0 comments on “Upcoming Event: September 26”

Upcoming Event: September 26

Evening_Poster_final

Small Humanitarian Acts that Make All the Difference in End of Life Care?
Evening Panel Discussion  |  18:30-20:30  | Maison de la paix
 
            Introductory remarks—

 

18:30-18:40
Dorschopper-doris2017_300x300is Schopper
 
Dr. Schopper is professor at the medical faculty of the University of Geneva and director of CERAH since July 2011.Trained as a medical doctor,Schopper spent several years with Médecins Sans Frontières (MSF) in the field. She was president of the Swiss branch of MSF and twice president of the MSF International Council. In 2001 Doris Schopper was asked to constitute an Ethics Review Board for MSF International. Since then she has chaired the Board coordinating the ethical review of MSF research proposals and providing advice on ethical matters to the organisation. httpslisa_preferred-photo-edited-e1430944033295://www.cerahgeneve.ch/cerah/faculty-staff/academics/prof-doris-schopper
 
 18:40-18:55
Lisa Schwartz
 
Prof. Schwartz is the Arnold L. Johnson Chair in Health Care Ethics with the Faculty of Health Sciences, Associate Professor in the Department of Clinical Epidemiology and Biostatistics, Associate Director of the Centre for Health Economics and Policy Analysis (CHEPA), and Associate Member of the Department of Philosophy, at McMaster University. Dr Schwartz is trained as a Clinical Ethics Consultant and has used and devised frameworks for the ethical challenges that arise in clinical care in high and low resource settings and in humanitarian crises settings. https://humanitarianhealthethics.net/home/about/lisa-schwartz/

 

 18:55-19:00 – Doris Shopper’s introduction of the keynote speaker
 
            Keynote message—19:00-19:20 (+5 mins of clarification questions)
 
Paul Bouvier on Small Acts of Humanitarian Kindness

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 Dr. Bouvier works with the International Committee of the Red Cross (ICRC) as course coordinator (the HELP course)and chair of the group on ethics in the practice of humanitarian action. Former ICRC Senior Medical Advisor, he is a medical doctor with specialization in pediatrics and public health, and Associate Lecturer at the Institute of Global Health, University of Geneva, where he has carried out research and prevention programs on child sexual abuse and violence. Along with his medical and training activities, Dr. Bouvier has also applied the perspectives he developed through his various roles and field experience in crises into various philosophical reflection and medical humanities activities. From published reflections on “small things and humanity” on the part of delegates visiting people in detention (2012), to an art history lesson on Francisco Goya’s Disasters of War prints in prefiguring Dunant’s Solferino relief efforts by several decades (2011), Dr. Bouvier has demonstrated his skills as a rich and diverse thinker on issues of suffering, morality and what it means to be human. A further complement to his professional work, and his intellectual writing, he has consulted on exhibitions at the International Red Cross and Red Crescent Museum<https://www.redcrossmuseum.ch/en> in Geneva including the main “Humanitarian Adventure” halls, and the most recent publication “Prisoners’ Objects<https://www.redcrossmuseum.ch/en/product/prisoners-objects/>.”
 
 
 19:25-19:30Schwartz introduces the panelists
 
 

 

           Panelists—19:30-20:15
 
0-2Ibraheem Abu Siam
 
Abu Siam, RN, CNS, is a Public Health Officer at UNHCR (Jordan). He is an experienced Public Health Specialist with a demonstrated history of working in the international affairs industry. Skilled in Policy Analysis, Government, Program Evaluation, Public Policy, and Research, he is a dedicated community and social services professional with a Master’s degree focused in Public Health/Community Nursing from Jordan University for Science and Technology. You can see him here on a video from the International Council of Nurses speak on the topic of safeguarding health during crises: https://www.youtube.com/watch?v=GFY8yHd_i_E
 
Emmanuel Musoni 
 
emmanuel_musoni-e1528994510848Dr. Musoni is a Psychiatrist at the Central Hospital of the University of Rwanda in Kigali (CHUK). Before starting his postgraduate studies in psychiatry, Dr. Musoni was the Clinical Director at the Masaka District Hospital, Rwanda. He also served as a Medical Officer in Darfur-North SUDAN for the UNAMID Peacekeeping mission. His research interests include bipolar disorders and palliative care. He is currently carrying out research on the effects and challenges of psychoeducation on patients with bipolar disorder in Rwanda. https://humanitarianhealthethics.net/home/research/hhe-research-studies/pall-iphc/case-study-conflict-protracted-refugees-rwanda/
 
