hinter ihm (mit dem Band des Eiserenes kreuzes im Knopfloch) Oberst v. Frankenberg, ihm zur Seite (den Handschuh in der Hand) Fathriddine-Pascha, Gouverneur von Damaskus. (247) [Abb.]: Anatolische Kavallerie, fertig zum Ausmarsch an die Front. (248) Der Türkenkrieg vom 1. Januar 1915 bis zur ersten Niederlage der Engländer und Franzosen vor den Dardanellen. (248) [Abb.]: Eine Erdbatterie im Fort Hamidijé. (248) [Karte]: Karte des Kaukasusgebietes und der angrenzenden Länder. (249) [Abb.]: Aufstellung türkischer Maschinengewehre an einem Waldesrand im Kaukasus. (251) [Abb.]: Vom Kriegsschauplatz in Galizien: Eine österreichisch-ungarische Munitionskolonne in schwierigem Terrain. (253) Österreichs und Ungarns Kämpfe im Januar und Februar 1915. (254) [2 Abb.]: (1)In einem österreichisch-ungarischen Flugzeug. Der vorn sitzende Offizier betätigt während des Fluges den Hebel zum Abwerfen von Bomben. (2)Die von den österreichisch-ungarischen Truppen gesprengte Brücke über den Dunajec bei Alt-Sandec. (255) [Abb.]: Die österreichisch-ungarische Offensive in der Bukowina: Rückzug der Russen. (256) [3 Abb.]: Bilder vom östlichen Kriegsschauplatz. (1), (2)Verwundeter Ungar. (3) Zusammengeschossene Feldbefestigung in Russisch-Polen. ( - ) Der Seekrieg vom 18. Februar bis Ende März 1915. (257) [Abb.]: Vom Kriegsschauplatz in Galizien: Eine Episode aus den Kämpfen bei Wladovice. Der Angriff einer österreichisch-ungarischen Infanterbrigade auf die von Russen besetzten Höhen südlich von Rzedkovice. (257) [Abb.]: Ein Nachtangriff der österreichisch-ungarischen Truppen gegen die Russen westlich von Neu-Sandec (Galizien). (258) [Abb.]: Der berühmte schwedische Forscher Sven Hedin (links), den die Royal Geographical Society in London wegen der wahrheitsgetreuen Schilderung seiner Erlebnisse an der Westfront als Ehrenmitglied der Gesellschaft gestrichen hat, auf dem östlichen Kriegsschauplatz. Rechts Rittmeister Tzschirner. (259) [Abb.]: Kapitänleutnant v. Mücke. (261) [Karte]: Karte zu der kühnen Fahrt von S. M. Hilfskreuzer "Ayesha" (Emden II). (261) Die Kämpfe im Westen bis zum deutschen Siege bei Ypern. (262) [Abb.]: Ein französisches Panzerautomobil im Kampf mit deutschen Vorposten auf der Combres-Höhe. (263) [Abb.]: Vom Kriegsschauplatz in den Vogesen: Landsturmleute bringen die Abendsuppe in die Stellung. (264) [4 Abb.]: Augenblicksbilder vom westlichen Kriegsschauplatz. ( - ) [2 Abb.]: (1)Französischer Drahtverhau. (2)Auf dem Vormarsch. (265) [Abb.]: Nachtangriff auf französische Stellungen an der Loretto-Höhe. (267) [Abb.]: Vom westlichen Kriegsschauplatz: Am Feldtelephon. (268) [Karte]: Zu den Kämpfen zwischen Maas und Mosel: Reliefkarte des Gebiets zwischen Verdun und Metz. (269) [Abb.]: Becelaere. (270) [Abb.]: Der deutsche Angriff mittels Gasbomben auf die feindlichen Stellungen bei Steenstraate. (271) [2 Abb.]: (1)Deutsche Soldaten üben sich mit französischen Maschinengewehren ein. (2)Eine Munitionskolonne im Schrapnellfeuer bei Neuve-Chapelle. (272) [2 Abb.]: (1)Von der schweren Niederlage der Engländer und der Franzosen bei Ypern in den Tagen vom 22. April bis Monatsende: Die Bergung einer eroberten schweren englischen Haubitze. (2)Rast der 47. Brigade im Tal des Durthe. (273) [Abb.]: (1)Der requirierte Bagagewagen. (2)"Liebe Mutter!" Im Schatten der Protzen. (274) [Abb.]: Von den Kämpfen in den Vogesen: Die Wiedereroberung des vielumstrittenen Hartmannsweilerkopfes durch die deutschen Truppen am 25. April. (275) Der Seekrieg mit England von Anfang April bis zum Untergang der "Lusitania". (276) [Abb.]: Rast an der Kirche in St. Souplet. Die Truppe trifft Vorbereitungen sich auf der Strasse häuslich einzurichten. ( - ) [Abb.]: Eine Funker-Abteilung auf dem Marsche. (277) [Abb.]: Kapitänleutnant Otto Weddingen, der heldenmütige verewigte Kommandant von "U 9" und später "U 29". (278) [Abb.]: Der Kampf eines deutschen Marineluftschiffes mit englischen Unterseebooten in der Nordsee am 3. Mai, wobei eines der mit Bomben beworfenen Boote zum Sinken gebracht wurde. (279) Die Kämpfe des deutschen Ostheeres im März und April. (280) [Abb.]: In einem Schützengraben am Dunajec. (281) Österreichs und Ungarns Kämpfe im März und April. (282) [Abb.]: Deutsche Truppen in den Karpathen auf dem Vormarsch in das Laborczatal. (282) [Abb.]: Flankenangriff einer österreichisch-ungarischen Husaren-Abteilung auf die ein galizisches Gehöft verteidigenden Russen. (283) [Abb.]: Feinde in Sicht. (284) [Abb.]: Eine österreichisch-ungarische Divisionsbäckerei. (285) [Abb.]: Von den schweren Kämpfen der österreichisch-ungarischen Truppen in den Karpathen: Ein Artilleriebeobachtungsposten beim Linzer Infanterie-Regiment Nr. 14. Die russischen Stellungen werden mit Schrapnells beschossen. (286) [Abb.]: Eine Feldmesse vor der Schlacht bei den österreichisch-ungarischen Truppen. (287) [Abb.]: Zu der ehrenvollen Übergabe der Festung Przemysl am 22. März, nach viereinhalbmonatiger Einschließung: Die Helden von Przemysl, Festungskommandant General der Infanterie v. Kusmanek, mit seinem engeren Stabe. Von links nach rechts: Untere Reihe: Oberleutnant Dr. Wlodzimierz, Ritter v. Blazovsky, Hauptmann Hubert Kurz, Intendant Alois Rausch, General Hermann v. Kusmanek, Oberleutnant Ottokar Hubert, Hauptmann Friedrich Zwiedinek, Hauptmann Gustav v. Kubik. Mittlere Reihe: