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Palliative Health Care in Jordan for Syrian Refugees – An HHE Report

 

Palliative Health Care in Jordan for Syrian Refugees

McMaster University’s Global Health student, Madeline McDonald completed this report within the Masters in Global Health program, under the supervision of Dr. Elysée Nouvet.

The full report is available here.

The Hashemite Kingdom of Jordan shares its northern border with the Syrian Arab Republic, and has been one of the main receiving countries of fleeing refugees since the beginning of the Syrian conflict in 2011. Currently over 650,000 Syrian refugees live in Jordan, most outside of refugee camps (Ministry of Planning and International Cooperation, 2015).

Refugees face many significant health concerns, both acute and chronic. While some are related to the conflict such as injuries and infections, non-communicable diseases claim the most Syrian lives (UNHCR, 2016b). Refugees receive care within the extensive Jordanian health system, which includes public, private and NGO facilities and services. The influx of refugees has put increased strain on both medical and human resources within the Ministry of Health in Jordan.

This paper examined factors affecting provision and accessibility of palliative care Syrian refugees. Palliative care focuses on providing relief from symptoms, pain and stress of a serious illness for patients and families (Razzak & Smith, 2014). Formal palliative care services are only available in the capital city of Amman: one in-patient palliative care unit and one home-based care service (Al Qadire et al., 2014). Jordan has no national policies on palliative care, nor palliative care education for health care providers.

Factors influencing provision and accessibility of palliative care services for refugees fall into three distinct categories:

  • Financial factors include costs to the patients and families for registration documents, user fees, medications and transportation. The health care system also incurred sizeable costs from providing care for the incoming refugees in addition to citizens.
  • Systemic and organizational factors complicate access to care through rigorous identification and registration requirements for refugees. Health care services are not evenly dispersed, nor are they equally accessible to all. Strict regulations surrounding the distribution and use of opioids restrict use for pain management.
  • Important cultural and ideological factors include a tradition of non-disclosure about poor prognosis, and the role of the family unit in decision-making and caring for patients. Many Muslims have strong religious beliefs about illness and death, which are reinforced by cultural norms. Finally, negative perceptions, misconceptions, and lack of awareness about palliative care, pain management and the use of opioids play an important role.

In conclusion, some future directions for research and policy are proposed for the national and international levels. These will support improvement and expansion of palliative care services in Jordan as a resource- and cost-effective way to provide better care for refugees and citizens alike.

PHOTOGRAPH: Syrian refugees seek medical attention at the Jordan Health Aid Society Clinic in the Zaatari refugee camp, located 10km east of Mafra, Jordan on June 04, 2014.
Photo © Dominic Chavez/World Bank   Photo ID: Jordan_EDIT_005

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Call now open for GFBR 2017

The Global Forum on Bioethics in Research will hold a two-day meeting in Bangkok, Thailand, on 28-29 November 2017 on the theme of: the ethics of alternative clinical trial designs and methods in low- and middle- income country research.

The CALL IS NOW OPEN for:

  1. CALL FOR CASE STUDIES
  2. CALL FOR PROPOSALS ON GUIDANCE AND POLICY ISSUES
  3. CALL FOR PARTICIPANTS

See the following link for more details and information:

http://www.gfbr.global/news/call-now-open-2017-gfbr/

If you have any questions about this call please email gfbr@wellcome.ac.uk.

All applications should be sent to gfbr@wellcome.ac.uk by 21.00 BST on Tuesday 30 May 2017, in English. Please specify in the subject line whether you are applying to attend, present a case study or present on guidance or a policy issue. Applications received after the deadline will not be considered.

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MARCH 31 CFP: Chapter contributions for volume on Humanitarian Action and Ethics

Humanitarian actors are now pressed to respond to increasingly complex crises in diverse and difficult contexts. Historically subject to multiple and often divergent interpretations, humanitarian values are now further challenged by changing conflict dynamics, globalization and its effect on shifting power relations, and a more sustained criticism of established forms of humanitarian response. Though under appreciated, ethical reflection offers an opportunity for deeper evaluation of humanitarian action, and its impact on those who endeavour to alleviate suffering and protect human dignity during, and in the aftermath of, humanitarian crises. This edited volume seeks to bring together academics and practitioners engaged in all aspects of both direct humanitarian response and scholarly humanitarian reflection, with the aim of offering a nuanced insight into the complexity of the humanitarian experience in a diversity of crisis contexts. As such, we welcome contributions related to any aspect of humanitarian action and ethics, with a particular interest in practitioner perspectives.

Call for Papers:

The volume is due to be submitted in its entirety by the 1st of August 2017. To be considered for inclusion in this volume, please kindly submit a 200-word abstract by the 31st of March to a.ahmad@ucl.ac.uk

Dr Ayesha Ahmad and Dr James Smith

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Not to be missed! Two incredible upcoming talks hosted by McMaster History of Medicine

Title:  “The Drowned, the Saved, and the Forgotten: Genocide Survivors and the Foundations of Modern Humanitarianism” 

Speaker:   Dr. Keith Watenpaugh, Professor and Director, Human Rights Studies Program, Co-Director University of California Human Rights Collaboration, Department of Religious Studies, University of California at Davis

The talk will take place:

  • Wednesday, March 22, 2017
  • 3:00pm to 5:00pm
  • Health Sciences Building/McMaster Medical Centre (HSC) 1A6

Abstract:  All humanitarian emergencies are not created equal, or at least not constructed in the humanitarian imagination equally.  Where they happen, who is affected, the judged “worthiness” of victims and the quality of need are among the several conditions that transform how a problem of humanity becomes a problem for humanity, like genocide.  Examining the international humanitarian response to the genocide of the Ottoman Armenians (1915-1922), he argues that modern humanitarianism and genocide have a complex and intertwined history that has particular relevance to concepts like humanitarian neutrality, humanitarian governance and the role of justice in relief and what would be called now, rights-based development.

