The medical and moral imperative that palliative care be integrated into standard responses to humanitarian crises can be fulfilled by basic training and an essential set of medicines, equipment, social support and protocols
Humanitarian crises often cause both extensive loss of life and widespread suffering. Yet humanitarian crisis response virtually never fully integrates palliative care, the discipline devoted to preventing and relieving suffering. Recently, the World Health Organization (WHO) recognised the necessity of integrating palliative care and symptom relief into responses to humanitarian crises of all types and published a guide to this integration.1 In this article, we summarise the WHO recommendations, explain why inclusion of palliative care as an essential part of humanitarian response is medically and morally imperative, and describe how to ensure that palliative care is accessible for those affected by humanitarian crises.
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- 1. Krakauer E, editor. Integrating palliative care and symptom relief into the response to humanitarian emergencies and crises: a WHO guide. Geneva: World Health Organization, 2018. http://apps.who.int/iris/bitstream/handle/10665/274565/9789241514460-eng.pdf (viewed July 2019).
- 2. United Nations Office for the Coordination of Humanitarian Affairs. World humanitarian data and trends 2018. Geneva: UNOCHA, 2018. http://interactive.unocha.org/publication/datatrends2018/ (viewed July 2019).
- 3. World Health Organization. WHO definition of palliative care. https://www.who.int/cancer/palliative/definition/en/ (viewed July 2019).
- 4. Smith J, Aloudat T. Palliative care in humanitarian medicine. Palliat Med 2017; 31: 99–101.
- 5. Schneider M, Pautex S, Chappuis F. What do humanitarian emergency organizations do about palliative care? A systematic review. Med Conflict Survival 2017; 33: 263–272.
- 6. International Committee of the Red Cross. Fundamental principles of the Red Cross and Red Crescent Movement. https://www.icrc.org/en/fundamental-principles (viewed July 2019).
- 7. Sphere Association. The Sphere handbook: humanitarian charter and minimum standards in humanitarian response. 4th ed. Geneva: Sphere Association, 2018. www.spherestandards.org/handbook (viewed July 2019).
- 8. Beauchamp TL, Childress JF. Principles of biomedical ethics. 7th ed. New York: Oxford University Press, 2012.
- 9. Holbrook TL, Galarneau MR, Dye JL, et al. Morphine use after combat injury in Iraq and post‐traumatic stress disorder. N Engl J Med 2010; 362: 110–117.
- 10. Joshi GP, Beck DE, Emerson R, et al. Defining new directions for more effective management of surgical pain in the United States: highlights of the inaugural surgical pain congress. Am Surg 2014; 80: 219–228.
- 11. Mollica RF. Invisible wounds: Medical researchers have recently begun to address the mental health effects of war on civilians. Sci Am 2000; 282: 54–57.
- 12. World Health Organization and International Committee of the Red Cross. WHO/ICRC technical meeting for global consensus on triage, 11‐12 January 2017. Meeting report. https://www.humanitarianresponse.info/sites/www.humanitarianresponse.info/files/documents/files/triage_2017_meeting_report-b.pdf (viewed July 2019).
- 13. Inter‐Agency Standing Committee. IASC guidelines on mental health and psychosocial support in emergency settings. Geneva: IASC, 2007. https://www.who.int/mental_health/emergencies/9781424334445/en/ (viewed July 2019).
- 14. World Health Organization and United Nations High Commissioner for Refugees. mhGAP humanitarian intervention guide: clinical management of mental, neurological and substance use conditions in humanitarian emergencies. Geneva: WHO, 2015. http://www.who.int/mental_health/publications/mhgap_hig/en/ (viewed July 2019).
- 15. World Health Organization, War Trauma Foundation and World Vision International. Psychological first aid: guide for field workers. Geneva: WHO, 2011. https://www.who.int/mental_health/publications/guide_field_workers/en/ (viewed July 2019).
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