Oberleutnant Andreas Puchner, Oberleutnant Felix Hölzer, Hauptmann Alfred Lutsch, Unterintendant Joseph Frhr. v. Tkalcsevich, Hauptmann Joseph Kurz v. Traubenstein, Rittmeister Hugo Frhr. de Pont, Leutnant Rudolf Mossig, Fähnrich Gustav Schnabl. Obere Reihe: Oberleutnant Alois Zimmermann, Oberleutnant Ludolf Elbrich, Leutnant Herbert Schlegel, Leutnant Alfred Nechuta, Leutnant Georg Auspitz, Leutnant Schanzer. (288) [2 Abb.]: Erbeutete russische Leuchtraketen werden für die Nacht gebrauchsfertig gemacht. (2)Vom Kriegsschauplatz in den Karpathen: Eine österreichisch-ungarische Artilleriestellung (Schwere Haubitzen). (289) [2 Abb.]: (1)Erbeutete, mit russischer schwerer Artilleriemunition beladene Schmalspurwagen. (2)Von den Russen zurückgelassene schwere Artillerie-Munition (Geschoßlänge 1 1/2 Meter). (290) [Karte]: Reliefkarte des Dardanellengebiets. Im Vordergrund die englisch-französische Flotte während der Beschießung der Dardanellenforts am 18. März, die mit einem glänzenden Sieg der Türken endete. (291) [2 Abb.]: (1)Eine Militär-Karawane mit Proviant an den Dardanellen. (2)Eine türkische Feldküche. (292) Der Türkenkrieg vom 19. März bis Ende April. (292) [4 Abb.]: (1)Dschemal-Pascha (x), Oberbefehlshaber der IV. Armee in Beirut, rechts der Wali von Beirut (XX). (2)Der Drusenfürst vom Libanon, der mit seinen Leuten am Suezkanal gegen die Engländer Kämpft. (3)Transport von Futtermitteln für die Kavallerie. (4)Eine türkische Batterie gefechtsbereit am Suezkanal. (293) [Abb.]: Ein großes Trainlager auf der Halbinsel Gallipoli. (294) [Abb.]: Von der Feier der Übertragung des Titels "El Ghazi" (der Sieggekrönte) an Sultan Muhammed Reschad Chan V. in Konstantinopel am 30. April: Der Sultan begibt sich in feierlichem Zuge zum Selamlik in die Aja-Sophia-Mosche, wo ihm der Titel "El Ghazi" verliehen wurde, ein Beiname, den seit Jahrhunderten kein Sultan mehr geführt hat. (295) Der See- und Luftkrieg im Mai. (296) [Abb.]: Zu der Torpedierung des 12 600 t großen französischen Panzerkreuzers "Léon Cambetta" durch das österreichisch-ungarische Unterseeboot "U 5" in der Straße von Otranto 20 Meilen vom Kap Santa Maria die Leuca in der Nacht vom 26. zum 27. April: Das Kriegsschiff im Sinken nach der zweiten Torpedierung. (297) [2 Abb.]: (1)Ein von deutschen Marineartilleristen bedientes Küstengeschütz in einem Dardanellenfort während des Gefechts am 18. März 1915. (2)Zu dem glänzenden türkischen Sieg über die vereinigte englisch-französische Flotte in den Dardanellen: Der Untergang des französischen Linienschiffs "Bouvet" am 18. März. (Rechts ein havariertes englisches Schlachtschiff mit starker Schlagseite.) (298) [Abb.]: Türkische Truppen in Verteidigungsstellung bei Kum-Kale. (299) Einband ( - )
BACKGROUND: Traumatic brain injury (TBI) and spinal cord injury (SCI) are increasingly recognised as global health priorities in view of the preventability of most injuries and the complex and expensive medical care they necessitate. We aimed to measure the incidence, prevalence, and years of life lived with disability (YLDs) for TBI and SCI from all causes of injury in every country, to describe how these measures have changed between 1990 and 2016, and to estimate the proportion of TBI and SCI cases caused by different types of injury. METHODS: We used results from the Global Burden of Diseases, Injuries, and Risk Factors (GBD) Study 2016 to measure the global, regional, and national burden of TBI and SCI by age and sex. We measured the incidence and prevalence of all causes of injury requiring medical care in inpatient and outpatient records, literature studies, and survey data. By use of clinical record data, we estimated the proportion of each cause of injury that required medical care that would result in TBI or SCI being considered as the nature of injury. We used literature studies to establish standardised mortality ratios and applied differential equations to convert incidence to prevalence of long-term disability. Finally, we applied GBD disability weights to calculate YLDs. We used a Bayesian meta-regression tool for epidemiological modelling, used cause-specific mortality rates for non-fatal estimation, and adjusted our results for disability experienced with comorbid conditions. We also analysed results on the basis of the Socio-demographic Index, a compound measure of income per capita, education, and fertility. FINDINGS: In 2016, there were 27·08 million (95% uncertainty interval [UI] 24·30-30·30 million) new cases of TBI and 0·93 million (0·78-1·16 million) new cases of SCI, with age-standardised incidence rates of 369 (331-412) per 100 000 population for TBI and 13 (11-16) per 100 000 for SCI. In 2016, the number of prevalent cases of TBI was 55·50 million (53·40-57·62 million) and of SCI was 27·04 million (24·98-30·15 million). From 1990 to 2016, the age-standardised prevalence of TBI increased by 8·4% (95% UI 7·7 to 9·2), whereas that of SCI did not change significantly (-0·2% [-2·1 to 2·7]). Age-standardised incidence rates increased by 3·6% (1·8 to 5·5) for TBI, but did not change significantly for SCI (-3·6% [-7·4 to 4·0]). TBI caused 8·1 million (95% UI 6·0-10·4 million) YLDs and SCI caused 9·5 million (6·7-12·4 million) YLDs in 2016, corresponding to age-standardised rates of 111 (82-141) per 100 000 for TBI and 