Continuing our new series about palliative care in the context of humanitarian crises where we shall look at the implications of providing palliative care for migrants, refugees and people who have fled war-torn countries and places of conflict and how the hospice and palliative care community can offer appropriate support.
Joan Marston, Friedemann Nauck, Mhoira Leng and Lukas Radbruch review some current initiatives, and explain how the European Association for Palliative Care (EAPC) Task Force for Refugees and Migrants is working with PalCHASE on a new white paper that aims to help strengthen collaboration between palliative care and humanitarian healthcare practitioners and organisations.
Refugees, migrants and internally displaced persons (IDP) in Europe are a heartbreaking outcome of the continuing unrest in Syria, the Donbass region of Ukraine and of a growing number of people escaping wars, civil unrest and poverty in Africa. Over the past three years there has been a significant increase in interest in refugee, migrant and IDP health from the international palliative care community. This has led to the establishment of PalCHASE –Palliative Care in Humanitarian Aid Situations and Emergencies – a collaborative of palliative care and humanitarian aid practitioners, ethicists, educators, researchers and advocates promoting palliative care integration into all humanitarian aid situation, and into the humanitarian health response.
Small but effective programmes in countries such as Bangladesh with the Rohingyan refugees, Jordan, Palestine and Uganda show that such development can be achieved. International humanitarian health organisations such as Doctors without Borders have acknowledged the need for palliative care within their programmes, and are working towards this. The important inclusion of a Palliative Care Standard in the new edition of the Sphere Handbook, which reaches into a wide range of humanitarian activities, is a significant step forward. The Sphere philosophy that all possible steps should be taken to alleviate human suffering arising from disasters and conflict, and that those affected have the right to assistance, is in alignment with palliative care principles. (You’ll hear more about this in a subsequent post from Sphere).
Steps towards greater collaboration and guidance
The need for strengthening collaboration between palliative care and humanitarian healthcare practitioners and organisations – for education that includes expertise from both groups, as well as guidance on ways to develop this integration – has become increasingly apparent. A number of palliative care practitioners, clinical, psychosocial and spiritual, have indicated their willingness to assist in humanitarian situations and in education. However despite the obvious need for palliative care in humanitarian situations accessing funding has been a challenge.
Where refugees with palliative care needs have settled or have been in transit in countries in Europe with established palliative care and/or hospice programmes, some have been admitted into these programmes and have received palliative care. An assessment of the experiences for both the refugee families and the programmes would be of value to the EAPC Task Force for Refugees and Migrants in Europe.
How the EAPC will contribute – development of white paper
This EAPC task force has been collaborating with PalCHASE (supported by International Association for Hospice & Palliative Care – IAHPC) and is to develop a white paper that will include the following activities:
- Undertaking a literature review.
- Assessing the palliative care needs of refugees of all ages from neonates and children, to older persons.
- Making recommendations for palliative care professionals, as well as for professionals working in humanitarian organisations.
The white paper is to describe structural and organisational aspects as well as methods for screening, assessment and treatment. The paper will be used to formulate the agenda for the task force’s later activities and to produce an action plan for the task force and the EAPC. Read more about the EAPC Task Force for Refugees and Migrants in Europe here. .
More about the authors…
Friedemann Nauck, Clinic for Palliative Medicine, University Medical Center Goettingen, Germany.
Mhoira Leng, Medical Director, Cairdeas International Palliative Care Trust; Global Health Academy, University of Edinburgh, and Department of Palliative Medicine, Makerere University, Kampala, Uganda.
Follow Mhoira on Twitter @drmhoira
Lukas Radbruch, Department of Palliative Medicine, University Hospital of Bonn, Germany; Chair of the International Association for Hospice & Palliative Care (IAHPC).
Follow Lukas on Twitter @LukasRadbruch
Waldman E and Glass M (eds.) A Field Manual for Palliative Care in Humanitarian Crises. Oxford University Press; November 2019. View Marcia Glass and Elisha Waldman’s chapter, Introduction: Why Palliative Care? FREE OF CHARGE online until 14 February 2020.
Read more in the ‘Palliative Care in Humanitarian Crises’ series on the EAPC blog, Next in the series will be a post from Sphere on the Palliative Care Standard in the new edition of their handbook.