0
January 22, 1997, Vol 277, No. 4 >
ARTICLE | January 22, 1997

Genocide and the Plight of Children in Rwanda FREE

Paul Geltman, MD, MPH
[+] Author Affiliations

Edited by Annette Flanagin, RN, MA, Associate Senior Editor.

Reprints: Paul Geltman, MD, MPH, Physicians for Human Rights, 100 Boylston St, Suite 702, Boston, MA 02116 (e-mail: phr@igc.apc.org).


JAMA. 1997;277(4):289-294. doi:10.1001/jama.1997.03540280027017
Text Size: A A A
Published online
Article
References

THE RWANDAN genocide of 1994 will be remembered as one of the greatest human tragedies of our time. In less than 3 months, extremists systematically slaughtered more than 500 000 people, including thousands of children.1 The massacres reignited a bloody civil war that forced more than 4 million people to flee their homes.2 Today, nearly 3 years later, Rwanda remains a highly traumatized society, where children are its most vulnerable members. Among those most at risk are more than 100000 children who were orphaned or separated from their parents (United Nations Children's Fund, unpublished data, press release 94/26, May 24, 1994).

Between August 1994 and February 1996, we traveled on 3 occasions to Rwanda and northeastern Zaire as representatives of Médecins du Monde and Physicians for Human Rights. Our task was to assess the nature and scope of the Rwandan genocide and its effects on children. We also

REFERENCES

1 +
Omaar R. Rwanda: Death, Despair, and Defiance . London, England: African Rights; 1994;.
2 +
Bureau of Humanitarian Response, Office of US Foreign Disaster Assistance. Consolidated Rwanda Report Update #14 . Arlington, Va: US Agency for International Development; 1994;.
3 +
Reisman MW, Antoniou CT, eds. The Laws of War: A Comprehensive Collection of Primary Documents on International Laws Governing Armed Conflict . New York, NY: Vintage Books; 1994;:84-86.
4 +
Lifton RJ. The Nazi Doctors: Medical Killing and the Psychology of Genocide . New York, NY: Basic Books Inc Publishers; 1988;.
5 +
Allodi F, Randall GR, Lutz EL, Quiroga J, Zunzunegui MV.  Physical and psychiatric effects of torture: two medical studies . In: Stover E, Nightingale EO, eds. The Breaking of Bodies and Minds: Torture, Psychiatric Abuse, and the Health Professions . New York, NY: WH Freeman & Co; 1985;:58-78.
6 +
Summerfield D.  Addressing human response to war and atrocity: major challenges in research and practices and the limitations of western psychiatric models . In: Leber RJ, Figley CR, Gersons BPR, eds. Beyond Trauma: Cultural and Societal Dynamics . New York, NY: Plenum Publishing Corp; 1995;: 17-29.
7 +
Borton N. Rwanda: Civil Strife/Displaced Persons Situation Report #4 . Arlington, Va: US Agency for International Development; 1995;.
8 +
Schoepf BG. Genocide and gendered violence in Rwanda. Med Anthropol Q. 1997.In press.
9 +
Hall P, Carney A. Rwanda 1994: A Report of the Genocide . Dundee, Scotland: Physicians for Human Rights (UK); 1994;.
10 +
Lorch D.  Frantic, bittersweet reunion for Rwandan exile children . New York Times . (September 18) , 1995;:A1.
11 +
Stover E.  In the shadow of Nuremberg: pursuing war criminals in the former Yugoslavia and Rwanda . Med Global Survival . 1995;;3:140-147.
12 +
UNICEF. Children: The Future of Rwanda: A UNICEF/Rwandan Ministry of Labour and Social Affairs Joint Update on Children in Especially Difficult Circumstances . Kigali, Rwanda: UNICEF; June 1995;.
13 +
Gupta L. Exposure to War Related Violence Among Rwandan Children and Adolescents: A Brief Report on the National Baseline Trauma Survey . Kigali, Rwanda: UNICEF Trauma Recovery Program; 1996;.
14 +
Murray-Lee M. Rwanda's Lost Souls . New York, NY: UNICEF; 1994;.
15 +
Goma Epidemiology Group.  Public health impact of Rwandan refugee crisis: what happened in Goma, Zaire, in July, 1994? Lancet . 1995;;345:339-344.