130 (90-170) per 100 000 for SCI. Falls and road injuries were the leading causes of new cases of TBI and SCI in most regions. INTERPRETATION: TBI and SCI constitute a considerable portion of the global injury burden and are caused primarily by falls and road injuries. The increase in incidence of TBI over time might continue in view of increases in population density, population ageing, and increasing use of motor vehicles, motorcycles, and bicycles. The number of individuals living with SCI is expected to increase in view of population growth, which is concerning because of the specialised care that people with SCI can require. Our study was limited by data sparsity in some regions, and it will be important to invest greater resources in collection of data for TBI and SCI to improve the accuracy of future assessments. FUNDING: Bill & Melinda Gates Foundation. ; Bill & Melinda Gates Foundation ; We acknowledge the funding and support of the Bill & Melinda Gates Foundation. AK was supported by the Miguel Servet contract, which was financed by the CP13/00150 and PI15/00862 projects integrated into the National Research, Development, and Implementation,and funded by the Instituto de Salud Carlos III General Branch Evaluation and Promotion of Health Research and the European Regional Development Fund (ERDF-FEDER). AMS is supported by the Egyptian Fulbright Mission Program. AF acknowledges the Federal University of Sergipe (Sergipe, Brazil). AA received financial assistance from the Indian Department of Science and Technology (New Delhi, India) through the INSPIRE faculty programme. AS is supported by Health Data Research UK. DJS is supported by the South African Medical Research Council. AB is supported by the Public Health Agency of Canada. SMSI received a senior research fellowship from the Institute for Physical Activity and Nutrition, Deakin University (Waurn Ponds, VIC, Australia), and a career transition grant from the High Blood Pressure Research Council of Australia. FP and CF acknowledge support from the European Union (FEDER funds POCI/01/0145/FEDER/007728 and POCI/01/0145/FEDER/007265) and National Funds (FCT/MEC, Fundação para a Ciência e a Tecnologia, and Ministério da Educação e Ciência) under the Partnership Agreements PT2020 UID/MULTI/04378/2013 and PT2020 UID/QUI/50006/2013. TB acknowledges financial support from the Institute of Medical Research and Medicinal Plant Studies, Yaoundé, Cameroon. AM of Imperial College London is grateful for support from the Northwest London National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research andCare and the Imperial NIHR Biomedical Research Centre. KD is funded by a Wellcome Trust Intermediate Fellowship in Public Health and Tropical Medicine (grant number 201900). PSA is supported by an Australian National Health and Medical Research Council Early Career Fellowship. RT-S was supported in part by grant number PROMETEOII/2015/021 from Generalitat Valenciana and the national grant PI17/00719 from ISCIII-FEDER. The Serbian part of this contribution (by MJ) has been co-financed with grant OI175014 from the Serbian Ministry of Education, Science and Technological Development; publication of results was not contingent upon the Ministry's approval. MMMSM acknowledges support from the Serbian Ministry of Education, Science and Technological Development (contract 175087). MM's research was supported by the NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust (London, UK) and King's College London. The views expressed are those of the authors and not necessarily those of the UK National Health Service, the NIHR, or the UK Department of Health. TWB was supported by the Alexander von Humboldt Foundation through the Alexander von Humboldt professor award, which was funded by the German Federal Ministry of Education and Research ; Sí
The pandemic of COVID-19 has afflicted every individual and has initiated a cascade of directly or indirectly involved events in precipitating mental health issues. The human species is a wanderer and hunter-gatherer by nature, and physical social distancing and nationwide lockdown have confined an individual to physical isolation. The present review article was conceived to address psychosocial and other issues and their aetiology related to the current pandemic of COVID-19. The elderly age group has most suffered the wrath of SARS-CoV-2, and social isolation as a preventive measure may further induce mental health issues. Animal model studies have demonstrated an inappropriate interacting endogenous neurotransmitter milieu of dopamine, serotonin, glutamate, and opioids, induced by social isolation that could probably lead to observable phenomena of deviant psychosocial behavior. Conflicting and manipulated information related to COVID-19 on social media has also been recognized as a global threat. Psychological stress during the current pandemic in frontline health care workers, migrant workers, children, and adolescents is also a serious concern. Mental health issues in the current situation could also be induced by being quarantined, uncertainty in business, jobs, economy, hampered academic activities, increased screen time on social media, and domestic violence incidences. The gravity of mental health issues associated with the pandemic of COVID-19 should be identified at the earliest. Mental health organization dedicated to current and future pandemics should be established along with Government policies addressing psychological issues to prevent and treat mental health issues need to be developed. References World Health Organization (WHO) Coronavirus Disease (COVID-19) Dashboard. Available at: https://covid19.who.int/ [Accessed on 23 August 2020] Sim K, Chua HC. The psychological impact of SARS: a matter of heart and mind. CMAJ. 2004; 170:811e2. https://doi.org/10.1503/cmaj.1032003. Wu P, Fang Y, Guan Z, Fan B, Kong J, Yao Z, et al. The psychological impact of the SARS epidemic on hospital employees in China: exposure, risk perception, and altruistic acceptance of risk. Can J Psychiatr. 