0 comments on “How well was HHErg represented at HEI Research Day 2019? Extremely well, thank you.”

How well was HHErg represented at HEI Research Day 2019? Extremely well, thank you.

On March 14, McMaster’s Department of Health Research Methods, Evidence and Impact hosted its annual Research Day.

The HHErg was well represented this year with two poster presentations (below) and an oral presentation entitled, “Dying in the Margins:  Palliative Care, Humanitarian Crises and the Intersection of Global and Local Health Systems.”

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Pictured from L to R, Jhalok Talukdar, Rachel Yantzi, and Takhliq Amir.

Slide1

Downloadable PDF of the Natural Disasters Array poster.

Slide1

Downloadable PDF of the Opportunities and Challenges poster.

 

 

0 comments on “Resisting Borders, 9-11 October 2017”

Resisting Borders, 9-11 October 2017

CLICK HERE FOR THE CONFERENCE PROGRAM

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.

In solidarity with these refugees and migrants, we are hosting 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.

ResistingBorders_Picture

Location: Online (no travel)

Cost: Free

For registration and other information: http://www.resistingborders.com

0 comments on “Call for Abstracts”

Call for Abstracts

1st World Congress on Migration, Ethnicity, Race and Health (MERH)
The MERH 2018 Congress is hosted by an independent, non-profit making company working under the auspices of The University of Edinburgh, the European Public Health Association and NHS Health Scotland.  We intend to deliver to you a memorable, affordable, academic and social programme in one of the most spectacular cities in the world.
Congress aims :
  • To improve research, population health and health care for migrants and other discriminated-against populations
  • To bring together policy, social science, clinical, social service and public health perspectives and share and transfer learning within and across countries.
  • To examine contemporary problems across the globe and debate suggested solutions
  • To Consider health effects of social, environmental and demographic change associated with population migration, and the effects on diseases and their causes
  • To find ways to overcome differences in concepts and terminology so the field can be understood internationally in acceptable language.
  • To provide opportunities for people to showcase their work and to meet to share experience and motivations
  • To build networks that will last beyond the Congress itself
Abstract Submission and Registration is now open. 
Deadline for submissions is October 6, 2017.

http://www.merhcongress.com

0 comments on “Hot off the press! REFLECTIONS newsletter: Volume 5 Issue 1, Summer 2017”

Hot off the press! REFLECTIONS newsletter: Volume 5 Issue 1, Summer 2017

ACCESS THE FULL SUMMER 2017 ISSUE HERE.

 

Refugee Health: ensuring and asserting Well Being

We’re all familiar with pictures of refugee camps and of settlements inhabited by people forced from their homes. Depicted are shelters, some more roughshod than others. The structures can provoke a range of emotions, the least likely of which are feelings of comfort and belonging. These are really not the types of places people would call home if circumstances allowed. While the pictures do provoke reactions, the types of which are determined largely by our subject position, there is much these pictures cannot tell. The pictures can invite us—if we are willing—to look beyond their content, beyond their frame. In that case, what we are looking at transforms from pictures of shelters to commodities of a capitalist humanitarian system, to products of generations of global structures of violence, of transnational mechanisms of exclusion, and of regime made disasters, and to pictures of new, makeshift communities. The pictures can also help us imagine (so much as imagining is possible considering that even they are shaped by our cultural and personal experiences) the life people left behind, the good times, the terrifying ones, the ways of life gone perhaps forever and the ways of life currently lived and being adapted to. We may even gain a sense through the images of the ongoing anxieties, the hopes, and even the dreams (the latter having even become the focus of some recent photography of refugee experiences) of people whose trajectories have been forcibly altered. For the luckier ones, these places will be temporary residences. For others, these will be the last places they know as age, disease or the extensions of conflict take their lives.

This issue of reflections focuses on the politics and ethics of healthcare provision to refugees. The provision of healthcare to individuals displaced and on the move is an ethical imperative. It involves a responsibility to attend to the physical or emotional suffering of people, and it is also as a way of extending and integrating newcomers into their new (possibly, but not likely, temporary) community.

