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A Field Manual for Palliative Care in Humanitarian Crises

Medical providers in resource-limited settings use many reference materials to look up diagnoses, epidemiology, and treatments. However, after working in settings around the world as palliative care physicians, we realized that there was no reference book written for clinicians working in crisis situations. Likewise, we acknowledged that, while deployment of palliative care specialty-trained clinicians with all humanitarian aid missions might seem like an admirable goal, the dearth of such clinicians makes attaining such a goal unlikely.

Thus, we recognized the need for a concise, practical manual that could be used by clinicians without palliative care training to incorporate principles of palliative care into their humanitarian work. We were fortunate enough to find a highly qualified, international group of palliative care specialists, internists, pediatricians, dermatologists, surgeons, therapists, chaplains, nurses, ethicists, lawyers, public health workers, palliative researchers, pain specialists, pharmacists, geriatricians, and emergency doctors with whom to collaborate. The end result is the manual that you hold in your hands.

We wrote this book with several possible audiences in mind. Most obviously, we wrote it for humanitarian aid workers who have no formal palliative care training. But we also wrote it for local providers to use for teaching and guidance in integrating palliative care into local relief efforts. Finally, we hope this manual will serve as a useful teaching tool in any educational setting for medical providers and trainees who may be called on one day to provide care in resource-limited and crisis settings.

We have covered the fundamentals of palliative care, including comprehensive symptom control, communication frameworks, and psychosocial support, with a particular focus on trauma-informed care. We have also built in public health material focused on the integration of palliative care into epidemics, conflicts, and natural disasters.

We hope this manual serves as an asset in the vital mission of alleviating the pain and suffering that may be experienced by people anywhere in the world facing humanitarian crises.

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