Abstract

Abstract

Abstract

In 2012, the Nigerian-American writer and artist Teju Cole called out the culture of white saviourism in the USA and introduced the concept of the White Saviour Industrial Complex (WSIC). The make-up of global health education perpetuates and feeds into the WSIC, with universities in high-income countries (HICs) accounting for a major share of global health programmes. Global health education is in certain respects a growth industry of whiteness that promotes justice only on paper and remains rooted in harmful colonial worldviews. Cole noted that the WSIC is “not about justice”, rather “it is about a big emotional experience that validates privilege”. This reflection applies to how global health is taught, including by us as educators based in Canada, irrespective of our roots and citizenship in Sri Lanka, Rwanda, Mexico, and India. Those who work in global health in HICs benefit from an imbalance of power that maintains the white supremacist status quo, and consequently an entrenched divide in global health. As global health educators we are then compelled to ask: are we training students to be “white saviours”, irrespective of their ethnicity or country of origin, and how can global health education be reconfigured?

Abstract

Abstract

DOI

https://doi.org/10.31223/X52Q21

Subjects

Public Health

Keywords

climate change, health, Public health, Global Health, vulnerability, adaptation, risks, Caribbean, West Indies

Résumé

Introduction : Les populations autochtones au Canada sont disproportionnellement touchées par le virus de l’hépatite C (VHC). L’intégration des cultures et savoirs autochtones aux interventions de santé est fragmentée et la pratique infirmière présente des lacunes à cet égard.

Objectifs : Cette revue narrative des écrits visait à analyser les interventions communautaires de lutte au VHC réalisées auprès de populations autochtones afin de proposer des recommandations pour renforcer la pratique infirmière en matière de VHC et la rendre plus cohérente aux besoins et valeurs des communautés autochtones.

Méthodes : Des méthodes d’examen rapide ont été adoptées. Les bases de données CINAHL, MEDLINE, EMBASE et Cochrane et le moteur de recherche Google ont été consultés. Le modèle de réceptivité communautaire de Stanley et al., (2014), qui favorise le développement d’interventions appropriées selon les forces, la problématique et le contexte, a guidé l’analyse.

Résultats : Au total, 24 sources ont servi à analyser 13 projets d’intervention. Des similarités sont ressorties dans 11/13 projets d’intervention adoptant une approche holistique (n=11) et/ou une approche de réduction des méfaits (n=7), ce qui comprend une relation de confiance, sans jugement et non stigmatisante. La mobilisation communautaire était inhérente aux 13 projets d’intervention et c’est par une approche axée sur l’autodétermination que les infirmières étaient les plus susceptibles d’inciter cette mobilisation nécessaire à l’intervention en matière de VHC.

Discussion et conclusion : Avec une approche holistique de la réduction des méfaits, l’infirmière pourrait davantage soutenir l’autodétermination et la mobilisation communautaire afin de réduire efficacement le fardeau du VHC vécu par les communautés autochtones.

Abstract

Background:Adolescence is a critical period for reinforcing healthy dietary behaviors and supporting the development of cooking skills. Social media may be an avenue for supporting these behaviors, as it is popular among adolescents and can improve access to nutrition education interventions. This study sought to understand the optimal implementation of effective social media–based nutrition education interventions to inform the implementation of future social media–based nutrition education interventions.

Objective:A scoping review of the characteristics, feasibility, effectiveness, and factors influencing social media–based nutrition education interventions for adolescents was conducted.

Methods:We searched MEDLINE, Embase, CINAHL, Web of Science, and PsycINFO databases using a predefined search strategy. Primary research articles were independently screened and included if they involved adolescent populations (10-18 years old) and delivered nutrition education through social media. The information on intervention characteristics, feasibility, effectiveness, and factors influencing social media–based nutrition education interventions was extracted.

Results:A total of 28 publications out of 20,557 met the eligibility criteria. Twenty-five nutrition interventions were examined by 28 studies. Fourteen interventions used homegrown social media platforms, 8 used Facebook, and 2 used Instagram. Feasibility outcomes were infrequently reported, and the cost of intervention delivery was not reported. Engagement with interventions was variable; high engagement was not required to elicit significant improvements in dietary behaviors. Tailoring interventions, offering practical content, meaningful peer support, and involving families and communities facilitated successful interventions. Strategies to address engagement and technical issues were varied.

