0 comments on “Missed our event in Geneva? Looking for a summary? Here it is.”

Missed our event in Geneva? Looking for a summary? Here it is.

 

Have a look at a summary of the events that took place 26-27 September when the HHE Research Group visited Geneva.

Thank you to our co-hosts CERAH, and to all of our participants over the two days and one evening of exciting activities.

 

DayPostcardFront

By all means, if you have thoughts you’d like to share with us about our ongoing research or the events from September in Geneva, please contact us!

0 comments on “HHE Representation at HSR2018, Liverpool”

HHE Representation at HSR2018, Liverpool

From 8-12 October the Fifth Global Symposium on Health Systems Research was held in Liverpool, UK.

The HHE research group was well represented with a presentation on the Perceptions of Ebola Virus Disease Research project by Ani Chénier entitled “Beyond Triumphalist Discourses” and a poster on the Palliative Care in Humanitarian Crisis settings.

From the study on perceptions of EVD research:

The full citation of the presentation is:

Elysée Nouvet, Ani Chénier, Oumou Bah-Sow, John Pringle, Sékou Kouyaté, Sonya de Laat, Matthew Hunt, Carrie Bernard, Lynda Redwood-Campbell, Laurie Elit, Lisa Schwartz, Beyond triumphalist discourses: West African voices on the need to recognize and sustain national research capacity in the wake of the 2014-6 Ebola epidemic. Fifth Global Symposium on Health Systems Research, 8 12 October 2018,Liverpool, UK.

ABSTRACT:

BACKGROUND The 2014-6 West African Ebola epidemic, in which a neglected disease for which no effective treatment or vaccine was yet known claimed over 11,000 lives, was a stark reminder of the essential role that health research plays within health systems.

In 2016, we launched the “Perceptions and moral experiences of research conducted during the West Africa Ebola outbreak” study. This qualitative study seeks to better understand socially-situated practices and moral experiences of research conducted in public health crisis situations, and to deepen understanding of challenges to and strategies for the ethical conduct of research during public health emergencies. It explored, among other issues, the practical and ethical complexities of international research collaborations established during the outbreak.

METHODS We conducted in-depth semi-structured interviews with 108 stakeholders directly involved in research at trial sites in Guinea, Sierra Leone, and Liberia. Participants included: 1- people having participated in clinical and persistence studies; 2- people engaged in the conduct of research (as investigators or research staff), 3- local and international research ethics board members; 4- governmental and civil society leaders. Most (91%) were from West African countries.

RESULTS Participants identified many strengths of research conducted during the outbreak, notably: 1) the success of some international partnerships (especially vaccine trials), 2) the development of innovative and adapted strategies for communicating with participants, 3) opportunities for capacity building, especially for first-time researchers, and 4) rigorous and constructive oversight by national research ethic boards.

Key challenges or failures included:  1) limited opportunities for higher-level engagement of affected-country researchers within international partnerships, 2) limited engagement of mid- or late-career researchers in the development or leadership of studies, 3) unequal access to and control over research materials like bio-samples, and 4) failures to sustainably invest in national research institutions.

CONCLUSIONS Our findings highlight the important role played by health research within local and national health systems, and complicate triumphalist discourses about the role of ‘capacity building’ in international research. During the 2014-6 West African Ebola outbreak, efforts towards capacity building were appreciated by many. Yet many also expressed frustration with the lack of investment in national research infrastructure and institutions, and the lack of opportunities for mid- and late-career researchers from affected countries. This had important practical implications, notably for the setting of research priorities that reflect needs and possibilities at the national level. Capacity must not only be built: it must also be recognized, supported, and sustained.

