In a world ravaged by war, epidemics and natural disasters, palliative care is essential. 20 June 2015 is World Refugee Day, when countries around the world remember the more than 60 million people living in a state of uncertainty, danger, poverty and even trauma and illness, often brought about by Complex Humanitarian Emergencies (CHEs).
Recognising the holistic needs that accompany these emergency situations, a new network – Palliative care in Complex Humanitarian Emergencies (PALCHE) – has been developed to address current limitations in providing palliative care to people facing CHEs.
CHEs are defined by the United Nations as “a humanitarian crisis in a country, region or society where there is total or considerable breakdown of authority resulting from internal or external conflict which requires an international response that goes beyond the mandate or capacity of any single and/or ongoing UN country program.” Natural disasters – such as the 2010 earthquake in Haiti, the more recent earthquakes in Nepal, and epidemics such as Ebola in Western Africa in 2014 – can trigger a CHE. In short, a CHE is an acute emergency layered over ongoing instability that typically needs large-scale, multi-faceted humanitarian assistance.
CHEs can generate terror, pain, trauma and hopelessness for people caught up in them. Groups such as children, pregnant and nursing women, migrants, displaced people and those affected by progressive life-limiting illnesses are especially vulnerable in these situations. This vulnerability arises from the catastrophic destruction of social networks and health systems and services, which means that vital needs cannot be met.
Adults and children with existing chronic diseases also face exacerbation of their illness due to conditions caused by a disaster (e.g., lack of water and food, exposure to the elements, disruption in supply of their medications, etc.). As a result, morbidity and mortality from chronic disease increases during disasters and is a specific area where palliative care can assist.
But many people without palliative care needs prior to a CHE may also need palliative care due to their new situation – e.g., Ebola brought life-threatening illness to entire communities – as well as complex bereavement needs which are usually ignored in the face of more ‘urgent’ medical and rescue priorities.
Since 2000 there have been positive palliative care developments globally. However, the significant need for effective palliative care persists. Despite the prioritization of health care in international responses to CHEs, palliative care has historically been neglected, the prime focus generally being on acute medical interventions, e.g., setting broken bones. The PALCHE network plans to address this gap.
PALCHE is an informal collaborative network listed within the International Association for Hospice and Palliative Care (IAHPC) and comprised of individuals committed to increasing availability and access to palliative for those facing war, natural disasters, epidemics, poverty, hunger and displacement…read more