Conclusions:Emerging evidence demonstrates that social media interventions for adolescent nutrition are acceptable and improve nutrition outcomes. Future interventions should strengthen peer support components and tailor delivery to specific populations. Further research should examine engagement, adherence, and the impact of interventions on behavioral and physical outcomes. This review is the first to examine the use of social media as the primary medium for nutrition education for adolescent populations. The analysis used in this review argues the importance of peer support in social media–based nutrition interventions and the need for user-centered design of the interventions.

JMIR Pediatr Parent 2023;6:e36132

doi:10.2196/36132

Background

Climate change (CC) adaptation is considered a priority for Caribbean Small Islands Developing States (SIDS), as these territories and communities are considered particularly vulnerable to climate-related events. The primary health care (PHC) system is an important actor in contributing to climate change adaptation. However, knowledge on how PHC is prepared for CC in Caribbean SIDS is very limited. The objective of this paper is to discuss health adaptation to climate change focusing on the PHC system.

Methods

We explored the perspectives of PHC professionals in Dominica on climate change. Focus group discussions (FGDs) were conducted in each of the seven health districts in Dominica, a Caribbean SIDS, between November 2021 and January 2022. The semi-structured interview guide was based on the Essential Public Health Functions: assessment, access to health care services, policy development and resource allocation. Data coding was organized accordingly.

Results

Findings suggest that health care providers perceive climate change as contributing to an increase in NCDs and mental health problems. Climate-related events create barriers to care and exacerbate the chronic deficiencies within the health system, especially in the absence of high-level policy support. Healthcare providers need to take a holistic view of health and act accordingly in terms of disease prevention and health promotion, epidemiological surveillance, and ensuring the widest possible access to health care, with a particular focus on the ecological and social determinants of vulnerability.

Conclusion

The Primary Health Care system should be a key actor in designing and operationalizing adaptation and transformative resilience. The Essential Public Health Functions should integrate social and climate and ecological determinants of health to guide primary care activities to protect the health of communities. This indicates a need for improved research on the linkages between climate events and health outcomes, surveillance, and development of plans that are guided by contextual knowledge in the SIDS.

Résumé

Background

Refugees, asylum seekers, and migrants without status experience precarious living and working conditions that disproportionately expose them to coronavirus disease 2019 (COVID-19). In the two most populous Canadian provinces (Quebec and Ontario), to reduce the vulnerability factors experienced by the most marginalized migrants, the public and community sectors engage in joint coordination efforts called intersectoral collaboration. This collaboration ensures holistic care provisioning, inclusive of psychosocial support, assistance to address food security, and educational and employment assistance. This research project explores how community and public sectors collaborated on intersectoral initiatives during the COVID-19 pandemic to support refugees, asylum seekers, and migrants without status in the cities of Montreal, Sherbrooke, and Toronto, and generates lessons for a sustainable response to the heterogeneous needs of these migrants.

En prenant appui sur la mission de l’école québécoise qui consiste à instruire, socialiser et qualifier, le projet PhiloJeunes, implanté au Québec depuis 2015, œuvre au renforcement des facteurs de protection face à la radicalisation violente par la voie de l’implantation d’une pratique philosophique en classe. Le présent article se fonde sur une étude qualitative menée auprès de pédagogues engagés dans ce projet éducatif, afin d’explorer leur expérience lors de la formation et de l’application dudit projet. L’analyse met en lumière les défis et les leviers rencontrés par les pédagogues, notamment en regard d’une certaine prescription/proscription normative quant à l’expression et à la circulation des émotions. L’inévitable imbrication entre la sphère rationnelle et la sphère émotionnelle amène les autrices à soutenir, dans la veine de l’héritage de John Dewey, un dépassement de cette désuète opposition, afin d’embrasser une éducation démocratique sensible qui puisse favoriser la réalisation des objectifs de prévention de la radicalisation violente par la voie de la discussion philosophique en contexte scolaire.