 
Sonya_De_Laat2-2Sonya de Laat
 
Dr. de Laat is the Postdoctoral Fellow in Humanitarian Health Ethics at McMaster University, Canada. With backgrounds in anthropology and media studies, her interests and approaches are mixed and multidisciplinary—straddling social science, health science and humanities. Her research interests include the moral, political and historical dimensions of humanitarian visual culture. Currently, she is focusing on the role of photography in shaping people’s impressions of and in mediating responses to global migration, with a particular focus on the conditions and experiences of being a refugee, and on humanitarian (health)care for refugees. www.sonyadelaat.weebly.com
 
olive205-e1520279214382Olive Wahoush
 
Dr. Wahoush has been an advocate and researcher of refugee health care since 1987. She came to this topic through teaching undergraduate nurses maternal newborn health in a refugee camp in Jordan and through hospital administration and volunteer roles in Pakistan and Canada. Through her roles at the School of Nursing at McMaster University, Dr. Wahoush was instrumental is leading and promoting research with refugees, newcomers and other underserved populations. Recent research Dr. Wahoush has been involved in or leading include studies focused on reproductive health, health and resettlement of refugees and refugee-like families in Canada and exploring the selection process for refugees in transit countries like Jordan.
 
20:15-10:30  Schopper & Schwartz closing remarks
0 comments on “Becoming an anthropologist in post-Ebola Giunea”

Becoming an anthropologist in post-Ebola Giunea

Follow this link to the blog authored by Sekou Kouyate on the opportunities and challenges of becoming an anthropologist and a qualitative researcher in post-Ebola Guinea.

Kouyate is the research assistant and coordinator for HHERG’s two R2HC funded studies in Guinea: on perceptions of research and on the provision of palliative care during the 2014-16 Ebola Virus Disease outbreak.

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0 comments on “Is there space for palliative care in humanitarian action?”

Is there space for palliative care in humanitarian action?

Read this new blog post to find out about…

MAKING SPACE FOR PALLIATIVE CARE IN HUMANITARIAN ACTION: REFLECTIONS ON OBSTACLES TO THE INTEGRATION OF PALLIATIVE CARE APPROACHES IN HUMANITARIAN HEALTHCARE

by Matthew Hunt, Carrie Bernard and Kevin Bezanson

 

http://www.elrha.org/r2hc-blog/making-space-palliative-care-humanitarian-action-reflections-obstacles-integration-palliative-care-approaches-humanitarian-healthcare/

 


This research project  is funded by Elrha’s Research for Health in Humanitarian Crises (R2HC) Programme.

r2hc_logo_FOR ONLINE USE

R2HC DFID and WT- FOR ONLINE USE

0 comments on “Obstacles and moral experiences with palliative care provision in humanitarian crises…”

Obstacles and moral experiences with palliative care provision in humanitarian crises…

From September 17-19, Kevin Bezanson represented the Humanitarian Health Ethics research group at the 5th International Public Health and Palliative Care Conference held in Ottawa, ON.

Here is the PDF version of the poster entitled –

Health professionals’ lived experiences of palliative care provision in humanitarian crisis: Moral experiences confronting the suffering of patients who are dying or likely to die in settings of war, disaster, or epidemic.

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Kevin Bezanson presenting the HHE poster at the 5th International Public Health and Palliative Care Conference, Ottawa, ON, Sept. 17-19, 2017.

 

The poster is based on ongoing research for a R2HC funded project entitled:

Aid when there is ‘nothing left to offer’: A study of ethics and palliative care during international humanitarian action


The research project is funded by Elrha’s Research for Health in Humanitarian Crises (R2HC) Programme. The Research for Health in Humanitarian Crises (R2HC) programme aims to improve health outcomes by strengthening the evidence base for public health interventions in humanitarian crises. Visit www.elrha.org/work/r2hc for more information. The R2HC programme is funded equally by the Wellcome Trust and DFID, with Elrha overseeing the programme’s execution and management.
0 comments on “Hear Lisa Schwartz explain HHE’s project on palliative care in humanitarian contexts”

Hear Lisa Schwartz explain HHE’s project on palliative care in humanitarian contexts

From a new resource on Community of Practice for Integrated People Centred Palliative Care by WHO, info@integratedcare4people.org.

