Health in Humanitarian crises: overcoming challenges

In this blog, Dr Karl Blanchet, Director of the Health in Humanitarian Crises Centre at the London School of Hygiene & Tropical Medicine, reflects on recent work in Greece and Lebanon exploring health issues among populations displaced by crises. He reflects on how humanitarian crises are evolving and how the nature of humanitarianism is changing as a result, and thus on the need to innovate the delivery of humanitarian responses, and how the Crises Centre is contributing.

Humanity and Solidarity

In November 2016, Professor Phillip Mayaud and I visited Athens whilst working on an explorative study about mental health and violence among refugee populations with MSF’s Epicentre. We visited Victoria Square in the centre of the city, which has become a meeting point for refugees arriving in Greece. Here, there is a hotel provided by the Government to refugee populations, where I met a mother from Syria with her two children queuing up in the refectory. Her face expressed tiredness and anxiety. She explained that she was very worried about her husband who she was separated from during the journey. Now in Greece, she was alone and had no idea what her future would be.

We also visited several refugee camps around Athens and in the north of the country around Greece’s second city, Thessaloniki. I was amazed to discover the scale of the health and particularly then mental health needs of the individuals and families who left behind everybody they loved and everything they possessed because they had no choice. Enduring violence and war in their own country was no longer an option if they wanted to survive and have hope for their future. Their personal stories were so intense and the hardship they had experienced during their journey to Europe was so huge that no-one hearing their stories could remain unaffected and indifferent to their plight.

These hardships are exactly what my colleagues and I at the London School of Hygiene & Tropical Medicine are committed to tackling. We want to make sure that our public health and research expertise can serve people affected and displaced by crises like war and unrest. It is for this reason that we have developed a new, free online course on Health in Humanitarian Crises that can guide all individuals and professionals who want to know more about the key issues and how to go about addressing them.

Humanitarian responders are changing

Humanitarism has changed a lot over the last decade because the nature of crises and the actors who respond to them have changed. In Greece, we met with newly formed organisations from all over Europe and Greece providing services for refugee populations, hiring mostly short-term volunteers and relying largely on crowdfunding (using the internet for donations from individuals to fund ventures). And of course, for all these burgeoning organisations, it is very challenging and almost unfeasible to train each volunteer before they start their placements, especially as turnover among volunteers can be quite rapid.

Whilst in Lebanon recently, I also met with small local NGOs led by Syrian professionals offering services to their country fellows. Here, in contrast to Greece, volunteers were often very well qualified, but their knowledge on how to deliver care in humanitarian settings and of relevant humanitarian standards and guidelines is very limited.

These new sets of actors have a lot to offer to the humanitarian sector, and, as in the 1970s in France, their motivation is largely rooted into the good will of civil society promoting values of humanity and solidarity. We need to make sure that we do not spend precious time reinventing the wheel, and that the learnings from what the humanitarian sector has built over the years, in terms of health care guidelines and evidence, is used by volunteers to ensure optimum quality care is delivered to those populations affected by the crises.

Innovations in the humanitarian sector

In March 2016, I participated in the first World Humanitarian Summit in Istanbul, where discussions revealed how evident it is that innovations are necessary in the humanitarian sector to be able to respond to contemporary humanitarian challenges for key reasons.

  • Firstly, the scale of the challenge: we are confronted every day by large movements of people, the largest movement of population since the Second World War, which makes the provision and continuity of healthcare very challenging.
  • Secondly, humanitarian efforts remain massively under-resourced by ‘traditional’ international donors to cover all the needs, despite funding levels for humanitarian action hitting record levels in 2014 and 2015. The lack of funding for non-communicable diseases that require longer-term continuity and continuum of care is of particular concern.
  • Thirdly, large-scale natural disasters are growing in scale and frequency, the threat of communicable disease outbreaks is tangible and armed conflicts are becoming more protracted. This needs humanitarian actors to deploy faster at scale.

To address these challenges, we need to be more innovative to become more efficient to respond to these modern challenges. Further, we need to share experiences and learnings more widely; many innovations have been applied in high-income countries that could be tested in humanitarian contexts to guide clinicians and public health professionals (e.g. electronic clinical protocols, text messaging for surveillance and patient follow up) and patients (e.g. self testing, mental health support app, medical passport).

So what is The Crises Centre doing?

The Humanitarian Crises Centre at the School has invited some of the best specialists in the field to explain what the most pressing needs of populations are, how to respond to these needs, what the areas of interventions are, how to address coordination issues during crises, or what the latest innovations in health in humanitarian crises are. This course will help all practitioners with or without health background understand what the main challenges are in delivering effective health interventions providing the latest evidence, which has been analysed and explained by our team.

During this course, you can also learn about how else The Crises Centre is contributing to the evolving humanitarian context, through research and the organisation of teaching modules and short-courses and how you can contribute to the Crises Centre.

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