2009; 54:302e11. https://doi.org/10.1177/070674370905400504. Brooks SK, Webster RK, Smith LE, Woodland L, Wessely S, Greenberg N, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020; 395:912e20. https://doi.org/10.1016/S0140-6736(20)30460-8. Robertson E, Hershenfield K, Grace SL, Stewart DE. The psychosocial effects of being quarantined following exposure to SARS: a qualitative study of Toronto health care workers. Can J Psychiatr. 2004; 49:403e7. https://doi.org/10.1177/070674370404900612. Barbisch D, Koenig KL, Shih FY. Is there a case for quarantine? Perspectives from SARS to Ebola. Disaster Med Public Health Prep. 2015; 9:547e53. https://doi.org/10.1017/dmp.2015.38. Jeong H, Yim HW, Song YJ, Ki M, Min JA, Cho J, et al. Mental health status of people isolated due to Middle East Respiratory Syndrome. Epidemiol Health. 2016;38: e2016048. https://doi.org/10.4178/epih.e2016048. Liu X, Kakade M, Fuller CJ, Fan B, Fang Y, Kong J, et al. Depression after exposure to stressful events: lessons learned from the severe acute respiratory syndrome epidemic. Compr Psychiatr. 2012; 53:15e23. https://doi.org/10.1016/j.comppsych.2011.02.003 Chadda RK, Deb KS. Indian family systems, collectivistic society and psychotherapy. Indian J Psychiatry. 2013;55: S299‑ https://dx.doi.org/10.4103%2F0019-5545.105555. Grover S, Sahoo S, Mehra A, Avasthi A, Tripathi A, Subramanyan A, et al. Psychological impact of COVID‑19 lockdown: An online survey from India. Indian J Psychiatry. 2020; 62:354-62. https://doi.org/ 10.4103/psychiatry.IndianJPsychiatry _427_20. Hawkley LC, Cacioppo JT. Loneliness matters: a theoretical and empirical review of consequences and mechanisms. Ann Behav Med. 2010; 40: 218–27. https://dx.doi.org/10.1007%2Fs12160-010-9210-8. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13. https://doi.org/10.1016/S0140-6736(20)30211-7. Bhandari S, Sharma R, Singh Shaktawat A, Banerjee S, Patel B, Tak A, et al. COVID-19 related mortality profile at a tertiary care centre: a descriptive study. Scr Med. 2020;51(2):69-73. https://doi.org/10.5937/scriptamed51-27126. Baumeister RF, Leary MR. The need to belong: desire for interpersonal attachments as a fundamental human motivation. Psychol Bull. 1995; 117: 497–529. https://doi.org/10.1037/0033-2909.117.3.497. Caspi A, Harrington H, Moffitt TE, Milne BJ, Poulton R. Socially isolated children 20 years later: risk of cardiovascular disease. Arch Pediatr Adolesc Med. 2006; 160(8):805-11. https://doi.org/10.1001/archpedi.160.8.805. Eaker ED, Pinsky J, Castelli WP. Myocardial infarction and coronary death among women: psychosocial predictors from a 20-year follow-up of women in the Framingham Study. Am J Epidemiol. 1992; 135(8):854-64. https://doi.org/10.1093/oxfordjournals.aje.a116381. Luo Y, Hawkley LC, Waite LJ, Cacioppo JT. Loneliness, health, and mortality in old age: a national longitudinal study. Soc Sci Med. 2012 Mar; 74(6):907-14. https://dx.doi.org/10.1016%2Fj.socscimed.2011.11.028. Olsen RB, Olsen J, Gunner-Svensson F, Waldstrøm B. Social networks and longevity. A 14-year follow-up study among elderly in Denmark. Soc Sci Med. 1991; 33(10):1189-95. https://doi.org/10.1016/0277-9536(91)90235-5. Patterson AC, Veenstra G. Loneliness and risk of mortality: a longitudinal investigation in Alameda County, California. Soc Sci Med. 2010; 71(1):181-6. https://doi.org/10.1016/j.socscimed.2010.03.024. Savikko N, Routassalo P, Tilvis RS, Strandberg TE, Pitkalla KH. Predictors and subjective causes of loneliness in an aged population. Arch Gerontol Geriatrics. 2005; 41:3;223-33. https://doi.org/10.1016/j.archger.2005.03.002. Health Advisory for Elderly Population of India during COVID19. Available at: https://www.mohfw.gov.in/pdf/AdvisoryforElderlyPopulation.pdf [Accessed on 13 August 2020]. Dicks D, Myers R, Kling A. Uncus and amygdala lesions: effects on social behavior in the free-ranging rhesus monkey. Science. 1969; 165:69–71. https://doi.org/10.1126/science.165.3888.69. Kanai R, Bahrami B, Duchaine B, Janik A, Banissy MJ, Rees G. Brain structure links loneliness to social perception. Curr Biol. 2012; 22(20):1975-9. https://dx.doi.org/10.1016%2Fj.cub.2012.08.045. Bender AR, Daugherty A, Raz N. Vascular risk moderates associations between hippocampal subfield volumes and memory. J Cogn Neurosci. 2013; 25:1851–62. https://doi.org/10.1162/jocn_a_00435. Raz N. Diabetes: brain, mind, insulin–what is normal and do we need to know? Nat Rev Endocrinol. 