16 +
Paquet C, van Soest M.  Mortality and malnutrition among Rwandan refugees in Zaire . Lancet . 1994;;344:823-824.
17 +
Center for International Health Information. Rwanda Country Health Statistics Profile . Arlington, Va: US Agency for International Development; 1995;.
18 +
Dowell SF, Toko A, Sita C, et al.  Health and nutrition in centers for unaccompanied refugee children: experience from the 1994 Rwandan refugee crisis . JAMA . 1995;;273:1802-1806.
19 +
Dabelstein N, ed. The International Response to Genocide: Lessons From the Rwanda Experience . Copenhagen, Denmark: Danish Ministry of Foreign Affairs; 1996;:7-13.
20 +
Carney A.  Lack of care in Rwanda . Br J Psychiatry . (October) , 1994;;165:556.
21 +
Callaghan MP, Immerman B.  PHS mission to Goma, Zaire . Public Health Rep . 1995;;110:95-99.
22 +
Bonneau J. Rapport de Mission AFSEA-Goma (Zaire): Aupres des Enfants Rwandais Refugies non Accompagnes . Paris, France: Association Departementale de Sauvegarde de l'Enfance et de l'Adolescence; 1995;.
23 +
Calvin F.  Children traumatized by catastrophic situations . In: Eth S, Pynoos RS, eds. Post-traumatic Stress Disorder in Children . Washington, DC: American Psychiatric Press; 1985;:103-120.
24 +
Dawes A.  The effects of political violence on children: a consideration of South African and related studies . Int J Psychol . 1990;;25:13-31.
25 +
Kanji N.  War and children in Mozambique: is international aid strengthening or eroding community-based policies? Community Dev J . 1990;;25:102-112.
26 +
Melville M, Lykes MB.  Guatemalan Indian children and the sociocultural effects of government-sponsored terrorism . Soc Sci Med . 1992;;34:533-548.
27 +
Allodi F.  The psychiatric effects in children and families of victims of political persecution and torture . Danish Med J . 1980;;22:229-232.
28 +
Van der Veer G.  Psychotherapeutic work with refugees . In: Leber RJ, Figley CR, Gersons BPR, eds. Beyond Trauma: Cultural and Societal Dynamics . New York, NY: Plenum Publishing Corp; 1995;:151-170.
29 +
Mollica RF, Fish-Murray C, Donelan D, et al. Repatriation and Disability: A Community Study of Health, Mental Health, and Social Functioning of the Khmer Residents of Site Two . Vol 2. Boston, Mass: Harvard Program in Refugee Trauma, Harvard University School of Public Health; 1989;.
30 +
Kinzie JD, Sack W, Angell R, Clarke G, Ben R.  A three-year follow-up of Cambodian young people traumatized as children . J Am Acad Child Adolesc Psychiatry . 1989;;28:501-504.
31 +
Augustyn M, Parker S, Groves BM, Zuckerman B.  Silent victims: children who witness violence . Contemp Pediatr . 1995;;12:35-57.
32 +
McKelvey RS, Webb JA.  Long-term effects of maternal loss on Vietnamese Amerasians . J Am Acad Child Adolesc Psychiatry . 1993;;32:1013-1018.
33 +
Suarez-Orozco MM.  Speaking of the unspeakable: toward a psychosocial understanding of responses of terror . Ethos . 1990;;18:353-383.
34 +
Suarez-Orozco MM.  A grammar of terror: psychocultural responses to state terrorism in dirty war and post-dirty war Argentina . In: Nordstrom C, Martin J, eds. The Paths to Domination, Resistance, and Terror . Berkeley: University of California; 1992;:219-259.
35 +
Bracken PJ, Giller JE, Summerfield D.  Psychological responses to war and atrocity: the limitations of current concepts . Soc Sci Med . 1995;;8:1073-1082.
36 +
Lifton RJ.  The concept of the survivor . In: Dimsdale J, ed. Survivors, Victims, and Perpetrators: Essays on the Nazi Holocaust . Washington, DC: Hemisphere Publications; 1980;:123.
37 +
Nosiglia JE. Botin de Guerra . Buenos Aires, Argentina: Abuelas de Plaza de Mayo; 1985;.
38 +
Fariña JJ.  El terrorismo del estado como fantasma . In: Martínez V, ed. Terrorismo de Estado: Efectos Psicologicos en los Niños . Buenos Aires, Argentina: Paidos; 1987;:21-41.
