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Why It’s About Time For Palliative Care in Humanitarian Emergencies

In the first issue of the Humanitarian Health Digest, Paul Spiegel stresses the need to highlight the lack of palliative care in humanitarian emergencies. Both refugees and nationals with life-limiting illnesses need more dignified, cost-effective care, he argues.

Written by Paul Spiegel Published on Read time Approx. 2 minutes
Rohingyas wait to receive treatment in the Sadar Hospital in the Bangladeshi town of Cox’s Bazar in October 2017.Ozge Elif Kizil/Anadolu Agency/Getty Images

The Syrian crisis is a watershed moment in humanitarian action. It has shed a light on a myriad of complex issues and gaps, many relating to the protracted nature of conflict and displacement outside of camp settings in middle-income countries.

The importance of palliative care in such contexts is critical, but rarely discussed, never mind addressed. It’s time to provide holistic palliative care in humanitarian emergencies consisting of pain management and psychosocial support, including social and spiritual aspects.

In Pinheiro and Jaff’s recent article in Medicine, Conflict and Survival entitled “The Role of Palliative Care in Addressing the Health Needs of Syrian Refugees in Jordan,” the authors undertake an exploratory qualitative study of the gaps and challenges of providing such long-term, specialized and continuous services to refugees with life-limiting conditions.

Such care is not available to the majority of Jordanians, never mind most Syrian refugees, and thus there is a need to provide specific and specialized training in palliative care in an integrated manner to health professionals in Jordan and humanitarian NGOs. Besides providing dignity and comfort to persons suffering from such conditions, it is also cost-effective as the delivery of palliative care is less expensive compared to curative interventions, and reduces the number and length of stay of hospitalizations.

 It’s time to provide holistic palliative care in humanitarian emergencies consisting of pain management and psychosocial support, including social and spiritual aspects.

Pinheiro and Jaff recommend that specialized training of health professionals in providing palliative care be integrated into the existing health systems of host countries and be made available to nationals and refugees alike. Given that most Syrian refugees live outside of camps, the need to improve national systems that will benefit all persons is in accordance with recent humanitarian concepts that attempt to avoid parallel services for refugees by increasing national capacities to provide such services to everyone.

Even if such palliative care was available more widely in Jordan, the financial barriers to refugees receiving such services would likely be prohibitive, particularly as the amount of funding to Syrian refugees is decreasing. Therefore, further consideration as to how such services, despite their cost-effectiveness, would be paid for is needed.

One obvious way to alleviate the financial burden would be to allow refugees the right to work. Another would be improved guidance as to the prioritization of the provision of health care according to its effectiveness and cost.

The need to provide palliative care is not just limited to humanitarian emergencies in middle-income countries. There is already a need for such care in low-income countries, which will only increase as noncommunicable diseases become more predominant.

Just as the need for mental health interventions in humanitarian emergencies has become clearly recognized, the need for palliative care in such settings should also be self-evident. It’s time to support the training and provision of holistic palliative care interventions in humanitarian emergencies.

The views expressed in this article belong to the author and do not necessarily reflect the editorial policy of Refugees Deeply.

This commentary was originally published in the the first issue of the Humanitarian Health Digest, a quarterly bibliography of the latest published, peer-reviewed journal articles on humanitarian health work from the The Johns Hopkins Center for Humanitarian Health and The Lancet. You can read the full digest here.

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