Join HHE’s Dr. Kevin Bezanson and Prof. Elysée Nouvet for their upcoming webinar, hosted with the World Association for Disaster and Emergency Medicine (WADEM), entitled Life, Death, and Isolation: Reflections on Palliative Care from Ebola to COVID-19. Registration is required!
CITATION: Nouvet et al. Dying in Honor: experiences of end-of-life palliative care during the 2013-2016 Ebola outbreak in Guinea. Journal of International Humanitarian Action 2021 6(10): 1-17. Open access link
ABSTRACT: With no cure and a high mortality rate, Ebola virus disease (EVD) outbreaks require preparedness for the provision of end-of-life palliative care. This qualitative study is part of a larger project on palliative care in humanitarian contexts. Its goal was to document and deepen understanding of experiences and expectations related to end-oflife palliative care for patients infected with Ebola virus disease (EVD) in West African Ebola treatment centres (ETCs) during the 2013–2016 epidemic. It consisted of 15 in-depth semi-structured interviews with individuals impacted by EVD in a Guinean ETC: either as patients in an ETC, healthcare providers, healthcare providers who were also EVD patients at one point, family relations who visited patients who died in an ETC, or providers of spiritual support to patients and family. Analysis was team based and applied an interpretive descriptive approach. Healthcare delivery in humanitarian emergencies must remain respectful of patient preferences but also local and contextual values and norms. Of key importance in the Guinean context is the culturally valued experience of “dying in honour”. This involves accompaniment to facilitate a peaceful death, the possibility of passing on final messages to family members, prayer, and particular practices to enact respect for the bodies of the deceased. Participants emphasized several challenges to such death in Ebola treatment centres (ETCs), as well as practices they deemed helpful to alleviating dying patients’ suffering. An overarching message in participants’ accounts was that ideally more would have been done for the dying in ETCs. Building on participants’ accounts, we outline a number of considerations for optimizing end-of-life palliative care during current and future public health emergencies, including for COVID19.
The Transformative Disaster Risk Governance Webinar Series at York University is continuing with a session on Humanitarian ethics: moral purpose and moral hazard. The keynote is Prof. Hugo Slim, followed by a panel discussion with Professors Peter Timmerman and Nergis Canefe from York University, as well as a Q&A session with the audience.
Join the Canadian Coalition for Global Health Research and Western University (London, Canada) on Wednesday January 27 @ noon for a webinar on “MSF’s Stories of Change as a health promotion method in humanitarian settings”
Health-care decisions, such as changing practices to reduce the risk of the transmission of an illness, are not only based on biomedical knowledge but also on local knowledge, perspectives and experiences. Health promotion (HP) strategies should therefore both disseminate biomedical illness information and information that includes local knowledge and experiences. Yet, in practice it remains challenging to move away from the more ‘traditional’ health education approaches to participatory approaches that include local knowledge.
In 2019, MSF provided medical support in Goma responding to a cholera outbreak. A pilot of a participatory storytelling intervention was carried out to support the HP team in their efforts to encourage people to adapt protective hygiene practices. This interactive storytelling method presented an alternative to the traditional HP approach of top-down one-way communication. This webinar brings four individuals with front line experience using MSF’s Story of Change as a simple, sustainable, cost effective method for health promotion.
PhD candidate Ning Wang at the Institute of Biomedical Ethics and History of Medicine (IBME), University of Zurich recently published an articles in the IEEE Technology and Society Magazine entitled: “We Live on Hope…”: Ethical Considerations of Humanitarian Use of Drones in Post-Disaster Nepal. This work results from a three-week field study in rural Nepal, where local population’s livelihood was affected by the 2015 earthquake, and where drones were used in assisting disaster relief work. The article focuses on the ethical considerations associated with the use of technology for humanitarian purposes, and raises awareness for the need of critical analysis in the deployment of technology in the aid sector.
Full text can be accessed here. A related live talk regarding this case study is available here. The author can be contacted at: email@example.com.
