‘World Humanitarian Day’ is celebrated on August 19th each year as per the resolution passed by the United Nations (UN) General Assembly to commemorate the bomb attack that killed 22 humanitarian aid workers in Iraq in 2003. Each year, the campaign led by the UN office brings together partners from different parts of the world to work for the well-being and dignity of people affected by disasters and for the safety of aid workers. The theme for the year 2024 is ‘No Matter What: Humanitarians Deliver‘ which highlights the firm dedication and endurance of humanitarian workers who provide much-needed assistance to vulnerable people despite the difficulties they face.
According to a report by the United Nations Office for the Coordination of Humanitarian affairs in 2017, more than 128.6 million people across 33 countries require life-saving humanitarian assistance, 92.8 million of whom are particularly vulnerable. Humanitarianism is a belief in improving people’s lives and reducing suffering. It aims to prevent and relieve human suffering wherever it may be found, to protect life and health, and to ensure respect for all. The integration of palliative care in humanitarian settings has gained attention since 2016. Palliative care aims to improve the quality of life, provide dignity and comfort, and advise on relieving financial suffering due to illness or disability. Incorporation of palliative care into public healthcare systems is a fundamental part of universal health coverage.
Humanitarian aid is needed in several incidents involving thousands of people, which can either be single large events like hurricanes, floods, and earthquakes, or prolonged events like pandemics. These events can adversely affect health services either due to the physical destruction of facilities or due to the increase in the number of people with acute injuries and illnesses seeking healthcare support. This can, in turn, affect the care provided for patients with chronic conditions, the elderly, and other vulnerable populations. Palliative care would be needed not just for patients who are directly affected by the disaster, but also for those with pre-existing life-limiting illnesses like advanced cancer, those in the last days of life receiving care in institutions like hospice, or those with comorbidities whose health deteriorates due to disasters. People living in low- and middle-income countries are more susceptible as they have inadequate access to illness prevention, diagnosis, management, and social care compared to high-income countries.
The World Health Organization has developed a comprehensive guide, Integrating palliative care and symptom relief into the response to humanitarian emergencies and crises, on integrating palliative care and symptom relief into humanitarian responses. It describes the range of suffering of people affected by sudden devastating events and the recommended steps to integrate palliative care into humanitarian response. It also proposes an essential package that includes safe, low-cost, and widely available medicines, simple and inexpensive equipment, and basic social supports, targeted at preventing and alleviating all types of suffering. Volunteers are an important part of the palliative care team in many countries, and they can lead the civil society response to disasters by forming community rescue camps at shelter points which prioritize care for women, children, and housebound people. Nurses can help with wound care, urinary catheter management, and other minor procedures as part of the campsite activities for ongoing care of chronically ill patients.
There are a few organizations working to develop guidelines and training for palliative care in humanitarian settings. These include PALCHASE (Palliative Care in Humanitarian Aid Situations & Emergencies), which is an international network of practitioners and scholars advocating for research on and practice of palliative care in humanitarian settings, and MSF (Médecins Sans Frontières), a medical humanitarian organisation.
There is an increasing number of natural disasters and humanitarian catastrophes globally, highlighting the critical need to develop palliative and end-of-life policies and practices that can be promptly implemented.
About the Author:
Dr Sunitha Daniel is a Consultant in Palliative Medicine working in York and Scarborough Teaching Hospitals NHS Foundation Trust, York, United Kingdom.
Note: This article is a republication from the August 2024 edition of the Indian Association of Palliative Care’s (IAPC) e newsletter.
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