Biography:  Professor Keith David Watenpaugh studies the history, theory and practice of human rights and humanitarianism and directs the UC Davis Human Rights Studies Program. He is author of Bread From Stones: The Middle East and the Making of Modern Humanitarianism (California, 2015) and Being Modern in the Middle East (Princeton, 2006). His work has been translated into French, German, Armenian, Arabic, Turkish and Persian.

 

 

Title:  “Refugees, Human Rights, and the Syrian War” 

Speaker:   Dr. Keith Watenpaugh, Professor and Director, Human Rights Studies Program, Co-Director University of California Human Rights Collaboration, Department of Religious Studies, University of California at Davis

The talk will take place:

  • Wednesday, March 22, 2017
  • 7:30pm to 9:00pm
  • Health Sciences Building/McMaster Medical Centre (HSC) 1A1

Abstract:  With several years of fieldwork in Syria and the Middle East, Dr. Watenpaugh will trace a history of the conflict in Syria and an understanding of the situation of Syrian refugees.  He has worked with Syrian refugees in camps in Turkey and will provide some insights for health professionals working with these populations.  He will explore the legal dilemmas of global humanitarianism and will address the recent ban on Muslims and refugees in the United States.

These two talks are co-sponsored by the following:

Department of History , Orphan Sponsorship Program, McMaster Muslim Student Association,  Department of Health, Aging, Society, Humanitarian Healthcare Network, Department of Religious Studies

The History of Medicine and Medical Humanities Speaker Series is made possible by an endowment from Associated Medical Services (AMS).

For more information; please contact the Hannah Chair Dr. Ellen Amster at:  amstere@mcmaster.ca.

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Call for Papers (April 15th): Resisting Borders – A Virtual Conference on Refugee and Migrant Health, Mobility, Human Rights and Responsibilities

Refugees and many migrants have long suffered under constraints on their mobility, 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 may face pressing needs for food, water, shelter, and health care. To explore these and other overlapping issues, in solidarity with these refugees and migrants we are hosting a no-travel virtual conference to explore the following questions:

 What kinds of restrictions on movement and travel of refugees are ethically permissible and which are not? When if ever are such restrictions ethically justifiable for refugees with needs for health services?

 Greater acceptance and humanitarian support is presented as being in tension with greater concerns for security, but how does this tension play out empirically and philosophically?

 What are the implications of ethically justified and unjustified restrictions? For example, in what ways do they create or perpetuate inequities?

 What is the proper moral response of and toward states that opt to provide acceptance and support versus those that opt for restrictions on refugees and migrants?

 

 Are there lessons from history that can shine light on the ethical dimensions and significance of mobility restrictions on refugees and migrants, and on fitting moral responses?

… and many other critical areas of inquiry.

We are especially interested in contributions from scholars and practitioners working in the areas of refugee health and/or international humanitarian law, immigration and security, health law and policy. Submissions from those who come from or work in regions facing travel restrictions are especially encouraged.

Interested participants should submit an abstract of 250 words no later than Saturday, April 15th, 2017. Abstracts should be submitted via email to the Organizing Chairs at info@resistingborders.com.

All abstracts should be in Word or RTF formats and contain the following information: a) author(s), b) affiliation, c) email address, d) title of abstract, e) body of abstract, f) type of presentation (oral paper or panel presentation), and g) 3 keywords.

Panel presentations should consist of three to four abstracts organized around a central topic of direct relevance to the conference theme. Please use a plain sans serif 12-point font and abstain from using footnotes and any special formatting, characters or emphasis (such as bold, italics or underline). More information will be forthcoming at http://resistingborders.com

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TALK: Corpses and Places: Remaking World and Afterworld in a Camp for Displaced Persons Elizabeth Dunn

Corpses and Places: Remaking World and Afterworld in a Camp for Displaced Persons

Date: Tuesday, March 21, 2017

Time: 3:30-5:00 pm

Location: Degroote School of Business, Room 505

Abstract: For refugees and internally displaced people (IDPs), displacement is more than a technical problem of logistics and delivery, and more than just a problem of maintaining biological existence.  It is an existential dilemma posed by the destruction not only of their homes, but of the world they once knew, including many of their social relationships, their attachments to places and the structures and practices they used to create meaning. In this talk, I look at how IDPs in the Republic of Georgia create topolgangers—two very different and distinct places on the identical terrain—to recreate the villages they lost on the grounds of the camp.   In doing so, they begin to reconstitute the world as a comprehensible space where action has meaning.

Biography: Elizabeth Dunn is a trained anthropologist and currently an associate professor cross-appointed in geography and international studies at Indiana University.  In addition to numerous academic articles and books on post-socialist privatization and questions of public health after communism, she has written on aid, humanitarianism, and refugee policy for Science, Boston Reviewand Slate, and this research has also been featured in The Los Angeles Times, Die Zeit, and SINC, a Spanish news agency.  More information can be found at http://www.elizabethcullendunn.com/