Abstract

bstract

Ce mémoire a été élaboré par des membres chercheuses de l’équipe Inclusion et diversité ethnoculturelle en éducation (IDEÉ) financée par le Fonds de recherche du Québec – Société et Culture. Cette équipe a pour principaux objectifs :

1. de comprendre comment le personnel scolaire contribue à produire ou à réduire les inégalités éducatives en contexte de diversité ethnoculturelle ;

2. d’identifier comment les institutions éducatives, du préscolaire jusqu’à l’université, et leurs agents peuvent contribuer à réduire les inégalités et favoriser la justice sociale ;

3. de contribuer à éclairer les politiques en éducation et en immigration, les initiatives communautaires, la formation initiale et continue du personnel scolaire et les pratiques des milieux éducatifs. L’équipe IDEÉ adopte une posture critique afin de comprendre comment certaines pratiques et certains processus structurels agissent sur la réussite éducative et sur l’expérience de tou.te.s les actrices et acteurs de l’école, notamment les actrices et acteurs de groupes minorisés ou racisés. L’équipe IDEÉ rassemble :

● 11 chercheuses régulières mobilisant une diversité d’approches de recherche et de disciplines dont la sociologie, la psychopédagogie, la psychologie sociale, la didactique et l’administration scolaire;

● 40 étudiantes et étudiants à la maitrise et au doctorat;

● 11 collaboratrices et collaborateurs des milieux de pratique travaillant dans les institutions éducatives et gouvernementales ainsi que dans des organismes communautaires.

Introduction

Abstract

Abstract

The stopmtl.ca project uses a participatory mapping methodology to allow individuals to self-report their police stop experiences in the city of Montreal, Canada. Between July 14th 2021 and December 21st 2021, a total of 714 police stop experiences were contributed to the stopmtl.ca website. Of these contributions, approximately 28% (N = 197) were removed due to a programming error that led to the duplication of cases. Of the remaining contributions (N = 517), 21% were suspected fake data and 7% were excluded due to missing data. A total of 369 contributed police stop experiences were retained (71%). A descriptive analysis of the data suggests that most police stop experiences were reported by men (74%), individuals who identified as being White (55%), hetereosexual (70%) and being aged between 19 and 24 years (27%). A Black racioethnic identity was the second most frequent racioethnic identity (17%). In terms of spatial distribution, stop experiences were reported as occurring most frequently in the Côte-des-Neiges (13%) and Ville-Marie (12%) boroughs of Montreal. Nearly half of all reported stops were reported as having occurred in 2021 (49%), and most frequently in the summer months (May-August) (65%), peaking in July (33%). The most frequent activity individuals reported doing during their stop was being in a vehicle (42%), followed by walking (23%). Respondents could identify multiple reasons for which they believed they were stopped. The perceived reason for the stop most frequently identified was what the person was doing (39%), followed by their appearance (30%). Roughly equal proportions of police stops were seen as justified (41%) and as not justified (43%). There are several similarities between the characteristics of self-reported police stop experiences contributed to stopmtl.ca and police-recorded stops in the city of Montreal, Canada. Namely, there appears to be a comparable spatial distribution of police stops in both data sets, as well as some indication of a comparable social distribution (e.g., gender, age and racioethnic identities of those stopped). However, the self-reported police stop data is limited in several important ways. Namely, for self-reported police stops with available data on whether the respondent received a sanction following their stop (i.e., fine, arrest or charge) (N = 129), 42% were said to have led to a sanction. This limits the capacity to draw strong comparisons between self-reported data and police-recorded data (which excludes all stops leading to a sanction). Though criteria were applied to exclude suspected fake data, it is not possible to establish the veracity of self-reported stops. Nevertheless, these preliminary descriptive results provide a snapshot of who self-reported their stops and of the types of stops that led to self-reports. Furthermore, the data provide insight into citizens’ perceptions of their police stop experiences. Future directions for research, including planned validation analyses and a second wave of data collection are discussed.

Abstract

Nos membres Naïma Bentayeb et Lara Gautier sont les responsables du dernier numéro de la revue Alterstice sous le thème « Expérience des réfugiés, demandeurs d’asile et migrants sans statut et offre de services de santé et sociaux pendant la pandémie au Québec ». 

Plusieurs autres membres de SHERPA ont contribué à ce numéro dont Janet Cleveland, Jill Hanley, Patrick Cloos, Mélanie M. Gagnon et  Andréanne Dufour, membre de notre équipe.