Additional interviews prepared by WHO’s Community of Practice for Integrated People Centred Palliative Care:

Interview of Dr Christian Ntizimira Médecin Head of Avocacy & Research department of Rwanda Palliative Care and Hospice Organization
Interview of Katherine Pettus, Advocacy Officer for Human Rights and Palliative Care at International Association for Hospice & Palliative
0 comments on “New Fears, Old Problems – Palliative Care, EVD & the DRC”

New Fears, Old Problems – Palliative Care, EVD & the DRC

New Fears, Old Problems:
An Appeal for Palliative Care in the DRC Ebola Virus Outbreak

by Dr. Pedro Favila Escobio, MD (MS Palliative Care)

As a medical doctor involved in humanitarian response, I (as many of my colleagues were), was very concerned and followed very closely the evolution of the Ebola Outbreak in West Africa.

I was in the Guinean capital city of Conakry in November 2015 when Nubia, a one month old baby girl and the last Ebola case in Guinea whose mother had died because of the outbreak, was released from the Ebola Treatment Centre. What to do, what not to do, clinical and case management, community involvement, social mobilization, infection and prevention control, priorities, constraints, and the post-Ebola response scenario were all familiar words in my thoughts during that period. Palliative care was not, for whatever reason, in my head.

In Coyah, 50km away from Conakry, just before leaving the country I met a traditional midwife who, during the peak of the outbreak ,was one of the frontline workers in the response to the epidemic. “Despite all the efforts, nobody will bring us back our dead and repair their suffering” she said.

I barely could imagine the suffering of all those affected by the outbreak. Of the approximately 40 million of people around the world in need of palliative care services, only 14% have access to them, mainly in high income countries. Back home, in Spain, during my specialization training as a Family and Community Medicine Doctor and after specialization, palliative care was part of my everyday work life, and a basic component of the integrative health services we provide. So why, working as a humanitarian professional, was I neglecting what I consider a basic pillar in the standard of care?

On 11th May 2017, a new Ebola outbreak in DRC was declared. This outbreak thankfully seems to be coming under control as I write, but this does not change the fact that to this day there are no proven effective treatments or vaccines against Ebola. The mortality rate remains at 50%. Will palliative care be part of what healthcare providers have in their minds, and are they prepared to provide it when facing such deadly outbreaks?

A review of the literature (publication forthcoming) on the clinical management and treatment of EVD in West Africa yields few mentions of care provided to patients in Ebola Treatment Centers that was not curative in intention. Indeed, palliative care is practically absent in reports and recommendations for EVD patient management. Those very few articles that mention palliative care being provided do not include an explanation on the provision of such services.

Two challenges of providing palliative care in an Ebola context are clear from this literature. First, limited understanding of when Ebola patients are nearing death makes knowing which patients are beyond recovery and dying. Secondly, in some cultural contexts and certainly in the three most affected West African countries during the last outbreak, the administration of opioids and other pain relief to dying patients was controversial and required careful perceptions management. In an environment of high distrust, morphine being given before a patient’s death risks being interpreted and reported by surviving patients (and even healthcare staff) as the cause of death. This could cause serious harm to the reputation of ETCs and its staff.

West Africa, DRC, and Beyond
I applaud the recommendations of WHO for the implementation of strategies for prevention and control of the epidemic, which include case management among others. Updated WHO guidelines for the management of EVD patients following the epidemic in West Africa point out that health personnel have an obligation to provide symptomatic relief and palliative care when necessary, and that terminally ill patients require end-of-life care provided by trained personnel, including psychosocial support for the patient and family.

I hope that inclusion of and access to essential palliative care medical kits will be facilitated, along with basic training and sensitization in palliative care for all health personnel working in the response. This will improve decision making and contribute to improvement of the processes of communication between health personnel, patients, family and community.

The recent opening of an ETC in Likati and the possible opening of a new centre in Muma, DRC should be used to assess the quality of care and the correct use of medicines necessary for pain control and patient well-being.

Equally, with the aim of guaranteeing the highest level and quality of care, priority should be given to promoting research on palliative care that allows us to offer conclusions about the effectiveness of palliative care in humanitarian crisis contexts, taking into account the complexity of providing services in such contexts.

Certainly much more should be done to make palliative care part of any health intervention. The first step is to stop the current outbreak of Ebola from DRC, to protect the lives of those affected and to ensure that health professionals, patients, and families know that when survival options have disappeared, it is not necessary to die in pain and suffering.

Dr. Escobio

 

Pedro Favila Escobio is a medical doctor specialized in family and community medicine, with a master in palliative care working in the humanitarian sector. His practice is focused especially on neglected diseases, displaced populations, migrant health and emergency response. He can be reached at p.favila[at]gmail.com. 

1 comment on “Palliative Health Care in Jordan for Syrian Refugees – An HHE Report”

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