39 +
Bureau of Humanitarian Response, Office of US Foreign Disaster Assistance. Consolidated Rwanda Report Update #11 . Arlington, Va: US Agency for International Development; 1994;.
40 +
UNICEF. Children: The Future of Rwanda: A Ministry of Labour and Social Affairs Update With UNICEF Support on Children in Especially Difficult Circumstances . Kigali, Rwanda: UNICEF; September 30, 1996;.
41 +
Gordon-Bates K. International Committee of the Red Cross News . Geneva, Switzerland: International Committee of the Red Cross; 1995;;14.
42 +
de Charry A. Synthèse sur les Orphelinats, Avril 95 . Paris, France: Médecins du Monde; 1995;.
43 +
Frank DA, Klass PE, Earls F, Eisenberg L.  Infants and young children in orphanages: one view from pediatrics and child psychiatry . Pediatrics . 1996;;97:569-578.
44 +
Ajdukovic M, Ajdukovic D.  Psychological well-being of refugee children . Child Abuse Neglect . 1993;;17:843-854.
45 +
Eisenbruch M.  The mental health of refugee children and their cultural development . Int Migration Rev . 1988;;22:282-300.
46 +
Garbarino J.  Developmental consequences of living in dangerous and unstable environments: the situation of refugee children . In: McCallin M, ed. The Psychological Well-being of Refugee Children . Geneva, Switzerland: International Catholic Child Bureau; 1992;:1-23.
47 +
 Proceedings of the Conference on the Care of Dependent Children (1909) . In: Proceedings of the National Conference on the Care of Children, 1895-1915 . New York, NY: Arno; 1971;:6.
48 +
Chapin HD.  Are institutions for infants necessary? JAMA . 1915;;64:1-3.
49 +
Goldfarb W.  Effects of psychological deprivation in infancy and subsequent stimulation . Am J Psychiatry . 1945;;102:18-33.
50 +
Tizard B, Hodges J.  The effect of early institutional rearing on the development of eight-year-old children . J Child Psychol Psychiatry . 1978;;19:99-118.
51 +
Tizard B, Hodges J.  IQ and behavioral adjustment of ex-institutionalized adolescents . J Child Psychol Psychiatry . 1989;;30:53-75.
52 +
Klackenberg G.  Studies in maternal deprivation in infants' homes . Acta Paediatri . 1956;;45:1-12.
53 +
Saltz R.  Effect of part-time 'mothering' on IQ and SQ of young institutionalized children . Child Dev . 1973;;17:80-90.
54 +
Hansen AB.  Short term differences of infant development in nursery homes and in private families . Acta Paediatr Scand . 1971;;60:571-577.
55 +
Miller LC, Kiernan MT, Mathers MI, Klein-Gitelman M.  Developmental and nutritional status of internationally adopted children . Arch Pediatr Adolesc Med . 1995;;149:40-44.
56 +
Miller N.  The influence of HIV/AIDS in the Rwanda tragedy . AIDS Soc . 1994;;4:1-6.
57 +
Simasathien S, Duangmani C, Echeverria P.  Haemophilus influenzae type B resistant to ampicillin and chloramphenicol in an orphanage in Thailand . Lancet . 1980;;2:1214-1217.
58 +
Takala AK, Jero J, Kela E, et al.  Risk factors for primary invasive pneumococcal disease among children in Finland . JAMA . 1995;;273:859-864.
59 +
Brahmadathan KN, Koshi G.  Epidemiology of streptococcal pyoderma in an orphanage community of a tropical country . Am J Trop Med Hyg . 1988;;91:306-314.
60 +
US Agency for International Development Congressional Report FY1997. Arlington, Va: US Agency for International Development; 1996.
61 +
Makhlouf SA, Sarwat MA, Mahmoud DM, Mohamad AA.  Parasitic infection among children living in two orphanages in Cairo . J Egypt Soc Parasitol . 1994;;24:137-145.
62 +
Janoff EN, Mead PS, Mead JR, et al.  Endemic Cryptosporidium and Giardi lamblia infections in a Thai orphanage . Am J Trop Med Hyg . 1990;;43:248-256.
63 +
Reid E.  The psychology of war and HIV epidemic . AIDS Soc . 1994;;4:6.
