Specialist paediatric care is essential in humanitarian settings

By Julie Griffiths on 04 December 2018 MSF - Médecins Sans Frontières Paediatric Care

Trained non-medics such as specialist nurses are essential to provide quality paediatric critical care in humanitarian settings, says a paper in The Lancet. 

The paper, written by staff at Médecins Sans Frontières (MSF), says that these trained specialist healthcare professionals are crucial because paediatric critical care is impossible without them.   

The paper says that most healthcare workers who are responding to a humanitarian crisis are generalists, often without training in paediatric critical care or even in paediatrics. 

Yet they will be faced with patients in critical or terminal conditions, anywhere along the health continuum from community assessment to hospital discharge, and often without the typical peer support or team structures inherent to high-resource paediatric intensive care units.

The authors said that, if necessary, relief teams must be brought in with training provided when experienced staff have fled. 

And the paper says that hospital practices and team structures are standardised to help to ensure quality care despite the surrounding crisis. First-line interventions – vaccination, infection control, empirical antibiotic use, and disease screening – are required to minimise the need for paediatric critical care.

Beyond that, establishment of organisational systems to triage, identify the care needed, and commence care rapidly is key to providing care.

In resource-limited settings with high burdens of preventable illness and poor access to preventative and curative health care, many children become critically ill, requiring immediate lifesaving interventions. 

These needs increase rapidly during humanitarian emergencies – whether natural or man-made disasters, conflict, epidemics, or the collapse of existing healthcare systems – and are often coupled with an even more acute scarcity of resources, said the authors. 

Diseases and conditions such as malaria, malnutrition, and vaccine-preventable illnesses can quickly escalate to catastrophic levels. 

Lack of health literacy, which prevents timely recognition of illness, coupled with poor healthcare access and competing survival priorities frequently mean that families might delay or be unable to seek care for children until even normally treatable illnesses become life-threatening.

Consequently, the numbers of critically ill children needing care can far exceed the capacity of emergency responders, including MSF.

Access the paper here.