Providing Palliative Care Education in a Humanitarian Crisis Situation in Refugee Camps in Cox’s Bazar Bangladesh: Using online classes to integrate palliative care in the humanitarian settings
By Dr. Tasnim Binta Azad & Dr. Megan Doherty
Humanitarian crises, by their nature, generate a huge burden of suffering and death, which requires palliative care. The World Health Organization has recognized palliative care as an essential component of care in humanitarian emergencies and crises (1). Despite this recognition of the necessity for palliative care in humanitarian settings, its provision has largely been overlooked by the health sector.
Introductory Palliative Care for Humanitarian Healthcare Providers:
In September 2020, we launched an innovative virtual education program- Project ECHO: Introductory Palliative Care for Humanitarian Healthcare Providers, which focusses on supporting healthcare providers working in the Cox’s Bazar region of Bangladesh, where more than 900 000 Rohingya refugees are living.
The homes in the refugee camps are constructed from bamboo and tarpaulin and the area is prone to landslides and erosion during monsoon rains.
Program Structure:
The program consisted of an initial series of 7 interactive virtual classes on key palliative care topics, including pain and symptom management, wound care, palliative care delivery in Bangladesh, emotional support for family and caregivers, and sensitive communication.
Each session includes a short didactic teaching session presented by a palliative care expert, followed by an interactive case presentation from a participants followed by group discussion.
Image Caption: Joan Marston, international ambassador of the International Children’s Palliative Care Network and PalCHASE speaks to participants during the program’s most recent session on World Hospice and Palliative Care Day.
A committed group of national and international palliative care experts attended each session to share ideas and discuss challenging palliative care cases with the participants. Participants are also assigned to work in groups to complete an assignment, to develop ideas about how to improve palliative care in their work situation. Each group is linked to several faculty to mentor them in during their assignment preparation.
After each session, one participant summarizes the session and the key learning points are shared via social media. During each session, participants are encouraged to use the chat box to share their views and thoughts on the particular topic. Several faculty members monitor the chat comments and answer those question in both Bengali and English. At the end of each session there is a summery in Bengali by a local speaker.
Using Social Media:
Each session’s recording is been uploaded to a private YouTube playlist, where participants can review any session. A WhatsApp group with the participants and faculty has been created to allow dialogue about questions or challenging cases which participants may face in the future. Moreover the program will continue with regular teaching and mentoring sessions every 3 weeks going forward to keep the learning going.
Participants:
In total, sixty-five healthcare professionals, including doctors, nurses, and physiotherapists, have been participating in this virtual training program.
Future Plans:
Since there are many more healthcare workers who work in the camps and other settings in Bangladesh who are interested to join such trainings, we are planning to run the 7 introductory sessions again in the near future.
For healthcare providers wishing to participate this project, please contact Mr Saiduzzamin Bhuyian (saiduzz@hotmail.com). Interested individuals can watch the session videos at this link: https://www.youtube.com/playlist?list=PLZqwfKU623LraCuylJspC8PcgiC5R_JRi
The educational initiative is a collaborative partnership of Two Worlds Cancer Collaboration, Fasiuddin Khan Research Foundation and Palliative Care in Humanitarian Aid Situations and Emergencies (PalCHASE), with the support of ECHO India.
What is Project ECHO:
Project ECHO (Extension for Community Healthcare Outcome) is an online educational movement, initiated by Dr. Sanjeev Arora in New Mexico to increase workforce capacity to provide optimal care. Project ECHO is being implemented by over 220 partners in more than 39 countries across the globe.
About us:
FKRF (fkrf.org) is a Bangladesh-based foundation which is working directly on providing palliative care for Rohingya refugees, which is one of the first palliative care programs within a humanitarian response.
Two Worlds Cancer Collaboration Foundation (https://www.twoworldscancer.ca/news-events) is Canadian non-profit foundation. Our team of Canadian and international health care professionals collaborates with local care professionals in lesser-resourced countries to help reduce the burden of cancer and other life limiting illnesses.
PalCHASE is a network of professionals, focused on advocating for the palliative and end of life needs of people affected by humanitarian disasters and mass casualty incidents.
- World Health Organization. Integrating palliative care and symptom relief into responses to humanitarian emergencies and crises: a WHO guide [Internet]. Geneva: World Health Organization; 2018 [cited 2019 Feb 11] p. 107. Available from: https://apps.who.int/iris/bitstream/handle/10665/274565/9789241514460-eng.pdf?sequence=1&isAllowed=y
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