64 +
UNICEF. Children of Rwanda: An Update on Children in Especially Difficult Circumstances . No. 4. Kigali, Rwanda: UNICEF; May 1995;.
65 +
Toole MJ.  The public health consequences of inaction: lessons learned in responding to sudden population displacements . In: Cahill KM. A Framework for Survival: Health, Human Rights, and Humanitarian Assistance in Conflicts and Disasters . New York, NY: Basic Books Inc Publishers; 1993;:144-158.
66 +
Gruber AR. Children in Foster Care . New York, NY: Human Science Press; 1978;.
67 +
Rein M, Nutt TE, Weiss H.  Fostering family care: myth and reality . In: Schorr AL, ed. Children and Decent People . New York, NY: Basic Books Inc Publishers; 1974;:24-52.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Omaar R. Rwanda: Death, Despair, and Defiance . London, England: African Rights; 1994;.
2 +
Bureau of Humanitarian Response, Office of US Foreign Disaster Assistance. Consolidated Rwanda Report Update #14 . Arlington, Va: US Agency for International Development; 1994;.
3 +
Reisman MW, Antoniou CT, eds. The Laws of War: A Comprehensive Collection of Primary Documents on International Laws Governing Armed Conflict . New York, NY: Vintage Books; 1994;:84-86.
4 +
Lifton RJ. The Nazi Doctors: Medical Killing and the Psychology of Genocide . New York, NY: Basic Books Inc Publishers; 1988;.
5 +
Allodi F, Randall GR, Lutz EL, Quiroga J, Zunzunegui MV.  Physical and psychiatric effects of torture: two medical studies . In: Stover E, Nightingale EO, eds. The Breaking of Bodies and Minds: Torture, Psychiatric Abuse, and the Health Professions . New York, NY: WH Freeman & Co; 1985;:58-78.
6 +
Summerfield D.  Addressing human response to war and atrocity: major challenges in research and practices and the limitations of western psychiatric models . In: Leber RJ, Figley CR, Gersons BPR, eds. Beyond Trauma: Cultural and Societal Dynamics . New York, NY: Plenum Publishing Corp; 1995;: 17-29.
7 +
Borton N. Rwanda: Civil Strife/Displaced Persons Situation Report #4 . Arlington, Va: US Agency for International Development; 1995;.
8 +
Schoepf BG. Genocide and gendered violence in Rwanda. Med Anthropol Q. 1997.In press.
9 +
Hall P, Carney A. Rwanda 1994: A Report of the Genocide . Dundee, Scotland: Physicians for Human Rights (UK); 1994;.
10 +
Lorch D.  Frantic, bittersweet reunion for Rwandan exile children . New York Times . (September 18) , 1995;:A1.
11 +
Stover E.  In the shadow of Nuremberg: pursuing war criminals in the former Yugoslavia and Rwanda . Med Global Survival . 1995;;3:140-147.
12 +
UNICEF. Children: The Future of Rwanda: A UNICEF/Rwandan Ministry of Labour and Social Affairs Joint Update on Children in Especially Difficult Circumstances . Kigali, Rwanda: UNICEF; June 1995;.
13 +
Gupta L. Exposure to War Related Violence Among Rwandan Children and Adolescents: A Brief Report on the National Baseline Trauma Survey . Kigali, Rwanda: UNICEF Trauma Recovery Program; 1996;.
14 +
Murray-Lee M. Rwanda's Lost Souls . New York, NY: UNICEF; 1994;.
15 +
Goma Epidemiology Group.  Public health impact of Rwandan refugee crisis: what happened in Goma, Zaire, in July, 1994? Lancet . 1995;;345:339-344.
16 +
Paquet C, van Soest M.  Mortality and malnutrition among Rwandan refugees in Zaire . Lancet . 1994;;344:823-824.
17 +
Center for International Health Information. Rwanda Country Health Statistics Profile . Arlington, Va: US Agency for International Development; 1995;.
18 +
Dowell SF, Toko A, Sita C, et al.  Health and nutrition in centers for unaccompanied refugee children: experience from the 1994 Rwandan refugee crisis . JAMA . 1995;;273:1802-1806.
19 +
Dabelstein N, ed. The International Response to Genocide: Lessons From the Rwanda Experience . Copenhagen, Denmark: Danish Ministry of Foreign Affairs; 1996;:7-13.
20 +
Carney A.  Lack of care in Rwanda . Br J Psychiatry . (October) , 1994;;165:556.
