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Refugees and Migrants

According to the UNHCR 17% or 11,152 000 of the world’s 65.6 million forcibly displaced persons, including refugees and migrants, are in Europe. Most European countries are hosting refugees, with some hosting large numbers in relation to their country population eg Austria has 60,747 or 7.13 to every 1000 head of population. France and Germany are each hosting over 250 000 ; and Greece and Italy are the first port of call for those fleeing from African countries. Over half are under 18 years of age. Countries with high numbers of refugees and migrants such as Turkey report that their health systems are struggling to cope with the increased need for health services ; while in refugee camps and settlements health care is often provided by humanitarian health response non-government organisations such as Doctors without Borders (MSF) and Syrian American Medical Society (SAMS); supported by the International Committee of the Red Cross and Red Crescent (ICRC) which have no formal palliative care programmes. No assessment has been carried out as to the number of people who would benefit from palliative care but all humanitarian aid agencies have reported that they see many who would benefit from palliative care, but this care is not as yet part of their programmes


Aims and Objectives

  1. To develop a White Paper on palliative care in Europe for refugees and migrants – undertaking a literature review, assessing the palliative care needs of refugees and making recommendations for the Task Force’s later activities and producing an Action plan for the Task Force and the EAPC
  2. To develop and distribute a short powerpoint training module on palliative care for refugees and migrants for humanitarian health agencies
  3. To set up a contact list of palliative care experts from different disciplines to act as a resource to humanitarian aid agencies and practitioners
  4. To advocate to and collaborate with WHO and other relevant agencies and INGOs


Background

Discussions have been held with WHO, Doctors without Borders, Syrian American Medical Society, Save the Children UK and International Committee of the Red Cross regarding palliative care in humanitarian situations including for refugees and migrants. All organisations stated that they are seeing people with palliative care needs, especially those with non-communicable diseases and especially those living in refugee settlements for many years. Organisations identified the need for training in palliative care for both acute and long-term situations and for those involved in immediate humanitarian aid and health care to assist them when they cannot manage certain patients. Lack of access to pain medicines especially opioids is a major challenge to managing pain in humanitarian situations. There are promising developments such as a Standard on Palliative Care being finalised for the next edition of the Sphere Handbook for humanitarian organisations and the development of Guidance documents being developed by WHO working with a small group from the WHO Community of Practice for Palliative Care (Joan Marston is a member of this group). PALCHASE has been established as a collaborative of palliative care and humanitarian aid practitioners, ethicists, educators, researchers and advocates promoting palliative care integration in all humanitarian aid situations. The Task Force will work in collaboration with these groups. 


Milestones

  1. White Paper to provide guidance on the provision of palliative care to refugees and migrants to governmental and NGO health service providers
  2. Training powerpoint, guidance document and reference list to relevant materials for use by humantarian health repsonse organisations
  3. Resource list of palliative care expert practitioners who could be contacted to provide expert advice and /or peer support to humanitarian health agencies and those providing health care to refugees and migrants


White Paper 
Lead: Prof Lukas Radbruch and his Department at the University of Bonn To be completed in two years for presentation at the EAPC Conference in Berlin
Methodology: Literature review of palliative care for refugees
Survey to organisations working in health care with refugees and migrants such as Doctors without Borders,  Syrian-American Medical Society
Delphi study to identify priority palliative care needs of refugees and migrants
Collaboration with the Humanitarian Health Ethics Research group from McGill and McMaster Universities in Canada who have carried out a similar global survey; and with WHO Palliative Care Community of Practice group working on palliative care in humanitarian situations

Time Frame: 2 years

Training Powerpoint with a guidance document and list of useful reference materials 
Lead: Prof Friedemann Nauck
Methodology 
Using information from the Survey and Delphi study from the White Paper a short training course will be developed
Time-Frame: 1 year
 

Advisory Resource List of Multi-Disciplinary Palliative Care Practitioners to provide peer support to health care practitioners working with refugees and migrants
Lead: Joan Marston
Methodology
Working with the EAPC membership a survey will be circulated to ask for volunteers to agree to be part of an advisory resource group for humanitarian response organisations.
Time-Frame: 6 months
Guidelines for those on the Advisory Resource Group to be developed
Time-Frame: 6 months
Advisory Resource List with contact details drawn up and circulated to humanitarian response groups
Time-Frame: 1 year 
 

Communication with EAPC and with Humanitarian Health Response organisations 
Will be ongoing throughout the course of the development 

Chairs

Joan Marston RN

PALCHASE Palliative Care in Humanitarian Aid Situations and Emergencies and International Children's Palliative Care Network (Part of IAHPC)
Click here to contact by email


Prof Lukas Radbruch

Chair of Palliative Medicine
University of Bonn,  Germany

Click here to contact by email

 


 
 

Click on the logo to read posts relating to other EAPC task forces and reference groups. You can also read posts about "Palliative Care in humanitarian crises" here.
Many have been contributed by our task force/reference group members