2011; 7:636–7. https://doi.org/10.1038/nrendo.2011.149. Colcombe SJ, Erickson KI, Naftali R, Andrew GW, Cohen NJ, McAuley E, et al. Aerobic fitness reduces brain tissue loss in aging humans. J Gerontol A Biol Sci Med Sci. 2003; 58:176–80. https://doi.org/10.1093/gerona/58.2.m176. Maass A, Düzel S, Goerke M, Becke A, Sobieray U, Neumann K, et al. Vascular hippocampal plasticity after aerobic exercise in older adults. Mol Psychiatry. 2015; 20, 585–93. https://doi.org/10.1038/mp.2014.114. Wilson RS, Krueger KR, Arnold SE, Schneider JA, Kelly JF, Barnes LL, et al. Loneliness and Risk of Alzheimer Disease. Arch Gen Psychiatry. 2007;64(2):234–240. https://doi.org/10.1001/archpsyc.64.2.234. Kogan JH, Frankland PW, Silva AJ. Long-term memory underlying hippocampus-dependent social recognition in mice. Hippocampus. 2000;10(1):47-56. https://doi.org/10.1002/(sici)1098-1063(2000)10:1%3C47::aid-hipo5%3E3.0.co;2-6. Yorgason JT, España RA, Konstantopoulos JK, Weiner JL, Jones SR. Enduring increases in anxiety-like behavior and rapid nucleus accumbens dopamine signaling in socially isolated rats. Eur J Neurosci. 2013;37(6):1022-31. https://doi.org/10.1111/ejn.12113. Bledsoe AC, Oliver KM, Scholl JL, Forster GL. Anxiety states induced by post-weaning social isolation are mediated by CRF receptors in the dorsal raphe nucleus. Brain Res Bull. 2011;85(3-4):117-22. https://dx.doi.org/10.1016%2Fj.brainresbull.2011.03.003. Lukkes JL, Engelman GH, Zelin NS, Hale MW, Lowry CA. Post-weaning social isolation of female rats, anxiety-related behavior, and serotonergic systems. Brain Res. 2012; 1443:1-17. https://dx.doi.org/10.1016%2Fj.brainres.2012.01.005. Ago Y, Araki R, Tanaka T, Sasaga A, Nishiyama S, Takuma K, et al. Role of social encounter-induced activation of prefrontal serotonergic systems in the abnormal behaviors of isolation-reared mice. Neuropsychopharmacology. 2013; 38(8):1535-47. https://doi.org/10.1038/npp.2013.52. Veenema AH. Early life stress, the development of aggression and neuroendocrine and neurobiological correlates: what can we learn from animal models? Front Neuroendocrinol. 2009;30(4):497-518. https://doi.org/10.1016/j.yfrne.2009.03.003. Zhao X, Sun L, Jia H, Meng Q, Wu S, Li N, et al. Isolation rearing induces social and emotional function abnormalities and alters glutamate and neurodevelopment-related gene expression in rats. Prog Neuropsychopharmacol Biol Psychiatry. 2009;33(7):1173-1177. https://doi.org/10.1016/j.pnpbp.2009.06.016. Sciolino NR, Bortolato M, Eisenstein SA, Fu J, Oveisi F, Hohmann AG, et al. Social isolation and chronic handling alter endocannabinoid signaling and behavioral reactivity to context in adult rats. Neuroscience. 2010;168(2):371-86. https://dx.doi.org/10.1016%2Fj.neuroscience.2010.04.007. Ghasemi M, Phillips C, Trillo L, De Miguel Z, Das D, Salehi A. The role of NMDA receptors in the pathophysiology and treatment of mood disorders. Neurosci Biobehav Rev. 2014; 47:336-358. https://doi.org/10.1016/j.neubiorev.2014.08.017. Olivenza R, Moro MA, Lizasoain I, Lorenzo P, Fernández AP, Rodrigo J, et al. Chronic stress induces the expression of inducible nitric oxide synthase in rat brain cortex. J Neurochem. 2000;74(2):785-791. https://doi.org/10.1046/j.1471-4159.2000.740785.x. Maeng S, Zarate CA Jr, Du J, Schloesser RJ, McCammon J, Chen G, et al. Cellular mechanisms underlying the antidepressant effects of ketamine: role of alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid receptors. Biol Psychiatry. 2008;63(4):349-352. https://doi.org/10.1016/j.biopsych.2007.05.028. Kalia LV, Kalia SK, Salter MW. NMDA receptors in clinical neurology: excitatory times ahead. Lancet Neurol. 2008;7(8):742-755. https://dx.doi.org/10.1016%2FS1474-4422(08)70165-0. Waxman EA, Lynch DR. N-methyl-D-aspartate Receptor Subtypes: Multiple Roles in Excitotoxicity and Neurological Disease. The Neuroscientist. 2005; 11(1), 37–49. https://doi.org/10.1177/1073858404269012. Hermes G, Li N, Duman C, Duman R. Post-weaning chronic social isolation produces profound behavioral dysregulation with decreases in prefrontal cortex synaptic-associated protein expression in female rats. Physiol Behav. 2011;104(2):354-9. https://dx.doi.org/10.1016%2Fj.physbeh.2010.12.019. Sestito RS, Trindade LB, de Souza RG, Kerbauy LN, Iyomasa MM, Rosa ML. Effect of isolation rearing on the expression of AMPA glutamate receptors in the hippocampal formation. J Psychopharmacol. 2011;25(12):1720-1729. https://doi.org/10.1177/0269881110385595. Toua C, Brand L, Möller M, Emsley RA, Harvey BH. The effects of sub-chronic clozapine and haloperidol administration on isolation rearing induced changes in frontal cortical N-methyl-D-aspartate and D1 receptor binding in rats. Neuroscience. 2010;165(2):492-499. https://doi.org/10.1016/j.neuroscience.2009.10.039. Alò R, Avolio E, Mele M, Storino F, Canonaco A, Carelli A et al. Excitatory/inhibitory equilibrium of the central amygdala nucleus gates anti-depressive and anxiolytic states in the hamster. Pharmacol Biochem Behav. 2014; 118:79-86. https://doi.org/10.1016/j.pbb.2014.01.007. St JP, Petkov VV. Changes in 5-HT1 receptors in different brain structures of rats with isolation syndrome. General pharmacology. 