We use cookies to enhance your experience on our website. By clicking 'continue' or by continuing to use our website, you are agreeing to our use of cookies. You can change your cookie settings at any time. Continue Find out more Page of Palliative Care Needs of People Affected by Natural Hazards, Political or Ethnic Conflict, Epidemics of Life-Threatening Infections, and Other Humanitarian Crises Chapter: Palliative Care Needs of People Affected by Natural Hazards, Political or Ethnic Conflict, Epidemics of Life- Threatening Infections, and Other Humanitarian Crises Source: A Field Manual for Palliative Care in Humanitarian Crises Author(s): Eric L. Krakauer, Bethany-Rose Daubman, Tammam Aloudat, Nahid Bhadelia, Lynn Black, Sanja Janjanin, and Farzana Khan DOI: 10.1093/med/9780190066529.003.0002 Top Next Introduction Traditionally, humanitarian healthcare response has focused primarily on saving lives and has lacked a concerted focus on preventing and relieving suffering. Yet the principles of humanitarianism explicitly require prevention and alleviation of human suffering, and the imperative of saving lives does not conflict with the imperative of relieving suffering in most situations. Patients deemed “expectant” (expected to die) often suffer severely before they die, and failure to endeavor to relieve their suffering constitutes unethical abandonment (see Chapter 15). During comfort-oriented care, triage should be repeated because it may reveal that a patient deemed expectant could be saved, either because the patient’s condition unexpectedly stabilizes or because additional life-saving resources arrive. Humanitarian crises may be triggered by natural hazards (earthquakes, major storms, tsunamis, floods, droughts), violent political or ethnic conflict, epidemics of life-threatening infections, release of radiation, or other disastrous events. However, humanitarian crises rarely are caused by a single factor and are usually the result of mixed natural, human-made, environmental, political and economic causes and vulnerabilities. The consequences may vary greatly depending on the causes, location, and vulnerability of the population they affect, but the consequences often include extensive loss of life and physical, psychological, social, and spiritual suffering on a massive scale (Table 2.1). The poor, the displaced (refugees and internally displaced persons), and those living in low-income settings generally are most vulnerable to unnecessary suffering and death because healthcare and social support systems in their areas may be weak, dysfunctional, inaccessible, unaffordable, overburdened, or destroyed. Table 2.1. Common Symptoms and Forms of Distress Caused Directly by Humanitarian Emergencies Ebola Epidemic Earthquake Genocide/War Influenza Pandemic Pain X X X X Dyspnea X X X Nausea/vomiting X A Field Manual for Palliative Care in Humanitarian Crises » 1,2 3 3 * †