Ethics and health systems research in 'post'-conflict situations

Although considerable attention has been given to ethical issues related to clinical research in developing countries, in particular related to HIV therapy, there has been limited focus on health systems research, despite its increasing importance in the light of current trends in development assistance. This paper examines ethical issues related to health systems research in 'post'-conflict situations, addressing both generic issues for developing countries and those issues specific to 'post'-conflict societies, citing examples from the author's Cambodian experience. It argues that the destruction of health infrastructure results in a loss of structures and processes that would otherwise protect prospective research subjects who are part of vulnerable populations. It identifies the growth of health systems research as part of a trend towards sectoral and programmatic development assistance, the emergence of 'knowledge generation' as a form of research linked to development, and the potential for conflict where multilateral and bilateral donors are both primary funders and users of health systems research. It also examines the position of the health system researcher in relation to the sponsors of this research, and the health system being analysed.

Peace beyond the State? NGOs in Bosnia and Herzegovina

By examining the work of several NGOs in the context of post-conflict reconstruction in Bosnia and Herzegovina (BiH), this essay scrutinizes both the potential and limits of NGO contributions to peace-settlements and long-term stability. While their ability to specialize and reach the grassroots level is of great practical significance, the contribution of NGOs to the reconstruction of war-torn societies is often idealized. NGOs remain severely limited by ad hoc and project-specific funding sources, as well as by the overall policy environment in which they operate. Unless these underlying issues are addressed, NGOs will ultimately become little more than extensions of prevalent multilateral and state-based approaches to post-conflict reconstruction.

A green stick or a fresh stick?: Locating customary penalties in the post-colonial era

Former colonies and dependencies in the South Pacific do not have the luxury of entirely ‘homegrown’ laws. Their legal systems are burdened with a ‘legacy’ of transplanted laws, developed for use in a foreign country, imposed on pre-existing systems of custom and culture. As a result, many small island countries are struggling to balance the demands of law from different sources, designed to operate in fundamentally different circumstances. In addition to the conflict that occurs in areas of substantive law, where customary and introduced law may prescribe a different rule for the same situation, the two systems differ in their approach to procedure, penalties and relief. This paper considers the divide between the theory and practice of introduced law and customary law and examines the way in which conflicts have been dealt with by the courts. In particular, it uses the example of banishment to illustrate the type of problems that arise in a plural system. The paper looks at the balancing exercise which has been necessary when custom, in the form of banishment, comes into conflict with introduced law, in the form of constitutional rights.