Author: Anindita Rochili
PallCHASE Communication WG Member
Since joining PallCHASE in 2017, Dr. Megan Doherty has been actively working and advocating for palliative care in humanitarian settings, with a major focus on education. Her initial work with the organization began during the wave of refugees from Myanmar to Bangladesh, also known as the Rohingya refugee crisis.
During this time, she witnessed thousands of people arriving at the camp with very few possessions, including food. Many had to flee quickly and walk long distances, so upon arrival, they needed immediate support. The need for palliative care (PC) became evident quickly, and email discussions were conducted. Some of the patients had to be carried to the refugee camp by their families due to their serious life-limiting conditions and the lack of medical care from where they came. Among the initial challenges for the health workers was understanding the needs of the patients and their caregivers.
“PallCHASE has grown over the past 7 years.”
It has been a journey, especially when examining the need for PC during times of crisis in detail, where novel ideas are crucial in fragile and conflict-affected settings. This includes leading and collaborating to support and deliver services as needed. It starts with recognizing existing abilities, identifying areas with gaps, and determining what to do next based on what we know and what we have yet to learn.
Dr. Megan Doherty explained that we could draw from previous experiences, including practices from informal urban settlements (slums). There may be similarities, such as working with community health workers. One could recruit someone from the community who knows more about the locals. In PC, patients’ cultures and preferences matter, so this could aid refugees and displaced people. She added that having a system for teaching and training doctors would help further, with support from experts and humanitarian health organizations.
PallCHASE has been quite successful in terms of increasing the level of awareness and advocacy of this area, particularly in humanitarian settings. It was refreshing to see someone with such hope for the future. Her vision is also to keep continuing in this direction: to assess the need, then help with responses, control, and planning of palliative care. “We can no longer say that we don’t know how, or how it’s not possible, not a priority. There is a sense of ownership, and how it should be.”
Dr Megan was also present during the World Health Assembly in Geneva last month, where she presented a statement on palliative care for children. She mentioned positive signs regarding the engagement of health actors, including the inclusion of PC.
Where WHO was concerned, there were also discussions on the quality, description, responses, and essential packages on PC. The shift in people’s ideas on the awareness and emphasis on PC is visible.
According to Dr. Megan Doherty, there are two other areas of concern:
- Service Delivery: How it evolves, the best ways to deliver care to patients with PC needs, and how to logistically manage long travel distances. For refugees in emergencies, it is important to understand what has happened in different countries and how to strengthen the quality of essential PC packages in such circumstances.
- Focused Research: Understanding what works best and what currently exists to support individuals with serious illnesses and their loved ones. Amplifying the voices of those in communities is crucial to ensure they are also part of the discussion. She mentioned that when patients are very ill, they usually do not have much energy to share their experiences, so their caregivers can help. However, when patients do share, it is important to raise their voices and include them in discussions that concern them.
While all areas in devising an effective strategy for the country are important, Dr. Megan Doherty is eager to close the gaps in education and training for health workers. She hopes to see more innovative training models to provide mentorship and guidance, either online or in person. She recalled how freshly graduated juniors in Bangladesh were expected to complete complex tasks. It would be beneficial to continue developing and exploring to improve responses in humanitarian crises.
We are looking forward to witnessing her continued excellence in the field.