Also included in this issue are reports on refugee healthcare in two countries that have been taking a great proportion of Syrian refugees. One is a broad overview of refugee healthcare in Jordan—with a particular focus on palliative care—produced by McMaster Global Health student Madeline McDonald. The other is a summary prepared by Dr. Michel Daher about the ethics and the current state of providing universal healthcare to refugees in Lebanon. In their own way, each report reveals the extent to which the governments and healthcare professionals in these countries are inherently involved in attending to the physical and psychological wellbeing of their new, unexpected arrivals. The reports also point to where current practices fall short, especially as concerns the response by the larger global community, thus providing us with more knowledge with which to read pictures of refugee experiences.

With over 65 million people having been forcibly displaced from their homes there is a growing sense of normalization around this phenomenon, even though to consider this situation as the new (or growing) norm is grounds for provoking indignation, as John Pringle demonstrates in this edition’s Commentary. A degree of normalization within the camps and settlements, however, is a crucial imperative for those living within them as it provides an existential sense of wellbeing, and of being a Well Being rather than disposable. This is the theme uniting ongoing projects summarized in this issue.

Sincerely,
Sonya de Laat, PhD(c)
Co-Editor of Reflections,
PhD candidate in Media Studies, FIMS Western University
Research Coordinator, HHE research group, McMaster University

0 comments on “In Focus: Olive Wahoush”

In Focus: Olive Wahoush

Photo courtesy of Olive Wahoush.

HHE Member Profile

Dr. Olive Wahoush has been an advocate and researcher of refugee health care since 1987. She came to this topic first through teaching undergraduate nurses maternal newborn health in a refugee camp in Jordan in the 1987 and later through hospital administration and volunteer roles in Pakistan and Canada. Olive trained as a nurse in Northern Ireland during the 1970s a period of civil conflict, during that time she was exposed to ethical issues around triage, resource allocation, discrimination, and direct patient care. Later during her time as a nurse educator and leader in the Middle East and Pakistan she became interested in global health issues when she was exposed to situations where populations were on the move, capacity development was essential in health service programs and in health professional education.

Olive emigrated to Canada in 1992 and continued to build on her interests in maternal and child health, community engagement and outreach to include vulnerable and underserved groups in Hamilton and Toronto. She completed her PhD at UofT and her doctoral research examined health care access and experiences of refugee and refugee claimant families in Hamilton. Through her roles at the School of Nursing at McMaster University, Olive was instrumental is leading and promoting research with refugees, newcomers and other underserved populations. Many undergraduate and graduate students now complete experiential learning placements in Hamilton, Toronto and Internationally with agencies serving refugees and other underserved groups.

When it comes to health for refugees as they work to settle in a new environment, Olive sees equitable outcomes as a fundamental ethical concern, it is not enough to focus on access, some people need more help than others to get to the same outcome. For example newcomers such as refugees need time, language development and information about their adopted country and the new systems they need to use to live well. When asked about what the main priorities are for refugee healthcare abroad, Olive identified respect and recognition of refugees’ situations and conditions [or, refugeedom] as a priority area for researchers concerned with ethical dimensions of care or of research. Although there are common concerns across refugee populations that enable rapid response programming, there are also significant differences related to the circumstances such as war or climate change and history affecting populations, settings and individuals.

Recent research Olive has been involved in or leading include studies focused on reproductive health, health and resettlement of refugee and refugee like families in Canada and exploring the selection process for refugees in transit countries like Jordan. She has recently become a co-investigator on the HHE project exploring ethical aspects related to palliative care in humanitarian crisis situations. She has made invaluable connections with practitioners, academics and researchers on the ground in Jordan in order to learn about the provision of palliative care in refugee contexts (in camps and in urban settings) in that country.

0 comments on “Ethics and Unmet Promises: Syrian refugees healthcare in Lebanon”

Ethics and Unmet Promises: Syrian refugees healthcare in Lebanon

The New York Declaration for Refugees and Migrants, adopted by the United Nations GEneral Assembly in September 2016, stresses that root causes should be addressed “through the prevention and peaceful resolution of conflict, greater coordination of humanitarian, development and peace-building efforts, the promotion of the rule of law at the national and international levels and the protection of human rights”. The international community has thus recognized “a shared responsibility to manage large movements of refugees and migrants in humane, sensitive, compassionate and people-centered manner”.

