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  • Print publication year: 2008
  • Online publication date: March 2013

14 - Hostile Geopolitical Environments




Traveling and working in conflict areas or regions with significant political volatility requires a far more detailed understanding of the unique attributes of conflict areas. Civilians should only consider the prospect of traveling or working in an active war zone under well-defined circumstances, such as with a reputable relief organization or another organization that has significant logistical and security capability. This chapter focuses on two major themes: the complexities of traveling in hostile geopolitical environments and the unique features of providing medical services to populations affected by war.

Most physicians and medical personnel practice in relatively safe and stable environments, although some health care providers have chosen to work in conflict settings that have some degree of political instability and personal danger. To an inexperienced health worker, remote climates may seem inherently dangerous, but the opposite is often the case. Practicing in a rural setting in Somalia, for example, may be remote and relatively austere, but is likely to be safe and secure, while working in inner city Nairobi, Kenya, may be much more dangerous.

Judging whether a certain geographical region is dangerous requires significant knowledge of the unique political, economic, social, and cultural context. It's important to realize the relative risk of travel itself and the likely causes of mortality in travelers. The greatest killer of travelers is cardiovascular disease and accidental injuries, most commonly motor vehicle accidents.

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