Abstract The noticeable turn to technology in humanitarian action raises issues related to humanitarianism, sovereignty, as well as equality and access for at-risk populations in disaster zones or remote areas lacking sufficient healthcare services. On a technical level, practical challenges include heightened risks of data safety and security, and the potential malicious use of technology. On a societal level, humanitarian innovation may disrupt relations between different stakeholders, may widen inequality between those with access and those without, and may threaten privacy, disproportionately affecting the vulnerable population. Drawing on the empirical findings of a case study of the 2015 Nepal earthquake, this paper presents an in-depth normative analysis to identify contextualised ethical considerations, and illuminate the wider debate about how technological innovation in the aid sector should be operationalised. In conclusion, on the normative level, a prudent attitude in adopting novel technology in the aid sector is required; while on the operational level, proposals for actionable ethical standards to guide and safeguard sector-wide innovation practices are needed.
Keywords Humanitarian technology; community consent; technology assessment; data safety and security; regulation deficit; stakeholder accountability
Abstract excerpt: We identified six recurrent ethical concerns highlighted by interviewees regarding closure of humanitarian projects: respectfully engaging with partners and stakeholders, planning responsively, communicating transparently, demonstrating care for local communities and staff during project closure, anticipating and acting to minimize harms, and attending to sustainability and project legacy. We present these ethical concerns according to the temporal horizon of humanitarian action, that is, arising across five phases of a project’s timeline: design, implementation, deciding whether to close, implementing closure, and post-closure. This exploratory study contributes to discussions concerning the ethics of project closure by illuminating how they are experienced and understood from the perspectives of national and international humanitarian workers. The interview findings contributed to the development of an ethics guidance note that aims to support project closures that minimize harms and uphold values, while being mindful of the limits of ethical ideals in non-ideal circumstances.
Hunt, M., Eckenwiler, L., Hyppolite, SR. et al. Closing well: national and international humanitarian workers’ perspectives on the ethics of closing humanitarian health projects. Int J Humanitarian Action5, 16 (2020). https://doi.org/10.1186/s41018-020-00082-4
Abstract excerpt: Participants discussed various obstacles to the provision of palliative care in humanitarian crises. More prominent obstacles were linked to the life-saving ethos of humanitarian organizations, priority setting of scarce resources, institutional and donor funding, availability of guidance and expertise in palliative care, access to medication, and cultural specificity around death and dying. Less prominent obstacles related to continuity of care after project closure, equity, security concerns, and terminology. Opportunities exist for overcoming the obstacles to providing palliative care in humanitarian crises. Doing so is necessary to ensure that humanitarian healthcare can fulfill its objectives not only of saving lives, but also of alleviating suffering and promoting dignity of individuals who are ill or injured during a humanitarian crises, including persons who are dying or likely to die.
Hunt, M., Nouvet, E., Chénier, A. et al. Addressing obstacles to the inclusion of palliative care in humanitarian health projects: a qualitative study of humanitarian health professionals’ and policy makers’ perceptions. Confl Health14, 70 (2020). https://doi.org/10.1186/s13031-020-00314-9
This seminar, chaired by HHE’s Dr. Lisa Schwartz will explore the response to COVID-19 and the need for rapid research to develop vaccines, treatments and other kinds of urgently needed knowledge. Previous public health emergencies have demonstrated that good community engagement helps move research forward, ensures it is feasible, relevant, and accepted, and that its findings are taken up. But how can it be done quickly, and in the midst of lockdowns? On this webinar we will explore these questions, and hear from the experts how to bring Good Participatory Practices to COVID-19 research.
Refugees and many migrants suffer from limits on their abilities to move around the world, even in pressing or urgent circumstances. They are often forced to leave their homes for reasons beyond their control, including war and civil unrest, political and religious persecution, economics, or famine and other natural or man-made disasters. Once displaced, whether internally or externally, they face pressing needs for food, water, shelter, and health care. Local governments, international agencies and non-governmental organizations often struggle with providing for their needs, particularly in resource-poor regions of the world. Recent socio-political changes in the United States, Western Europe and elsewhere have placed additional restrictions on the rights of migrants and refugees.
To explore these and overlapping issues, in solidarity with these refugees and migrants, on June 15th, 16th, 17th and 18th 2020, 7 am – 9 am Eastern Standard Time, we hosted a no-travel virtual conference to explore the ethical, legal, philosophical, and social issues associated with refugee and migrant health in a world of economic, geopolitical, and psychological borders.
In the coming weeks and months, this website will be updated with more information from the conference. Please note that the submission must be made before May 1st , 2020.
If you have any questions about the conference, want to register and/or participate, please send an email to firstname.lastname@example.org