International Committee of the Red Cross

Introduction: Healthcare needs from mass casualty events in humanitarian crises require trained personnel to manage complex patient care in challenging environments. Healthcare for humanitarian responses in conflict-affected contexts is characterized by staffing and material constraints, public health risks, mental health challenges, damaged infrastructure, the necessity for coordination between Ministries of Health, NGOs, and other international organizations, and risk to the safety and security of healthcare providers. There is a higher probability of conflict related mass casualty events. To improve preparedness, an adapted training resource was developed using the Emergo Train System (ETS) in collaboration with the International Committee of the Red Cross and Region Östergötland. ETS, an adaptable simulation platform, enables teams to practice managing critical patient flow scenarios, enhancing capability and capacity for patient care in mass casualty incidents in conflict settings. Methods: The module was iteratively designed based on ETS’s validated processes and customized for humanitarian settings. It underwent testing with health care personnel working in conflict settings, incorporating feedback from simulation instructors. Testing involved realistic contextualized scenarios that were easy to use, relevant, and supported capacity building. Results: The Humanitarian set was used in Ukraine, Nigeria, Yemen, and Somalia, where feedback was positive. The module was reported as highly relevant, easy to navigate, and valuable for capacity building. It improved the ability to perform triage of patients and enhanced healthcare workers’ communication and collaboration. Feedback indicated that the simulation supported skill acquisition in decision-making, contributing to a better-prepared healthcare workforce in conflict-affected settings. The set was further improved with roadblocks, military vehicles, religious buildings, and tented structures. Conclusion: The ETS-based module has proven effective in enhancing the readiness and competency of healthcare providers in humanitarian settings. This collaborative effort showcases the potential of ETS for capacity building, supporting the ICRC’s goals of delivering healthcare in crises.

This report reflects on some of the initiatives undertaken by the International Committee of the Red Cross (ICRC) to contribute to strengthen the ecosystem of assistive technology (AT) by promoting innovation, building partnerships, and prioritizing user-centered approach. The ICRC focused on strengthening national rehabilitation systems, involving end-users in product development, and fostering an environment for sustainable provision of AT. Access to AT has an indispensable role in nurturing a more inclusive society.

Background/Introduction:The evolving nature of irregular warfare and the increasingly frequent violations of human rights law and international humanitarian law pose unique challenges for humanitarian actors delivering trauma care in conflict settings.Objectives:This review aims to map out the challenges faced by humanitarian actors while providing trauma care within conflict zones, examine the solutions suggested or implemented across varied past conflict scenarios as well as document any requirements for effective interventions.Method/Description:A scoping review was conducted to analyze and review past humanitarian interventions offering trauma care in conflict settings. Relevant records were identified from scientific and grey literature. The thematic areas identified by the framework for a Public Health Emergency Operations Centre were used to facilitate the synthesis and analysis.Results/Outcomes:Eleven records examining all phases of conflict identifying gaps throughout the continuum of care in the trauma systems were included. Challenges, solutions and requirements in transportation capacity, data collection methodologies, field coordination mechanisms, and rehabilitative care services were highlighted. Addressing the shortages in skilled healthcare workers, implementing quality improvement measures, and developing standardized training curricula were some of the requirements reported.Conclusion:Our review findings suggest that multidimensional approach emphasizing strong coordination, leadership, and inclusive partnerships is fundamental for effective trauma care systems in conflict zones. Key recommendations include robust medical transport, comprehensive healthcare training, preemptive mass casualty planning, standardized educational materials, telemedicine, continuous local context reassessment, data protection, and improved transparency and accountability. These strategies could enhance trauma care interventions, ensuring they are effective, equitable, accountable, and sustainable.

BackgroundExperts suggest that Non-Communicable Disease (NCD) care is best delivered at the primary level, including in humanitarian crisis settings. In many crisis-affected countries, NCD care is predominantly delivered by specialists at secondary care level, and there is limited evidence on decentralising NCD care in such settings. We aimed to explore health actor and patient experiences of decentralising diabetes and hypertension (DM/HTN) care from a hospital to primary care clinics in the humanitarian setting of Duhok, Kurdistan Region of Iraq.Methods and resultsWe conducted a qualitative study including 30 semi-structured interviews with a purposive sample of patients (n = 16), healthcare providers (n = 7), and key stakeholders (n = 7) involved in the decentralisation project. Guided by a conceptual framework, data were analysed thematically using deductive and inductive approaches. The decentralisation project achieved its stated goals of (a) increasing patients’ access to DM/HTN care, by reducing cost and distance, and (b) decreasing workload at secondary care level. The approach appeared acceptable from patient, provider and stakeholder perspectives. Key health system inputs were put in place to support the decentralisation project, including medicines, equipment and health workforce training, but gaps remained. While access and quality seemed to improve, integration, continuity and sustainability were more challenging to achieve. Key systemic challenges to sustainability included a lack of health financing, and weak national supply chains and information systems. Patients’ trust in the service was important and was closely linked to having access to a continuous supply of trusted medications.ConclusionsWhile it is possible to decentralise diabetes and hypertension care from secondary to primary level in a humanitarian setting, multiple contextual factors must be considered, including supply chain strengthening and adaptation to existing workforce capacity. Our study findings may inform other actors exploring the decentralisation of NCD care elsewhere in Iraq and in other humanitarian settings.

