Palliative care in humanitarian crises: Always something to offer
THE LANCET | Online – 15 April 2017 – More than 128·6 million people across 33 countries require life-saving humanitarian assistance, 92·8 million of whom are particularly vulnerable. Palliative care (PC), however, has been omitted from efforts to tackle humanitarian crises. PC is, according to the World Health Organization, “an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering.” The authors propose holistic PC as an integral component of relief strategies. PC is especially applicable in four humanitarian scenarios. First, in protracted humanitarian crises for patients with life-limiting illnesses whose pre crisis PC is interrupted and for those whose PC needs are unmet or exacerbated as a result of the crises. Older people are the most prominent group here, given their vulnerability and poorly identified and understood health-care needs. Second, in mass casualty events where resources are overwhelmed by acute injuries and individuals are triaged according to their likelihood of survival. Third, in communicable disease outbreaks with high mortality and limited therapeutic interventions where relief of suffering can be the main treatment option available... Fourth, in camps for refugees and displaced people where some individuals need PC during transition through the camp.