Note:
Funding Declaration: We would like to acknowledge the support of Manon Lapierre, Director of Operations at La Maison Bleue, towards the realisation of this project. Additionally, we recognize the support provided to C.Woronko by the Ordre des infirmières et infirmiers du Québec Bourses de fin d’études à la maîtrise – 2021-2022. A Cuerrier acknowledges the support provided by the Ingram School of Nursing, McGill University, for the Student Research Support received. L Merry, P Li and A Van Hulst acknowledge the support received through Fonds de la recherche du Québec en santé Research Salary Awards.

Abstract

En nous appuyant sur une méthode mixte qui combine des sources primaires à des données empiriques collectées de façon extensive auprès d’intervenants en soins spirituels depuis 2012 au Québec, nous présentons les conditions d’émergence de cette profession dans les milieux de santé. Il apparait que cette nouvelle figure du soin offre un laboratoire fécond pour mieux saisir la mécanique de cette réalité fluctuante que constitue la spiritualité contemporaine. Nous soutenons que la vision normalisatrice du soin véhiculée actuellement dans les milieux de soins et par ricochet, dans les soins spirituels, situe le concept de spiritualité au croisement d’une conception du caring entendu sous la forme d’un humanisme qui se déploie et se réalise dans la rencontre et l’accompagnement de l’Autre d’une part, et de la réactualisation d’une représentation naturelle et universelle de la religion célébrée autour de la notion de la spiritualité d’autre part.

Résumé

In the wake of the killing of George Floyd on May 25, 2020, there was a strong call to action, first in North America and then globally, to tackle racism and promote racial justice . Many universities created “equity, diversity, inclusion, anti-racism (EDI-AR)” task forces and other mechanisms with goals of transforming institutions entrenched in histories of colonialism and white supremacy. Concurrently, decolonizing global health movements have been gaining momentum asking all stakeholders including academic institutes to advance equity and dismantle systemic forms of oppression .

Often equity efforts initiated during watershed moments face the challenge of losing team. The crescendos and unavoidable reckoning with every individual’s relationship to structural injustices ultimately dwindle and the status quo in academia continues to instill ingrained systems of discrimination. Deliberate equity building in academia including decolonizing curricula and institutional practices are also highly relevant to addressing structural fault lines in global health governing models, implementation practices and research partnerships . Lessons from failures in Covid-19 pandemic and climate crisis highlight the urgency to better equip students and faculty to lead equity centered approaches.

In this essay, we highlight six key considerations that senior leadership and community at large within high income country (HIC) global health academic institutions need to be mindful to successfully embed equity efforts into the fabric of their foundation. While our experiences as authors stem largely from our engagement in global health academia, the following reflections cut across disciplines.

This chapter, based on results from a qualitative research project commissioned by the Canadian Department of Justice, analyzes the availability of protection services for victims of trafficking in persons in Canada from the perspective of demand and supply.1 A first objective is to identify and highlight discrepancies between the “demand” for victim protection services versus the “supply” of community-based services. A second objective is to determine the root causes of these discrepancies. The voices of the NGOs who participated in the project will illustrate these dynamics. Policy recommendations to correct the imbalances between victims’ needs for services and NGOs’ ability to provide those services will conclude the chapter. 1. Despite the convention which usually places the word supply first when referring to supply and demand, the authors choose to inverse the terms in order to emphasize the demand aspect.

An overview of the phenomenon of human trafficking will situate the Canadian experience within an international context and the evolution of awareness and debates around trafficking among Canadian academics, policymakers and practitioners will be discussed. A brief description of the research project on which this chapter is based will be offered. The authors will specify the methodology applied and the results will be presented, discussing how the theory of demand and supply can be used to understand the dynamics surrounding community-based services for trafficking victims. The voices of NGOs, expressed through interview data, will illustrate the “demand” for services in terms of the needs of victims NGOs encounter and the “supply” of such services by community-based actors. An analysis of the gaps that exist between the demand and supply of services will precede the final section where policy recommendations will be offered to diminish the gaps in the hopes of better respecting the human rights of the victims of human trafficking.

This study examines the association between gender identity, mental health, social adversity, and sympathy for violent radicalization (VR). Data were collected through an online survey in Canada. A total of 6003 eligible participants who were residents of Montreal, Toronto, Calgary, or Edmonton and aged from 18 to 35 years were included. We used Fisher exact test to assess gender differences in gender-based discrimination and we used analysis of variance tests to assess differences in scores on bullying, mental health, and sympathy for VR. We used linear regression to assess the relationship between mental health, social adversities, and sympathy for VR. Individuals who self-identified as trans and gender diverse had greater sympathy for VR than females did, experienced online victimization more frequently, and reported higher levels of psychological distress than both male and female participants. Our findings indicate that more research is needed on the association between social adversity and support for VR among this vulnerable population.