UN Document A/71/L.1. (paragraph 11)

Refugees & Migrants and Ethical Responsibility for their Health Care:

  • It is more than simple generosity, simple charity.
  • It aims to build spaces of normalcy in the midst of what is abnormal.
  • More than offering material assistance, we aim to enable individuals to regain their rights and dignity as human beings.

Nobel Lecture by James Orbinski, Médecins Sans Frontières, Oslo, December 10, 1999

The Context

Since the start of the Syrian conflict in 2011, Lebanon has been host to incoming refugees. The UNHCR estimates 1,050,877 Syrians are now in Lebanon, amounting to 25% of the Lebanese population. Refugees are concentrated in the North and Bekaa regions, host communities that are already poor, underserved and vulnerable.[1]

The Issue

The large and constant influx of Syrian refugees into Lebanon has greatly strained the Lebanese healthcare system and economy. Many local and international NGOs, humanitarian organizations and governmental agencies are involved in providing humanitarian assistance and health services to Syrian refugees. Yet, there remain existing structures that limit refugee access to essential health care services, including poor coordination between them. The result is a rise in communicable diseases, increased risk of epidemics, suboptimal control of chronic diseases, and other health related matters.[2]

How can the Lebanese MOPH and other stakeholder organizations secure better access to essential and urgent healthcare needs of Syrian refugees?

Current Health Situation of Syrian Refugees in Lebanon

Access to Healthcare by Syrian Refugees in Lebanon

Roles and Responsibilities of the Lebanese Ministry of Public Health (MoPH)

Conclusion

It is important to promote access to Essential Health Care Services for Syrian Refugees in Lebanon and to recognize the severe shortage in financing and unmet promises by the international community. An immediate action and far greater support from the international community is needed to address the needs of refugees in Lebanon.

Recommendations for the MOPH and international aid agencies:

  1. Develop an essential package of healthcare services for Syrian refugees and Lebanese people.
  2. Develop a mechanism at the level of the government to raise funds to finance the delivery of the essential package.
  3. Expand the number of primary healthcare centers, and hospitals that are within the humanitarian sector.
  4. Developing refugee health information system through:
    • Identifying priority data needs and requirements;
    • Developing guidelines for data collection, and data use;
    • Establishing a mechanism for data monitoring, data sharing between all stakeholders including the private sector.
  5. Invest in building capacities of local infrastructure and local government (municipalities) to handle crisis situations.
  6. Explore mechanisms to increase transparency in the work including resource allocation of NGOs and other agencies in delivering health interventions.
  7. Invest in decentralizing decision making capacity at the level of the government departments to match interventions and aid to the needs of the local community.
  8. Identify research priorities on refugee health.
  9. Strengthen the stewardship function of governmental departments and having a lead organization that is capable to play a major role by coordinating and establishing effective partnerships with local and international agencies.

About the Author:

Michel Daher, MD, FACS
Professor of Surgery, Univ of Balamand
Secretary General, Lebanese National Ethics Committee
Vice-Chair, National Committee for Palliative Care
Saint George Hospital-UMC, Beirut- Lebanon
mndaher@inco.com.lb

 

Photo Credit: One-month-old baby boy, Walid, is comforted by his mother after a check-up provided by UK aid at a Save the Children clinic in Lebanon’s Bekaa Valley. Walid’s mum was worried about him but the diagnosis was just that’s he suffering from colic, which will hopefully get better by itself in time. The UK is supporting Save the Children to provide access to primary healthcare for thousands of Syrian refugee children in Lebanon, as well as ensuring that hundreds of pregnant Syrian women have access to anti-natal care. To find out more about how the UK is responding to the humanitarian crisis in Syria and its neighbouring countries, please see:www.gov.uk/government/news/syria-the-latest-updates-on-uk… Picture: Russell Watkins/Department for International Development

 

[1] (UNHCR, 2014 – WB&UN, 2013; UNHCR. 2015. Syria Regional Refugee Response http://data.unhcr.org/syrianrefugees/regional.php)

[2] (Refaat & Mohanna, 2013)