 From the study on palliative care in humanitarian crises:

Full reference for the poster:

de Laat, S., Matthew Hunt, Elysée Nouvet, Olive Wahoush, Kevin Bezanson, Carrie Bernard, Lynda Redwood-Campbell, Laurie Elit, Wejdan Khater, Oumou Bah Sow, Emmanuel Musoni, Rachel Yantzi, Ani Chénier , Lisa Schwartz, Dying in the Margins: Palliative Care, Humanitarian Crises and the Intersection of Global and Local Health Systems, Fifth Global Symposium on Health Systems Research, 8 12 October 2018, Liverpool, UK, Abstract ID: 3989

The poster is available below (& here as a PDF):

deLaat_ID3989_Poster_HSR2018_Final

Abstract:

OBJECTIVES There is no doubt that the primary goal of humanitarian healthcare has to be to save lives. Given the extremity of the crises in which humanitarians respond, not all lives can be saved. There is a growing acknowledgment of the role of palliative care in humanitarian healthcare. Here we present an interpretive description of the experience of palliative care in a variety of humanitarian crisis settings. Our objective is to map the diversity of those experiences and to examine the innovations and inconsistencies of global and local health systems to assess the obstacles and opportunities of these health systems in the support of palliative care during international humanitarian crises.

METHODS Four case studies were identified through stakeholder meetings and key informant interviews that represent a broad range of humanitarian emergency situations where palliative care needs arise:

  • A public health emergency: Guinea during the Ebola Crisis;
  • An acute conflict & refugee situation: Syrian refugees in Jordan;
  • A protracted refugee situation: Congolese and Burundian refugees in Rwanda; and,
  • Natural disaster situations: various geographic settings.

For each case study, in-depth, semi-structured interviews exploring experiences, needs, frustrations, and possibilities for palliative care were conducted with patients or family members of individuals with a terminal or life-threatening condition suited to palliative care. Along with interviews with crisis-affected people, local and international humanitarian healthcare providers were interviewed at each site.

RESULTS Global and local health systems—independently and intersecting with each other—emerged as a recurrent source of barriers to the provision of palliative care. Dominant themes include: global restrictions and local cultural anxieties to accessing essential medications for symptom relief; importance of culturally relevant, and locally informed, care and psychosocial support; the lack of international and local palliative care guidelines, training, and support for the provision of palliative care during international humanitarian crisis events. Changes to global health systems and improved interaction between local and international actors were cited as enablers to comprehensive palliative care provision. Palliative care was recognized as an essential component of holistic, comprehensive humanitarian healthcare, and should never act as a substitute to health system improvements for curative care.

DISCUSSION The alleviation of suffering is central to the work of humanitarian healthcare, and yet competing priorities often result in a lack of attention to palliative care. Our study presents critical insight onto the role of local and global health systems in the provision of palliative care in contexts of humanitarian crises.

 

1 comment on “The Humanitarian Visual Landscape of 2015”

The Humanitarian Visual Landscape of 2015

by Sonya de Laat

Miserable images of the ravages of Ebola Virus Disease in West Africa (thankfully, on a downward trajectory by that point) were at the forefront of the humanitarian visual landscape of 2015. These pictures were swiftly overtaken in the spring (and for the bulk of the year) with heart wrenching images of the perilous journeys taken by (im)migrants en route to Europe. The vast majority of these images are undoubtedly shocking. Photographs such as Samuel Aranda’s picture for the New York Times of a four-year-old girl lying on the urine soaked floor of a Sierra Leone health facility, and Nilufer Demir’s photograph of the tiny, lifeless body of 3-year-old Aylan Kurdi washed up on the beach in Bodrum, Turkey and countless others contributed to the ongoing debates about the ethics of showing pain and suffering. Such debates are longstanding, reaching back to the early days of the medium, and have focused on: what is acceptable to display under what circumstances or in what forms or forums; when is the circulation or display exploitation, appropriation or commodification; at what point does the representation of suffering render the phenomenon a spectacle?

0 comments on “The Humanitarian Politics of Cecil the Lion”

The Humanitarian Politics of Cecil the Lion

by Lauren Wallace

Two weeks ago Stephen Harper kicked off the election campaign. But it wasn’t clear if many Canadians were paying attention. Because the killing of Cecil the celebrity lion had already broken the Internet.

In case you missed it, in late July, Walter Palmer, a dentist from Minnesota, beheaded Cecil, a lion living in Hwange National Park in Zimbabwe. Within days of news of the murder breaking, the public’s violent backlash sent Mr. Palmer into hiding. Major airlines, including Air Canada, banned shipments of hunting trophies from Africa; a global petition demanding justice accumulated over 300,00 signatures; PETA called for the killer to be hanged to death; and, donations were made to erect a life size bronze statue of the martyr lion.