1990;21(2):223-5. https://doi.org/10.1016/0306-3623(90)90905-2. Miachon S, Rochet T, Mathian B, Barbagli B, Claustrat B. Long-term isolation of Wistar rats alters brain monoamine turnover, blood corticosterone, and ACTH. Brain Res Bull. 1993;32(6):611-614. https://doi.org/10.1016/0361-9230(93)90162-5. Van den Berg CL, Van Ree JM, Spruijt BM, Kitchen I. Effects of juvenile isolation and morphine treatment on social interactions and opioid receptors in adult rats: behavioural and autoradiographic studies. Eur J Neurosci. 1999;11(9):3023-3032. https://doi.org/10.1046/j.1460-9568.1999.00717.x. Vanderschuren LJ, Stein EA, Wiegant VM, Van Ree JM. Social play alters regional brain opioid receptor binding in juvenile rats. Brain Res. 1995;680(1-2):148-156. https://doi.org/10.1016/0006-8993(95)00256-p. Moles A, Kieffer BL, D'Amato FR. Deficit in attachment behavior in mice lacking the mu-opioid receptor gene. Science. 2004;304(5679):1983-1986. https://doi.org/10.1126/science.1095943. Panksepp J, Herman BH, Vilberg T, Bishop P, DeEskinazi FG. Endogenous opioids and social behavior. Neurosci Biobehav Rev. 1980;4(4):473-487. https://doi.org/10.1016/0149-7634(80)90036-6. Gong JP, Onaivi ES, Ishiguro H, Liu Q, Tagliaferro PA, Brusco A, et al. Cannabinoid CB2 receptors: immunohistochemical localization in rat brain. Brain Res. 2006;1071(1):10-23. https://doi.org/10.1016/j.brainres.2005.11.035. Breivogel CS, Sim-Selley LJ. Basic neuroanatomy and neuropharmacology of cannabinoids. Int Rev Psychiatry 2009; 21:2:113-121. https://doi.org/10.1080/09540260902782760. Haj-Mirzaian A, Amini-Khoei H, Haj-Mirzaian A, Amiri S, Ghesmati M, Zahir M, et al. Activation of cannabinoid receptors elicits antidepressant-like effects in a mouse model of social isolation stress. Brain Res Bull. 2017; 130:200-210. https://doi.org/10.1016/j.brainresbull.2017.01.018. Banach M, Piskorska B, Czuczwar SJ, Borowicz KK. Nitric Oxide, Epileptic Seizures, and Action of Antiepileptic Drugs. CNS & Neurological Disorders - Drug Targets 2011;10: 808. https://doi.org/10.2174/187152711798072347. Förstermann U, Sessa WC. Nitric oxide synthases: regulation and function. Eur Heart J. 2012;33(7):829-37, 837a-837d. https://dx.doi.org/10.1093%2Feurheartj%2Fehr304. Hu Y, Wu D, Luo C, Zhu L, Zhang J, Wu H, et al. Hippocampal nitric oxide contributes to sex difference in affective behaviors. PNAS. 2012, 109 (35) 14224-14229. https://doi.org/10.1073/pnas.1207461109. Khan MI, Ostadhadi S, Zolfaghari S, Mehr SE, Hassanzadeh G, Dehpour, A et al. The involvement of NMDA receptor/NO/cGMP pathway in the antidepressant like effects of baclofen in mouse force swimming test. Neuroscience Letters. 2016; 612:52-61. https://doi.org/10.1016/j.neulet.2015.12.006. Matsumoto K, Puia G, Dong E, Pinna G. GABAA receptor neurotransmission dysfunction in a mouse model of social isolation-induced stress: Possible insights into a non-serotonergic mechanism of action of SSRIs in mood and anxiety disorders. Stress. 2007; 10:1:3-12. https://doi.org/10.1080/10253890701200997. Zlatković J, Filipović D. Chronic social isolation induces NF-κB activation and upregulation of iNOS protein expression in rat prefrontal cortex. Neurochem Int. 2013;63(3):172-179. https://doi.org/10.1016/j.neuint.2013.06.002. Haj-Mirzaian A, Amiri S, Kordjazy N, Momeny M, Razmi A, Balaei MR, et al. Lithium attenuated the depressant and anxiogenic effect of juvenile social stress through mitigating the negative impact of interlukin-1β and nitric oxide on hypothalamic-pituitary-adrenal axis function. Neuroscience. 2016; 315:271-285. https://doi.org/10.1016/j.neuroscience.2015.12.024. Larson HJ. The biggest pandemic risk? Viral misinformation. Nature 2018; 562:309. https://doi.org/10.1038/d41586-018-07034-4. Zarocostas J. How to fight an infodemic. Lancet 2020; 395:676. https://doi.org/10.1016/S0140-6736(20)30461-X. World Health Organization, 2019. Ebola Virus Disease – Democratic Republic of the Congo. Geneva, Switzerland: WHO. Available at: https://www.who.int/csr/don/28-november-2019-ebola-drc/en/ [Accessed on August 8, 2020] Times of India. Covid-19: doctors gone to collect samples attacked in Indore. Available at: https://timesofindia.indiatimes.com/videos/news/covid-19-doctors-goneto- collect-samples-attacked-in-indore/videoshow/74942153.cms; 2020 [Accessed on August 8, 2020]. Withnall A. Coronavirus: why India has had to pass new law against attacks on healthcare workers. The Independent. April 23, 2020. Semple K. "Afraid to be a nurse": health workers under attack. The New York Times. 2020 Apr 27. The Economist. Health workers become unexpected targets during COVID-19. The Economist. May 11, 2020. Turan B, Budhwani H, Fazeli PL, Browning WR, Raper JL, Mugavero MJ, et al. How does stigma affect people living with HIV? The mediating roles of internalized and anticipated HIV stigma in the effects of perceived community stigma on health and psychosocial outcomes. AIDS Behav. 2017; 21: 283–291. https://doi.org/10.1007/s10461-016-1451-5. James PB, Wardle J, Steel A, Adams J. An assessment of Ebola-related stigma and its association with informal healthcare utilisation among Ebola survivors in Sierra Leone: a cross sectional study. BMC Public Health. 2020; 20: 182. https://doi.org/10.1186/s12889-020-8279-7. Aljazeera, 2020. Iran: Over 700 Dead after Drinking Alcohol to Cure Coronavirus. Aljazeera. Available at: https://www.aljazeera.com/ news/2020/04/iran-700-dead-drinking-alcohol-cure-coronavirus200427163529629.html. (Accessed June 4, 2020) Delirrad M, Mohammadi AB, 2020. New methanol poisoning outbreaks in Iran following COVID-19 pandemic. Alcohol Alcohol. 