Dans un contexte où les inégalités d’accès aux soins psychiatriques sont de plus en plus reconnues comme un enjeu préoccupant de santé publique dans les pays de la région subsaharienne, et alors que les représentations sociales associées aux troubles mentaux exercent une influence notable sur cet accès aux soins, celles-ci ont suscité jusqu’à présent peu de travaux. Dans cet article, nous appréhendons les entités nosologiques populaires et leurs principales caractéristiques en milieu urbain au Burkina Faso. Pour ce faire, 7 groupes de discussion et 16 entretiens individuels ont été menés auprès de différents acteurs dans la ville de Bobo-Dioulasso. Une analyse thématique a permis d’identifier deux entités nosologiques populaires. Le terme Kougolobana renvoie à une altération du cerveau associée à l’envoûtement par des entités surnaturelles et s’exprime sporadiquement ; alors que le terme Fatoya renvoie à une condition incurable causée par la commission d’actes transgressifs de différentes natures. Nos résultats mettent en lumière l’influence mutuelle des registres traditionnels et biopsychosociaux dans la construction de ces entités nosologiques. Ces résultats permettent d’amorcer une réflexion sur la place centrale qu’occupe la notion de transgression dans les représentations sociales des troubles de santé mentale dans la ville de Bobo-Dioulasso.

Background: The number of people living with type 2 diabetes (T2D) is increasing worldwide. The prevalence rate of this disease is generally higher in the migrant population compared to the general population. However significant inequalities in the prevalence of T2D are notable between and within migrant populations. Among them, migrants from sub-Saharan Africa, South America and South Asia are more affected than those of European origin. The act of eating and the corporality play an essential role in the development of this disease. Dietary and body norms systems favorable to the prevention and control of type 2 go against what is vital for most of these people, exposing them to conflicts of norms that are difficult to reconcile. 

Objectif: to identify factors that may influence the acceptance or rejection of dietary and body norm systems favorable to the prevention and control of T2D by Sub-Saharan Africa migrants living with T2D. 

Materials and methods: Scoping review according to the steps described by Arksey and O’Malley (2005) will be conducted. An electronic search of studies from 2011 to 2022, published English, Italian, French or in Portuguese will be conducted in eight databases (CINAHL, Cochrane library, Embase, Google Scholar, PsycInfo, PubMed, Scopus, and Web of Sciences). The grey literature including publication in Open Grey database and Website of non-governmental organizations working on migrant from Sub-Saharan Africa will be searched. All articles related to body norms, dietary behaviors, or determinants of body behaviors and dietary of migrants from Sub-Saharan Africa and those related to factors that influence acceptance or rejection of dietary and body norms systems favorable to the prevention and control of T2D among the migrants from Sub-Saharan Africa living with T2D or at risk to develop this disease will be included. This scoping review will be reported following the Standard Protocol Items: Recommendations for interventional Trials (SPIRIT) and Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. 

Results: The results will focus on factors influencing the acceptance or rejection of dietary and body norms systems favorable to the prevention and control of T2D among the migrants from Sub-Saharan Africa living with T2D or at risk to develop it.

The COVID-19 pandemic highlighted the impact of social inequalities in health (SIH). Various studies have shown significant inequalities in mortality and morbidity associated with COVID-19 and the influence of social determinants of health. The objective of this qualitative case study was to analyze the consideration of SIH in the design of two key COVID-19 prevention and control interventions in France: testing and contact tracing. Interviews were conducted with 36 key informants involved in the design of the intervention and/or the government response to the pandemic as well as relevant documents (n = 15) were reviewed. We applied data triangulation and a hybrid deductive and inductive analysis to analyze the data. Findings revealed the divergent understandings and perspectives about SIH, as well as the challenges associated with consideration for these at the beginning stages of the pandemic. Despite a shared concern for SIH between the participants, an epidemiological frame of reference dominated the design of the intervention. It resulted in a model in which consideration for SIH appeared as a complement, with a clinical goal of the intervention: breaking the chain of COVID-19 transmission. Although the COVID-19 health crisis highlighted the importance of SIH, it did not appear to be an opportunity to further their consideration in response efforts. This article provides original insights into consideration for SIH in the design of testing and contact-tracing interventions based upon a qualitative investigation.

