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Thursday Complexity PostMay 30, 2013


Building Resilience to Survive Calamities   


The number of the world's weather related disasters has tripled in the last 30 years. The number of people exposed to flooding has doubled since 1970. The cost of health care brings financial catastrophe to 150 million people every year. And food prices are more volatile than ever.


Citing those sobering conditions, Oxfam, an international confederation of 17 organizations working to provide humanitarian and development aid in 90 countries, asserts that governments, aid organizations and the international community must collaborate to reduce risks that now fall disproportionately on the world's most vulnerable populations. The Oxfam report, "No Accident: Resilience and the Inequality of Risk," emphasizes that vulnerability to all natural and politically induced hazards is higher in countries with greater income inequality.


While praising a growing focus on building resilience, authors of the report worry that progress will be limited by an excessively technical approach. They write that humanitarian and development programs have traditionally been "designed in linear fashion, whereby specific inputs are expected to lead to a predicted output, but this does not reflect the complexity of dynamic and interconnected risks and uncertainty." They suggest flexible programs that allow planning and adaptation along with careful monitoring and learning. They stress the need for a common way to measure resilience.


Oxfam defines resilience as "the ability of women, men and children to realize their rights and improve their well-being despite shocks, stresses and uncertainty."


The report also quotes Dante Dalabajan, Oxfam Program Manager in the Philippines: "There is neither a cookie cutter nor a cookbook for resilience."


To reach beyond technical fixes, the report says, "Building skills and capacity must go alongside tackling the inequality and injustice that make poor women and men more vulnerable in the first place. This means challenging the social, economic and political institutions that lock in security for some and vulnerability for many..."


The richest 11 percent of the world's population generates half of all carbon emissions, but suffers least from consequences of climate change, for example, while Southeast Asia suffers from flood losses 15 times greater than the wealthiest, most developed countries.


Oxfam calls recent crises a wakeup call. In Pakistan's floods in 2010 and 2011, thousands died and hundreds of thousands fled their homes. In recurring droughts in the Horn of Africa and the Sahel region in West Africa on the edges of the Sahara Desert, the report says more people could have been saved from death and malnutrition but for delayed or inefficient government and private response. While humanitarian aid will always be needed in times of crisis, the report says, more focus is needed on prevention and preparedness-categories that get only 2.6 percent of aid spending now.


In conflict-affected areas, the report says resilience requires "bottom-up empowerment." For example, in Afghanistan, the Ministry of Agriculture is trying to build trust through establishment of agricultural committees that are part civil society and part government. In Colombia, despite peace negotiations after 50 years of armed conflict, rural population displacement is high and actually increased in 2012. Access to farm fields and markets is still limited because of land mines placed by illegal armed groups, so Oxfam and local partners strengthened community organizations and networks as they cooperated to identify mine sites and find routes for safe passage. They also helped villagers develop kitchen gardens.


While such efforts alone won't create resilience, the report says, they can start to "build stronger governance with community voices at the center, which is a prerequisite for resilience building." Read the report 



Nursing Network PlexusCalls 
Wednesday, Jun 5, 2013 - 1-2 PM ET 
Register to receive your call-in number and pin: 
Making Sense of Prognosis Communication in Heart Failure Using a CAS Framework 
Guest: Patricia H. Strachan, RN, PhD and Rob Robson, MDCM, MSc, FRCP(C)  


Dr. Strachan is an Associate Professor in the School of Nursing at McMaster University, Canada where she completed a post-doctoral fellowship in cardiovascular nursing research from the Heart and Stroke Foundation of Ontario. Her research has broadly focused on communication issues involving patients with heart failure (HF) and end-of-life planning and care. She is eager to explore ways in which the science of complex adaptive systems can be integrated into research, education and practice particularly in relation to integration of a palliative approach to HF care.    

Dr. Robson is the Principal Advisor for Healthcare System Safety and Accountability in Canada and recently served as the Chief Patient Safety Officer at the Winnipeg Regional Health Authority for six years. Dr. Robson is a trained healthcare mediator and has worked for more than ten years in this field. Rob is a specialist emergency physician who continues to practice, having worked in community hospital and tertiary care emergency departments in Quebec, Ontario, Manitoba, and British Columbia.   


Friday, Jun 14, 2013 - 1-2 PM ET 
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Immigrants to Canada and Networks Among Those Who Help Them 
Guests: Chris Black, Liz Rykert, and Reluca Bejan

Canadian researchers have used social network analysis to understand those who are working to provide services to immigrants newly arriving in Toronto. Their report, "Balancing the Budget, But Who's Left to Budget the Balance," provides a visual representation of professional networks within the Toronto East Local Immigration Partnership. The report also looks at potential impact on the network of policy changes and funding cuts.


Friday, Jun 2, 2013 - 1-2 PM ET  
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Is Murder Contagious?   
Guest: April Zeoli 

April Zeoli led team of researchers at Michigan State University that studied the 2,366 homicides in Newark NJ between 1982 and 2008. In one of the first studies of its kind, the team used analytical software from the field of medical geography to track long term homicide trends. They found the killings followed a pattern similar to that of an infectious disease, evolving from the city's center and moving south and west over time in neighborhoods where most residents were poor and members of minority groups. Researchers also identified areas of Newark where there had been no clusters of homicide despite being surrounded by areas of deadly violence.



Visit the Plexus Institute Calendar for a detailed schedule of PlexusCalls, Healthcare PlexusCalls, Nursing Network PlexusCalls and other upcoming events from Plexus Institute and others.  


Audio from all PlexusCall series are available by searching the iTunes store for plexuscalls. Or, visit under Resources/Call Series. 


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