1 comment on “hhe members author ALNAP blog on palliative care in humanitarian crises”

hhe members author ALNAP blog on palliative care in humanitarian crises

Elysée Nouvet and Lisa Schwartz co-authored a blog post for ALNAP on July 10, 2015 entitled:

Is palliative care in humanitarian crises a luxury?

If there is one thing the Ebola crisis has generated these past 18 months, it is widespread recognition that globally we could be better prepared for responding swiftly and ethically to complex pandemics. Ethical issues that surfaced in the panicked first months of the last Ebola crisis have ranged from debates on whether or not healthcare workers in non-Ebola affected countries have a duty to respond and assist their colleagues in other affected countries, to the absence of a standard of care for treatment of affected patients. As members of the Humanitarian Healthcare Ethics Group, we were surprised that another big question was not, and still is not, receiving the deliberation it merits: What are the responsibilities of humanitarian healthcare teams, if any, vis a vis the palliative needs of patients?

Visit the ALNAP blog to find the full post.

0 comments on “An Outbreak of Outbreaks: Humanitarian Epidemiology in West Africa”

An Outbreak of Outbreaks: Humanitarian Epidemiology in West Africa

by John Pringle

I was disappointed that I couldn’t go to West Africa sooner. The Ebola epidemic was at its peak in the fall of 2014, the same time that I was preparing for my doctoral defence. I watched “Ebola Frontline” which conveyed tragedy and urgency. The documentary followed Médecins Sans Frontières (MSF) doctor Javid Abdelmoneim as he cared for Ebola patients in Sierra Leone.[1] It was graphic and raw, something out of Dafoe’s A Journal of the Plague Year. That people had to be turned away from Ebola treatment centres was profoundly inhumane. That traumatized aid workers had to turn people away because treatment centres were overrun, to watch helplessly as people died agonizing deaths in cars or on the ground—was yet another searing reminder of our collective failure, that there is no shared responsibility for global health, and that our notion of ‘international community’ is more dream than reality.

0 comments on “HumEthNet Member Dr. Lynda Redwood-Campbell Comments on the Importance of Coordination in Disaster Response Action”

HumEthNet Member Dr. Lynda Redwood-Campbell Comments on the Importance of Coordination in Disaster Response Action

“Coordination – that would be the big lesson of Haiti. Haiti was a disaster upon a disaster,” Canadian doctor Dr. Lynda Redwood-Campbell and HumEthNet member tells Globe and Mail reporter, Affan Chowdhry in a recent article about How past disasters will aid relief efforts in earthquake-ravaged Nepal. “There was a complete lack of coordination with foreign medical teams. Everybody and everybody’s cousin seemed to be there internationally. There was no good overarching coordination.”

0 comments on “On the Importance of Human Connection: Fear, Ebola and Security”

On the Importance of Human Connection: Fear, Ebola and Security

Photo of Larissa Fast

by Larissa Fast

Cross-posted with Political Violence @ a Glance

This week marks the first anniversary of the World Health Organization (WHO) declaration of an Ebola Virus Disease (EVD) outbreak in West Africa. A healthcare worker infected with Ebola while volunteering in Sierra Leone arrived in the US earlier this month. Another ten of this unnamed health worker’s colleagues were also evacuated to the US for monitoring after exposure to the virus.

The muted media reaction to this latest Ebola case is vastly different than last fall, when the outbreak was at its peak and the first case of Ebola arrived on North American shores. Hysteria mounted, tweets mentioning Ebola skyrocketed, and pictures of people in clinics and in western airports wearing various types of protective gear appeared in the media.

0 comments on “Ethics and Ebola: How Do We Address Complex Ethical Issues in an Evolving Humanitarian Emergency?”

Ethics and Ebola: How Do We Address Complex Ethical Issues in an Evolving Humanitarian Emergency?

poster_GH-speaker-series

Come out on Wednesday, 14 January 2015 for a timely lecture on Ethics and Ebola by Lisa Schwartz (McMaster University) and Ross Upshur (University of Toronto).
Time: 4:30-6:00pm
Location: MCDL 3020, McMaster University, Hamilton, ON, Canada.