55: 347–348. https://doi.org/10.1093/alcalc/agaa036. Hassanian-Moghaddam H, Zamani N, Kolahi A-A, McDonald R, Hovda KE. Double trouble: methanol outbreak in the wake of the COVID-19 pandemic in Iran-a cross-sectional assessment. Crit Care. 2020; 24: 402. https://doi.org/10.1186/s13054-020-03140-w. Soltaninejad K. Methanol Mass Poisoning Outbreak: A Consequence of COVID-19 Pandemic and Misleading Messages on Social Media. Int J Occup Environ Med. 2020;11(3):148-150. https://dx.doi.org/10.34172%2Fijoem.2020.1983. Islam MS, Sarkar T, Khan SH, Kamal AM, Hasan SMM, Kabir A, et al. COVID-19–Related Infodemic and Its Impact on Public Health: A Global Social Media Analysis. Am J Trop Med Hyg. 2020; 00(0):1–9. https://doi.org/10.4269/ajtmh.20-0812. Hawryluck L, Gold W, Robinson S, Pogorski S, Galea S, Styra R. SARS control and psychological effects of quarantine, Toronto, Canada. Emerg Infect Dis. 2004;10(7):1206–1212. https://dx.doi.org/10.3201%2Feid1007.030703. Lee S, Chan LYY, Chau AAM, Kwok KPS, Kleinman A. The experience of SARS-related stigma at Amoy Gardens. Soc Sci Med. 2005; 61(9): 2038-2046. https://doi.org/10.1016/j.socscimed.2005.04.010. Yoon MK Kim SY Ko HS Lee MS. System effectiveness of detection, brief intervention and refer to treatment for the people with post-traumatic emotional distress by MERS: a case report of community-based proactive intervention in South Korea. Int J Ment Health Syst. 2016; 10: 51. https://doi.org/10.1186/s13033-016-0083-5. Reynolds DL, Garay JR, Deamond SL, Moran MK, Gold W, Styra R. Understanding, compliance and psychological impact of the SARS quarantine experience. Epidemiol Infect. 2008; 136: 997-1007. https://dx.doi.org/10.1017%2FS0950268807009156. Marjanovic Z, Greenglass ER, Coffey S. The relevance of psychosocial variables and working conditions in predicting nurses' coping strategies during the SARS crisis: an online questionnaire survey. Int J Nurs Stud. 2007; 44(6): 991-998. https://doi.org/10.1016/j.ijnurstu.2006.02.012. Bai Y, Lin C-C, Lin C-Y, Chen J-Y, Chue C-M, Chou P. Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatr Serv. 2004; 55: 1055-1057. https://doi.org/10.1176/appi.ps.55.9.1055. Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/Guidelinesforhomequarantine.pdf [Accessed on 25 August 2020]. Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/RevisedguidelinesforHomeIsolationofverymildpresymptomaticCOVID19cases10May2020.pdf [Accessed on 25 August 2020]. Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/AdvisoryformanagingHealthcareworkersworkinginCOVIDandNonCOVIDareasofthehospital.pdf (Accessed on 25 August 2020). Ministry of Health and Family Welfare. Available at: https://www.mohfw.gov.in/pdf/RevisedguidelinesforInternationalArrivals02082020.pdf [Accessed on 25 August 2020]. Cost of the lockdown? Over 10% of GDP loss for 18 states. Available at: https://timesofindia.indiatimes.com/india/cost-of-the-lockdown-over-10-of-gdp-loss-for-18-states/articleshow/76028826.cms [Accessed on 21 August 2020]. Jorda O, Singh SR, Taylor AM. Longer-Run Economic Consequences of Pandemics. Federal Reserve Bank of San Francisco Working Paper. 2020-09. https://doi.org/10.24148/wp2020-09. Firdaus G. Mental well‑being of migrants in urban center of India: Analyzing the role of social environment. Indian J Psychiatry. 2017; 59:164‑ https://doi.org/10.4103/psychiatry.indianjpsychiatry_272_15. National Crime Record Bureau. Annual Crime in India Report. New Delhi, India: Ministry of Home Affairs; 2018. 198 migrant workers killed in road accidents during lockdown: Report. Available at: https://www.hindustantimes.com/india-news/198-migrant-workers-killed-in-road-accidents-during-lockdown-report/story-hTWzAWMYn0kyycKw1dyKqL.html [Accessed on 25 August 2020]. Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020; 20:689-96. https://doi.org/10.1016/S1473-3099(20)30198-5. Dalton L, Rapa E, Stein A. Protecting the psychological health of through effective communication about COVID-19. Lancet Child Adolesc Health. 2020;4(5):346-347. https://doi.org/10.1016/S2352-4642(20)30097-3. Centre for Disease Control. Helping Children Cope with Emergencies. Available at: https://www.cdc.gov/childrenindisasters/helping-children-cope.html [Accessed on 25 August 2020]. Liu JJ, Bao Y, Huang X, Shi J, Lu L. Mental health considerations for children quarantined because of COVID-19. Lancet Child & Adolesc Health. 2020; 4(5):347-349. https://doi.org/10.1016/S2352-4642(20)30096-1. Sprang G, Silman M. Posttraumatic Stress Disorder in Parents and Youth After Health-Related Disasters. Disaster Med Public Health Prep. 2013;7(1):105-110. https://doi.org/10.1017/dmp.2013.22. Rehman U, Shahnawaz MG, Khan NH, Kharshiing KD, Khursheed M, Gupta K, et al. Depression, Anxiety and Stress Among Indians in Times of Covid-19 Lockdown. Community Ment Health J. 2020:1-7. https://doi.org/10.1007/s10597-020-00664-x. Cao W, Fang Z, Hou, Han M, Xu X, Dong J, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research. 2020; 287:112934. https://doi.org/10.1016/j.psychres.2020.112934. Wang C, Zhao H. The Impact of COVID-19 on Anxiety in Chinese University Students. Front Psychol. 