21 +
Callaghan MP, Immerman B.  PHS mission to Goma, Zaire . Public Health Rep . 1995;;110:95-99.
22 +
Bonneau J. Rapport de Mission AFSEA-Goma (Zaire): Aupres des Enfants Rwandais Refugies non Accompagnes . Paris, France: Association Departementale de Sauvegarde de l'Enfance et de l'Adolescence; 1995;.
23 +
Calvin F.  Children traumatized by catastrophic situations . In: Eth S, Pynoos RS, eds. Post-traumatic Stress Disorder in Children . Washington, DC: American Psychiatric Press; 1985;:103-120.
24 +
Dawes A.  The effects of political violence on children: a consideration of South African and related studies . Int J Psychol . 1990;;25:13-31.
25 +
Kanji N.  War and children in Mozambique: is international aid strengthening or eroding community-based policies? Community Dev J . 1990;;25:102-112.
26 +
Melville M, Lykes MB.  Guatemalan Indian children and the sociocultural effects of government-sponsored terrorism . Soc Sci Med . 1992;;34:533-548.
27 +
Allodi F.  The psychiatric effects in children and families of victims of political persecution and torture . Danish Med J . 1980;;22:229-232.
28 +
Van der Veer G.  Psychotherapeutic work with refugees . In: Leber RJ, Figley CR, Gersons BPR, eds. Beyond Trauma: Cultural and Societal Dynamics . New York, NY: Plenum Publishing Corp; 1995;:151-170.
29 +
Mollica RF, Fish-Murray C, Donelan D, et al. Repatriation and Disability: A Community Study of Health, Mental Health, and Social Functioning of the Khmer Residents of Site Two . Vol 2. Boston, Mass: Harvard Program in Refugee Trauma, Harvard University School of Public Health; 1989;.
30 +
Kinzie JD, Sack W, Angell R, Clarke G, Ben R.  A three-year follow-up of Cambodian young people traumatized as children . J Am Acad Child Adolesc Psychiatry . 1989;;28:501-504.
31 +
Augustyn M, Parker S, Groves BM, Zuckerman B.  Silent victims: children who witness violence . Contemp Pediatr . 1995;;12:35-57.
32 +
McKelvey RS, Webb JA.  Long-term effects of maternal loss on Vietnamese Amerasians . J Am Acad Child Adolesc Psychiatry . 1993;;32:1013-1018.
33 +
Suarez-Orozco MM.  Speaking of the unspeakable: toward a psychosocial understanding of responses of terror . Ethos . 1990;;18:353-383.
34 +
Suarez-Orozco MM.  A grammar of terror: psychocultural responses to state terrorism in dirty war and post-dirty war Argentina . In: Nordstrom C, Martin J, eds. The Paths to Domination, Resistance, and Terror . Berkeley: University of California; 1992;:219-259.
35 +
Bracken PJ, Giller JE, Summerfield D.  Psychological responses to war and atrocity: the limitations of current concepts . Soc Sci Med . 1995;;8:1073-1082.
36 +
Lifton RJ.  The concept of the survivor . In: Dimsdale J, ed. Survivors, Victims, and Perpetrators: Essays on the Nazi Holocaust . Washington, DC: Hemisphere Publications; 1980;:123.
37 +
Nosiglia JE. Botin de Guerra . Buenos Aires, Argentina: Abuelas de Plaza de Mayo; 1985;.
38 +
Fariña JJ.  El terrorismo del estado como fantasma . In: Martínez V, ed. Terrorismo de Estado: Efectos Psicologicos en los Niños . Buenos Aires, Argentina: Paidos; 1987;:21-41.
39 +
Bureau of Humanitarian Response, Office of US Foreign Disaster Assistance. Consolidated Rwanda Report Update #11 . Arlington, Va: US Agency for International Development; 1994;.
40 +
UNICEF. Children: The Future of Rwanda: A Ministry of Labour and Social Affairs Update With UNICEF Support on Children in Especially Difficult Circumstances . Kigali, Rwanda: UNICEF; September 30, 1996;.
41 +
Gordon-Bates K. International Committee of the Red Cross News . Geneva, Switzerland: International Committee of the Red Cross; 1995;;14.
42 +
de Charry A. Synthèse sur les Orphelinats, Avril 95 . Paris, France: Médecins du Monde; 1995;.
