Palliative care for those affected by war, persecution or natural disasters

Links are needed between camps for refugees and internally displaced people, clinics, hospitals and palliative care services. However, challenges to providing such care include access to pain control, communication, communicable diseases, the unpredictable nature of the care setting, the large numbers of children/ orphans involved, a breakdown in community systems and networks, and co-ordination of care. 

In 2000 the WHO/UNAIDS (55) described palliative care as an essential activity. Therefore, ways of providing such care need to be developed within refugee and disaster situations.

There is commitment within the palliative care community to ensure access to palliative care to all those affected by war, persecution or natural disasters, and work is underway, coordinated by the International Association of Hospice and Palliative Care (IAHPC), the International Children’s Palliative Care Network (ICPCN) and the Worldwide Hospice Palliative Care Alliance (WHPCA) to facilitate work in this area, working with international organisations such as the World Health Organization (WHO), Medicins Sans Frontieres (MSF), Save the Children, UNICEF, UNHCR and others such as the International Medical Corps.

A network, Palliative Care in Complex Humanitarian Emergencies (PALCHE) has been set up to explore the palliative care response to such situations, linking in with the recent WHA resolution on palliative care that emphasises the right to palliative care for all.

Nathan Cherny, Director of the Cancer Pain and Palliative Care Service in the Oncology Department at the Shaare Zedek Medical Center, said: “The provision of palliative care in times and places of conflict is fraught with personal and infrastructural difficulty. In meeting theses challenges, healthcare providers have the potential to be positive agents of change. The challenges are great, but the potential rewards even greater.” 

This article was first published as a case study in the report: Hidden Lives, Hidden Patients, commissioned for World Hospice and Palliative Care Day 2015. The report can be found on the Worldwide Hospice Palliative Care Alliance website and will be officially launched on 10 October 2015 as part of the World Hospice and Palliative Care Day celebrations. To find out more or to register an event for the Day, please visit the World Hospice and Palliative Care Day webpage.