2020; 11:1168. https://dx.doi.org/10.3389%2Ffpsyg.2020.01168. Kang L, Li Y, Hu S, Chen M, Yang C, Yang BX, et al. The mental health of medical workers in Wuhan, China dealing with the 2019 novel coronavirus. Lancet Psychiatry 2020;7(3): e14. https://doi.org/10.1016/s2215-0366(20)30047-x. Lai J, Ma S, Wang Y, Cai Z, Hu J, Wei N, et al. Factors associated with mental health outcomes among health care workers exposed to coronavirus disease 2019. JAMA Netw Open 2020;3(3): e203976. https://doi.org/10.1001/jamanetworkopen.2020.3976. Lancee WJ, Maunder RG, Goldbloom DS, Coauthors for the Impact of SARS Study. Prevalence of psychiatric disorders among Toronto hospital workers one to two years after the SARS outbreak. Psychiatr Serv. 2008;59(1):91-95. https://dx.doi.org/10.1176%2Fps.2008.59.1.91. Tam CWC, Pang EPF, Lam LCW, Chiu HFK. Severe acute respiratory syndrome (SARS) in Hongkong in 2003: Stress and psychological impact among frontline healthcare workers. Psychol Med. 2004;34 (7):1197-1204. https://doi.org/10.1017/s0033291704002247. Lee SM, Kang WS, Cho A-R, Kim T, Park JK. Psychological impact of the 2015 MERS outbreak on hospital workers and quarantined hemodialysis patients. Compr Psychiatry. 2018; 87:123-127. https://dx.doi.org/10.1016%2Fj.comppsych.2018.10.003. Koh D, Meng KL, Chia SE, Ko SM, Qian F, Ng V, et al. Risk perception and impact of severe acute respiratory syndrome (SARS) on work and personal lives of healthcare workers in Singapore: What can we learn? Med Care. 2005;43(7):676-682. https://doi.org/10.1097/01.mlr.0000167181.36730.cc. Verma S, Mythily S, Chan YH, Deslypere JP, Teo EK, Chong SA. Post-SARS psychological morbidity and stigma among general practitioners and traditional Chinese medicine practitioners in Singapore. Ann Acad Med Singap. 2004; 33(6):743e8. Yeung J, Gupta S. Doctors evicted from their homes in India as fear spreads amid coronavirus lockdown. CNN World. 2020. Available at: https://edition.cnn.com/2020/03/25/asia/india-coronavirus-doctors-discrimination-intl-hnk/index.html. [Accessed on 24 August 2020] Violence Against Women and Girls: the Shadow Pandemic. UN Women. 2020. May 3, 2020. Available at: https://www.unwomen.org/en/news/stories/2020/4/statement-ed-phumzile-violence-against-women-during-pandemic. [Accessed on 24 August 2020]. Gearhart S, Patron MP, Hammond TA, Goldberg DW, Klein A, Horney JA. The impact of natural disasters on domestic violence: an analysis of reports of simple assault in Florida (1999–2007). Violence Gend. 2018;5(2):87–92. https://doi.org/10.1089/vio.2017.0077. Sahoo S, Rani S, Parveen S, Pal Singh A, Mehra A, Chakrabarti S, et al. Self-harm and COVID-19 pandemic: An emerging concern – A report of 2 cases from India. Asian J Psychiatr 2020; 51:102104. https://dx.doi.org/10.1016%2Fj.ajp.2020.102104. Ghosh A, Khitiz MT, Pandiyan S, Roub F, Grover S. Multiple suicide attempts in an individual with opioid dependence: Unintended harm of lockdown during the COVID-19 outbreak? Indian J Psychiatry 2020; [In Press]. The Economic Times. 11 Coronavirus suspects flee from a hospital in Maharashtra. March 16 2020. Available at: https://economictimes.indiatimes.com/news/politics-and-nation/11-coronavirus-suspects-flee-from-a-hospital-in-maharashtra/videoshow/74644936.cms?from=mdr. [Accessed on 23 August 2020]. Xiang Y, Yang Y, Li W, Zhang L, Zhang Q, Cheung T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. The Lancet Psychiatry 2020;(3):228–229. https://doi.org/10.1016/S2215-0366(20)30046-8. Van Bortel T, Basnayake A, Wurie F, Jambai M, Koroma A, Muana A, et al. Psychosocial effects of an Ebola outbreak at individual, community and international levels. Bull World Health Organ. 2016;94(3):210–214. https://dx.doi.org/10.2471%2FBLT.15.158543. Kumar A, Nayar KR. COVID 19 and its mental health consequences. Journal of Mental Health. 2020; ahead of print:1-2. https://doi.org/10.1080/09638237.2020.1757052. Gupta R, Grover S, Basu A, Krishnan V, Tripathi A, Subramanyam A, et al. Changes in sleep pattern and sleep quality during COVID-19 lockdown. Indian J Psychiatry. 2020; 62(4):370-8. https://doi.org/10.4103/psychiatry.indianjpsychiatry_523_20. Duan L, Zhu G. Psychological interventions for people affected by the COVID-19 epidemic. Lancet Psychiatry. 2020;7(4): P300-302. https://doi.org/10.1016/S2215-0366(20)30073-0. Dubey S, Biswas P, Ghosh R, Chatterjee S, Dubey MJ, Chatterjee S et al. Psychosocial impact of COVID-19. Diabetes Metab Syndr. 2020; 14(5): 779–788. https://dx.doi.org/10.1016%2Fj.dsx.2020.05.035. Wright R. The world's largest coronavirus lockdown is having a dramatic impact on pollution in India. CNN World; 2020. Available at: https://edition.cnn.com/2020/03/31/asia/coronavirus-lockdown-impact-pollution-india-intl-hnk/index.html. [Accessed on 23 August 2020] Foster O. 'Lockdown made me Realise What's Important': Meet the Families Reconnecting Remotely. The Guardian; 2020. Available at: https://www.theguardian.com/keep-connected/2020/apr/23/lockdown-made-me-realise-whats-important-meet-the-families-reconnecting-remotely. (Accessed on 23 August 2020) Bilefsky D, Yeginsu C. Of 'Covidivorces' and 'Coronababies': Life During a Lockdown. N. Y. Times; 2020. Available at: https://www.nytimes.com/2020/03/27/world/coronavirus-lockdown-relationships.html [Accessed on 23 August 2020]