43 +
Frank DA, Klass PE, Earls F, Eisenberg L.  Infants and young children in orphanages: one view from pediatrics and child psychiatry . Pediatrics . 1996;;97:569-578.
44 +
Ajdukovic M, Ajdukovic D.  Psychological well-being of refugee children . Child Abuse Neglect . 1993;;17:843-854.
45 +
Eisenbruch M.  The mental health of refugee children and their cultural development . Int Migration Rev . 1988;;22:282-300.
46 +
Garbarino J.  Developmental consequences of living in dangerous and unstable environments: the situation of refugee children . In: McCallin M, ed. The Psychological Well-being of Refugee Children . Geneva, Switzerland: International Catholic Child Bureau; 1992;:1-23.
47 +
 Proceedings of the Conference on the Care of Dependent Children (1909) . In: Proceedings of the National Conference on the Care of Children, 1895-1915 . New York, NY: Arno; 1971;:6.
48 +
Chapin HD.  Are institutions for infants necessary? JAMA . 1915;;64:1-3.
49 +
Goldfarb W.  Effects of psychological deprivation in infancy and subsequent stimulation . Am J Psychiatry . 1945;;102:18-33.
50 +
Tizard B, Hodges J.  The effect of early institutional rearing on the development of eight-year-old children . J Child Psychol Psychiatry . 1978;;19:99-118.
51 +
Tizard B, Hodges J.  IQ and behavioral adjustment of ex-institutionalized adolescents . J Child Psychol Psychiatry . 1989;;30:53-75.
52 +
Klackenberg G.  Studies in maternal deprivation in infants' homes . Acta Paediatri . 1956;;45:1-12.
53 +
Saltz R.  Effect of part-time 'mothering' on IQ and SQ of young institutionalized children . Child Dev . 1973;;17:80-90.
54 +
Hansen AB.  Short term differences of infant development in nursery homes and in private families . Acta Paediatr Scand . 1971;;60:571-577.
55 +
Miller LC, Kiernan MT, Mathers MI, Klein-Gitelman M.  Developmental and nutritional status of internationally adopted children . Arch Pediatr Adolesc Med . 1995;;149:40-44.
56 +
Miller N.  The influence of HIV/AIDS in the Rwanda tragedy . AIDS Soc . 1994;;4:1-6.
57 +
Simasathien S, Duangmani C, Echeverria P.  Haemophilus influenzae type B resistant to ampicillin and chloramphenicol in an orphanage in Thailand . Lancet . 1980;;2:1214-1217.
58 +
Takala AK, Jero J, Kela E, et al.  Risk factors for primary invasive pneumococcal disease among children in Finland . JAMA . 1995;;273:859-864.
59 +
Brahmadathan KN, Koshi G.  Epidemiology of streptococcal pyoderma in an orphanage community of a tropical country . Am J Trop Med Hyg . 1988;;91:306-314.
60 +
US Agency for International Development Congressional Report FY1997. Arlington, Va: US Agency for International Development; 1996.
61 +
Makhlouf SA, Sarwat MA, Mahmoud DM, Mohamad AA.  Parasitic infection among children living in two orphanages in Cairo . J Egypt Soc Parasitol . 1994;;24:137-145.
62 +
Janoff EN, Mead PS, Mead JR, et al.  Endemic Cryptosporidium and Giardi lamblia infections in a Thai orphanage . Am J Trop Med Hyg . 1990;;43:248-256.
63 +
Reid E.  The psychology of war and HIV epidemic . AIDS Soc . 1994;;4:6.
64 +
UNICEF. Children of Rwanda: An Update on Children in Especially Difficult Circumstances . No. 4. Kigali, Rwanda: UNICEF; May 1995;.
65 +
Toole MJ.  The public health consequences of inaction: lessons learned in responding to sudden population displacements . In: Cahill KM. A Framework for Survival: Health, Human Rights, and Humanitarian Assistance in Conflicts and Disasters . New York, NY: Basic Books Inc Publishers; 1993;:144-158.
66 +
Gruber AR. Children in Foster Care . New York, NY: Human Science Press; 1978;.
67 +
Rein M, Nutt TE, Weiss H.  Fostering family care: myth and reality . In: Schorr AL, ed. Children and Decent People . New York, NY: Basic Books Inc Publishers; 1974;:24-52.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems