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Found 32 results
  1. Content Article
    This article in The Lancet examines the role of national public health institutes (NPHIs) in dealing with health emergencies in the Eastern Mediterranean region. NPHIs are science-based organisations or networks concerned with public health functions in countries. The Covid-19 pandemic highlighted the importance of NPHIs and their potential in future emergency preparedness and response (EPR). A 2022 global review acknowledged the contribution of more than 13 NPHIs in the Eastern Mediterranean region during the pandemic and called for more clarity on the future role of NPHIs in EPR. These NPHIs have different governance models, organisational mandates, capacities and links within national and global systems—and this complexity raises questions about how they should best be engaged in EPR.
  2. Content Article
    This article in The Lancet looks at the need to prioritise palliative care and medications during armed conflict. The authors argue that the Israel–Hamas conflict amplifies the dire need for access to morphine and other essential palliative care medicines included on WHO's Model Lists of Essential Medicines in order to alleviate serious health-related suffering during humanitarian crises. They outline calls that the global palliative care community has made to the World Health Organization (WHO) and other aid organisations to: add adequate oral and injectable morphine and other pain-relieving medicines in humanitarian aid response packages ensure adequate essential medicine supplies for surgery and anaesthesia provide guidelines on the safe use of essential medicines and their distribution to all aid and health workers collaborate with receiving authorities to prevent removal of controlled medicines from emergency kits include paediatric essential medicine formulations for children. They argue that opioids and other essential palliative care medicines equip health workers with the means to relieve serious health-related suffering across clinical scenarios when curative or life-saving interventions are unavailable.
  3. Content Article
    Conflicts and wars contribute substantially to the development and spread of antimicrobial resistance (AMR). War-related factors that contribute to AMR include restricted resources, high casualties, suboptimal infection prevention control, and environmental pollution from infrastructure destruction and heavy metals release from explosives. This article in The Lancet looks at the impact of the war in Gaza on AMR. It highlights that access to essential antibiotics, primarily through donations, has been a continuous challenge due to the blockade of Gaza and that Gaza's already restricted national surveillance system for AMR adds to the challenges.
  4. Content Article
    From Kiev to Khartoum to Gaza, people are losing all their rights, including the right to life itself. From his observations of healthcare conditions in Sudan, Dr Ahmed Khalafalla presents some ideas on how we can improve healthcare services during times of war and uncertainty to make healthcare services accessible for those who need them.
  5. News Article
    The Gaza Strip’s health-care system stands on the brink of collapse as bombings damage hospitals and ambulances and as generators run out of fuel, highlighting how quality medical care is a casualty of war. Dire scenarios await Gaza’s medical professionals. They face dwindling basic resources such as power, water and anesthesia, compelling doctors to confront wrenching decisions on whose lives to save. The growing humanitarian crisis is plunging health-care workers into the critical emergency planning that follows both human-made and natural disasters — assessing staffing and other resources, managing existing health needs on top of gruesome new ones, and looking out for their own welfare. “When we are in a disaster setting or conflict, we usually have more patients than resources. We have to be very creative to be able to provide the best care for the most number of people,” said Lindsey Ryan Martin, who is director of global disaster response and humanitarian action at Massachusetts General Hospital in Boston and has been monitoring the situation in Gaza. The health-care crisis extends beyond Tuesday’s deadly blast at al-Ahli Hospital in Gaza City. Aid organizations say the war continues to imperil an already beleaguered health-care system. Gaza’s Health Ministry said five hospitals were out of service as of Thursday and an additional 14 health facilities have closed because they lack fuel and electricity. Read full story Source: The Washington Post, 19 October 2023
  6. News Article
    Violence against healthcare workers has become a “global crisis”, with 161 medics killed and 188 incidents of hospitals being destroyed or damaged last year, according to a new report. Data collected from 49 conflict zones by the Safeguarding Health in Conflict Coalition (SHCC), also found that 320 health workers were wounded in attacks, 170 were kidnapped and 713 people were arrested in the course of their work. The US-based group said on Tuesday that, although the total number of attacks was similar to those recorded in recent years, there had been an increase in violence in areas of new or renewed conflict in 2021, “underlining the fact that attacks on healthcare are a common feature in many of today’s conflicts”. Christina Wille, director at Insecurity Insight, which led the data collection and analysis, said: “Violence against healthcare resulted in widespread impacts on public health programmes, vaccination campaigns and population health, contributing to avoidable deaths and long-term consequences for individuals, communities, countries and global health writ large.” Read full story Source: The Guardian, 24 May 2022
  7. News Article
    Traumatised Ukrainian refugees who have sought sanctuary in the UK may have to wait two years before they can get specialised therapy to help them heal from the horrors of war, according to experts. Therapists who specialise in treating war trauma say they have seen NHS waiting lists of two years before refugees can access the specialist treatment they need. Services across the UK are patchy with some areas “treatment deserts when it comes to trauma”, according to Emily Palmer-White, a psychotherapist and community manager at the charity Room to Heal, which provides support for people who have fled persecution. “There are often extremely long waiting lists. I have been told two years. You can’t separate the psychological from the practical – it’s more difficult to help people if they’re preoccupied with survival,” said Palmer-White. A spokesperson for the Department of Health and Social Care said officials recognised the trauma Ukrainians were facing and stood shoulder-to-shoulder with them. However, beyond having access to NHS care officials did not cite any specific provision to provide newly arrived refugees with trauma support. Prof Cornelius Catona, of the Royal College of Psychiatrists, said the visa delays of several weeks would likely exacerbate mental illness for those already struggling and that the refugee schemes should have included a mechanism for spotting signs of trauma early. Viktoriia Liamets, a Ukrainian child and family therapist who recently arrived in the UK after fleeing the war, said Ukrainians arriving in Britain had multiple and complex traumas to contend with. Read full story Source: The Guardian, 9 May 2022
  8. News Article
    The Royal College of Obstetricians and Gynaecologists (RCOG) has called for the immediate suspension of charging for NHS maternity care for migrant women because members say this government policy is harming the health of pregnant women and their babies. It is the first time the health professionals’ body has issued a position statement on this issue. The charity Maternity Action and the Royal College of Midwives have long expressed concern about the impact of NHS charging on this group of women. Charging forms a key plank of the Home Office’s hostile environment for migrants. The government says the charging policy is in place to deter health tourism but medics treating migrant pregnant women say there is little evidence that previously free NHS maternity care for all attracted health tourists. According to the 2019 MBRRACE-UK confidential inquiry into maternal deaths, three women were found to have died between 2015 and 2017 who may have been reluctant to access maternity care due to fears about charging and impact on their immigration status. Dr Brenda Kelly, an NHS consultant obstetrician working in Oxford, treats many pregnant migrant women. She is calling for the barriers to them accessing maternity care to be removed urgently. She described the case of one migrant woman who arrived in A&E shortly before delivering a stillborn baby. The woman had been fearful of coming forward for antenatal care although she was suffering from multiple, pregnancy-related health problems. “I hope I never have to hear cries like that woman’s cries ever again,” said Kelly. “The way to safeguard these women is to build up trust. If they are landed with a bill of several thousand pounds they will disengage. They are not health tourists, they are desperate. The commitment to maternal health equity means ending charges for maternity care. The time for action is now.” Read full story Source: The Guardian, 27 March 2022
  9. News Article
    The UK's top public health doctor says anyone with a persistent cough and fever should not dismiss it as Covid - and should consider other infectious illnesses like tuberculosis (TB). Dr Jenny Harries' warning comes as provisional data shows there were 4,430 cases recorded in England in 2021, despite sharp declines in recent years. Charities are calling for more funding to tackle the disease around the world. They say the pandemic and conflicts have set back progress worldwide. In 2020, global deaths because of tuberculosis ranked second to Covid for any infectious disease. The charity Stop TB Partnership warns the war in Ukraine could have "devastating impacts on health services", including the country's strong national TB treatment programme. The charity is urging all countries to put facilities in place urgently so refugees can be given the care they need. In the UK a requirement for Ukrainians to take a TB test before arrival has been waived for those who are coming to the country on the family scheme visa. Refugees arriving on the scheme will get medical care and testing via GPs. Meanwhile Dr Jenny Harries, chief executive of the UK Health Security Agency, said delayed diagnosis and treatment, particularly during the pandemic, will have increased the number of undetected cases in England. Read full story Source: BBC News, 24 March 2022
  10. News Article
    Hospitals across Ukraine are “desperate” for medical supplies, doctors have warned, as oxygen stores are hit and other vital health supplies run low amid bombardment from Russian forces. UK-based Ukrainian doctors have issued an urgent appeal for donations of supplies as they travel to eastern Europe in response to reports of shortages of medical equipment and medicines. The World Health Organisation warned on Sunday evening that oxygen supplies in Ukraine were “dangerously low” as trucks were unable to transport oxygen supplies from plants to hospitals across the country. Dr Volodymyr Suskyi, an intensive care doctor at Feofaniya Clinical Hospital in Kyiv, told The Independent he had been forced to use an emergency back-up system to supply oxygen to a patient on life support after the area near plant which supplies his hospital was bombed. Dr Dennis Olugun, a UK-based doctor who is leading the group of medics from the Ukrainian Medical Association of the United Kingdom (UMAUK) to deliver medical supplies, said the situation was “desperate” in some areas. He said some hospitals did not have basic necessities such as rubber gloves. He told The Independent: “What they need in the hospitals is portable ultrasound machines, portable x-ray machines because they have so many patients they much rather walk around the wards and do whatever diagnostic work rather than transporting patients." The Association of the British Pharmaceutical Industry and European Federation of Pharmaceutical Industries and Associations have called for medicines, pharmaceutical ingredients and raw materials to be excluded from the scope of sanctions being levied against Russian trade. Read full story Source: The Independent, 1 March 2022
  11. News Article
    The Home Office has been accused of abandoning 55 asylum seekers with a range of severe disabilities and life-limiting conditions at a former care home in an Essex seaside town. The asylum seekers, who fled various conflict zones including Sudan and Afghanistan, are struggling with a range of health conditions they have suffered from since childhood or life-changing injuries suffered in war zones. One told the Guardian: “Everybody is suffering in this place. It used to be a care home but now there is no care. We are free to come and go but to me, this place feels like an open prison. We have just been left here and abandoned.” Those living in the former care home are struggling with health conditions including loss of limbs, blindness, deafness and mobility issues requiring a wheelchair – although not all have been able to access one. At least eight are paraplegic. They were placed in the former care home, which opened in November, by Home Office officials. It is staffed like a standard Home Office asylum seeker hotel with security guards and reception staff but does not have trained care workers or nurses there as part of the contract. Read full story Source: The Guardian, 23 June 2023
  12. News Article
    Women including refugees, asylum seekers, and undocumented migrants are being charged as much as £14,000 to give birth on the NHS in England, a report by Doctors of the World (DOTW) has found. The report, which examined inequalities in maternity care among migrant pregnant women and babies, gathered the experiences of 257 pregnant women accessing DOTW’s services from 2017 to 2021. It found that over a third (38%) who accessed its services had been charged for healthcare, often inappropriately. The women were charged £296 to £14 000, and half of them were billed over £7000. The report said that inequalities in access to antenatal care experienced by migrant women were likely to lead to poorer outcomes for their pregnancy and the health of their children. The evidence highlights the need for urgent action to address the inequalities experienced by migrant pregnant women and their babies. There is a pressing need for immigration status to be considered as part of the ethnic and racial health inequalities agenda and for independent action to be taken to review the impact of NHS charging policy. Read full story (paywalled) Source: BMJ, 20 June 2022
  13. Content Article
    To overcome this preventable disease we need to invest in failing infrastructure and tackle humanitarian crises at cholera’s roots, says Petra Khoury in this BMJ article. Once thought to be close to eradication, cholera is back—dehydrating and killing people within hours and ravaging communities across six continents. Despite the alarming numbers of cases and deaths over the past year, decision makers are averting their eyes, leaving people to die from a preventable and treatable disease. The healthcare community should sound the alarm for immediate actions. A strong and global emergency response is urgently needed, but it is only a first step. More than ever the world must invest in water and sanitation systems and prepare communities before outbreaks occur.
  14. Content Article
    Port-au-Prince, the capital of Haiti, has seen waves of clashes between armed groups. The violence has driven a stark need for emergency trauma care and surgery, and cut people off from the everyday healthcare services they need. Nurse Amadeus von der Oelsnitz explains how the Médecins Sans Frontières / Doctors Without Borders (MSF) principles of neutrality, impartiality and independence help teams provide vital healthcare in a city torn apart by insecurity.
  15. News Article
    A case of MRSA has been reported at the congested asylum processing centre at Manston in Kent, the Guardian has learned, after it emerged that Suella Braverman ignored advice that people were being kept at the centre unlawfully. The antibiotic-resistant bacteria was identified in an asylum seeker who initially tested positive for diphtheria. But the asylum seeker was moved out of the site in Ramsgate to a hotel hundreds of miles away before the positive test result was received, raising concerns about the spread of the infection. The Manston site is understood to now have at least eight confirmed cases of diphtheria, a highly contagious and potentially serious bacterial infection. Migrants are meant to be held at the short-term holding facility, which opened in January, for 24 hours while they undergo checks before being moved into immigration detention centres or asylum accommodation such as a hotel. But giving evidence to a committee of MPs last week, David Neal, the independent chief inspector of borders and immigration, said he had spoken to a family from Afghanistan living in a marquee for 32 days, and two families from Iraq and Syria sleeping on mats with blankets for two weeks. Conditions at the site left him “speechless”, he said. On a visit to the site on 24 October, Neal was told there were four confirmed cases of diphtheria. Protective medical equipment for staff has now been brought on to the site. Although diphtheria is a notifiable disease, meaning cases must be reported to authorities, those at Manston have not appeared on weekly public health reports. A Home Office spokesperson said it was “aware of a very small number of cases of diphtheria reported at Manston”, and that proper medical guidance and protocols were being followed. Read full story Source: The Guardian, 30 October 2022
  16. Content Article
    This new report from the British Red Cross describes how asylum seekers struggle to access the internet and lack digital tools. The British Red Cross explained that the report aims to improve understanding of the experiences of digital exclusion among people seeking asylum, and how these experiences may impact access to, and experience of, healthcare. Researchers conducted interviews with 30 people currently seeking asylum across England for the report. The researchers themselves also had lived experience of seeking asylum.
  17. Content Article
    A large proportion of avoidable harm and adverse events occur in fragile, conflict-affected and vulnerable (FCV) settings. This article in the BMJ Open outlines the online Delphi study approach that will be taken to generate a consensus on the most relevant patient safety interventions for FCV settings. The results of this study will create a list of the most relevant patient safety interventions, based on the consensus reached among a range of experts including frontline clinicians and administrators, non-governmental organisations, policymakers and researchers. The study aims to increase awareness of the issues in this area, and identify priority interventions as well as areas for further evaluation and research.
  18. Content Article
    This article in the Journal of Global Health aimed to consider which patient safety interventions are the most effective and appropriate in fragile, conflict-affected, and vulnerable (FCV) settings. The authors examined available literature published between 2003 and 2020, using an evidence-scanning approach. They found that the existing literature is dominated by infection prevention and control interventions for multiple reasons, including strength of evidence, acceptability, feasibility and impact on patient and healthcare worker wellbeing. They identified an urgent need to further develop the evidence base, specialist knowledge and field guidance on a range of other patient safety interventions such as education and training, patient identification, subject specific safety actions and risk management.
  19. Content Article
    The article in the Journal of Global Health examines the unique patient safety risks that can arise in fragile, conflict-affected and vulnerable settings (FCV), including humanitarian crises, conflict, extreme adversity, services disruption and immediate or protracted emergencies. Recent estimates suggest a large proportion of the total number of preventable deaths take place in FCV settings, including 60% of preventable maternal deaths, 53% of deaths in children under five years, and 45% of neonatal deaths. The authors highlight a gap in knowledge and research about healthcare in FCV settings, which prevents researchers from being able to effectively assess interventions for quality, safety and sustainability. They suggest that more academic research is urgently needed in order to make policy and practice more effective in improving patient safety in these settings.
  20. Content Article
    In this interview for Patient Safety Learning, Josie Gilday, qualified nurse and Global Medical Advisor for Save the Children, tells us more about working in the humanitarian and developmental field, and why she feels so passionately about patient safety.
  21. Content Article
    In fragile, conflict-affected and vulnerable settings there is an urgent need for action on quality of healthcare, given the significant health needs of the populations in these environments and the increasing numbers of people for whom such settings are home.
  22. Content Article
    In this article in the New Yorker, Lucy Easthope, who has worked on major emergencies since 9/11, says that small interventions can make a significant difference.
  23. Content Article
    Despite an increased focus in maternity services on ethnic and racial inequalities resulting in poorer outcomes, the experience of migrant women is often hidden from these data, research and improvement programmes. To understand these inequalities and their impact further, Doctors of the World UK (DOTW UK) analysed data collected through provision of health support to 257 pregnant women accessing their service between 2017 and 2021
  24. Content Article
    This literature review in the Journal of Patient Safety aimed to assess lessons learned on patient safety in Organization for Economic Cooperation and Development (OECD) countries, and to assess whether they can be applied to humanitarian medicine. The authors concluded that safety culture and strategies will need to be adapted to address different intervention contexts and to respond to the concerns and expectations of humanitarian staff. As there is no overarching authority for the sector, medical humanitarian organisations, have a major responsibility in the development of a general patient safety policy in all their operations.
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