When approaching the multiplicity of the spiritual experiences of healing, ethnographers are often presented with ideas of the existence of “other” worlds that may intersect with the so-called “material” or “physical” worlds. This book proposes a sensory ethnography of healing with a focus on ethnographic knowing as embedded in an embodied epistemology of healing. Epistemological embodiment signals that personal scholarly experience of the “unknown”—be it in the form of trance, or as the embodiment of an “other”—shapes the concepts of healing, body, trance, self, and matter by which ethnographers craft out analysis.

Digital technology offers several opportunities to improve access to professional expertise in primary care, and the offer of various “virtual” services has exploded in the past few years. The aim of this study was to evaluate the implementation of a direct-to-consumer on-line pharmacy consultation service (Ask Your Pharmacist – AYP) to a universal phone consultation service led by the universal public health system in Quebec (811 Info-Santé), through a direct bridge. Semi-structured interviews were conducted with clinician users of the service, and stakeholders involved in this pilot project funded by the Ministry of Economy (n = 22); documents were also analyzed, and content of the question was asked through the AYP service. Adoption of the service was low, and it suggests a poor alignment between the need and the service as implemented. Further research should investigate the mechanisms for an appropriate integration of digital services for primary care universal consultation services.

Background

Children in Afghanistan live in dangerous areas, and have been exposed to traumatic events and chaotic education. Progress has been made on access to education for girls who were the most affected by traditional attitudes against engagement in education.

Objectives

The objectives were to evaluate the mental health of Afghan children living in regions of conflict and the association of mental health with school attendance for girls and boys.

Method

The study included 2707 school aged children in eight regions of Afghanistan (16 provinces) residing in households recruited through a multi-stage stratified cluster sampling strategy in 2017. The level of terrorist threat was evaluated by the intensity of terrorist attacks recorded that year in each province. Child mental health was assessed with the parental report Strengths and Difficulties Questionnaire (SDQ) along with information on school attendance, sociodemographic characteristics and geographic location.

Results

A total of 52.75% of children had scores above threshold for the SDQ total difficulties score, 39.19% for emotional difficulties, 51.98% for conduct challenges, and 15.37% for hyperactivity/inattention. Peer relationship problems were high (82.86%) and 12.38% reported that these problems impacted daily life. The level of terrorist threat was associated with SDQ total difficulties (Adjusted Odds Ratio [AOR] = 4.08, P < 0.0001), with youth in regions with high levels of terrorist threat more likely to have problems than youth in regions with low or medium levels of danger, independent of region and ethnicity. School attendance was negatively associated with emotional symptoms (AOR = 0.65, P < 0.0001) and mental health difficulties with impairment (AOR = 0.67, P = 0.007), but positively associated with peer relationships difficulties (AOR = 1.96, P > 0.0001). Conduct (AOR = 1.66, P < .0001) and SDQ total difficulties (AOR = 1.22, P = 0.019) were higher among boys. Overall, gender did not modify the relationship between school attendance and child mental health.

Conclusion

Attending school is essential for children’s mental health, across gender, and should be supported as a priority in Afghanistan despite the return of the Taliban.

Inequalities in access to psychiatric care are increasingly recognized as a serious public health issue in sub-Saharan Africa. In these countries, little information is available regarding social representations of mental disorders, although these can have a significant influence on access to care. In this article, we examine the popular nosological entities and their characteristics in urban Burkina Faso. To do so, 7 focus groups and 16 individual interviews were conducted with various actors in the city of Bobo-Dioulasso. A thematic analysis revealed two popular nosological entities. The term Kougolobana refers to an alteration of the brain associated with bewitchment by supernatural entities and is expressed sporadically; whereas the term Fatoya refers to an incurable condition caused by the commission of transgressive acts of various kinds. Our results highlight the mutual influence of traditional and bio-psycho-social registers in the construction of these nosological entities. These results allow us to reflect on the centrality of the notion of transgression in the social representations of mental health disorders in the city of Bobo-Dioulasso.