This article addresses an under-conceptualized element of internationalization of higher education: students who have been forcibly displaced. Specifically, it assesses the impact of participation in civic engagement activities on forcibly displaced students, including refugees. Using a combination of survey data and individual interviews, the paper argues that civic engagement can have a salutary effect on forcibly displaced students’ sense of agency, feeling of connectedness, psychosocial health, and academic and professional development while making them better prepared to contribute to society.

Sudan has long grappled with complex humanitarian challenges rising from decades of armed conflict, displacement and scarcity of resources. For millions, the impact has been devasting and daily life has become unbearable; people are going without food, water and access to healthcare, and they often fear for their lives or risk them trying to access humanitarian aid. Thousands have been separated from their loved ones and have no news of their whereabouts. Since the latest outbreak of fighting, between the Sudanese Armed Forces and the Rapid Support Forces in 2023, over 11 million people have been forced to flee their homes. The fighting has also severely damaged critical civilian infrastructure, such as hospitals, power supply lines and telecommunication facilities. The deep humanitarian crisis is being exacerbated by non-compliance with international humanitarian law (IHL). The consequences of the conflict could last for decades if no action is taken urgently, but this requires ensuring the security and safety of humanitarian workers so that they can reach vulnerable communities in conflict-affected areas. Working in Sudan since 1978, the International Committee of the Red Cross (ICRC) has played a pivotal role in addressing these challenges, delivering life-saving aid and advocating for compliance with IHL. We promote respect for humanitarian law with the parties to the conflict and hold dialogue with them to secure direct access to violence-affected people. Often working in partnership with the Sudanese Red Crescent, we help people access healthcare and other essential services, meet their basic needs and reconnect with relatives separated by the violence. We also check on the well-being of detainees. This article examines the ICRC's response in Sudan during the period 2023-2024, with a focus on its partnerships with KSRelief and the UK's Foreign Commonwealth & Development Office (FCDO). It highlights the positive impact that the ICRC's work has had on affected people and lessons learned from the crisis response. It draws on the ICRC's experience in Sudan to provide recommendations for strengthening humanitarian action in other crisis settings.

BackgroundIn the face of escalating health emergencies globally, the need for timely rehabilitation services has become increasingly evident. However, deficiencies in the provision of early rehabilitation interventions following disasters underscore the urgent need for improved integration and response strategies. The objective of this study is to assess the effectiveness of the early physical rehabilitation response initiated by the International Committee of the Red Cross (ICRC) following the 2020 Beirut blast, with a focus on evaluating patient outcomes, time to intervention, and long-term outcomes. Additionally, the study aims to extract valuable lessons and to propose a plan of action aimed at enhancing preparedness and response frameworks for similar emergencies.MethodsA retrospective observational study was conducted on data from the ICRC physical rehabilitation program (PRP) database in Lebanon, encompassing patients who were identified as eligible for PRP rehabilitation services following the Beirut Blast. Hospital records and a dedicated hotline were used for recruitment, with 102 patients meeting the eligibility criteria. Rehabilitation interventions included mobility aid provision and individualized assessments for physiotherapy sessions, with outcomes evaluated using the Functional Independence Measure (FIM) score.ResultsA total of 102 eligible patients were included in the analysis, 41.2% of whom were aged 40–65 years, with the majority residing in Beirut (55.9%) and being Lebanese nationals (85.3%). Assistive devices and mobility aids were distributed to 60% of patients, and physiotherapy sessions were provided to 68.6% of patients, with variations in timing and frequency. Early initiation of physiotherapy sessions correlated with greater improvements in the FIM score, particularly among patients with secondary blast injuries and tendon cuts. Follow-up assessments revealed that 53% of patients achieved full recovery, while some required additional therapy or experienced permanent functional impairment. The proactive plan of action proposed by the ICRC PRP team for any emergency risk underscores the essential integration of its two core components: Preparedness and Response.ConclusionsIn the wake of the Beirut port blast, the collaborative efforts of a rehabilitation team to provide supportive/assistive devices alongside physiotherapy significantly contributed to the recovery of the victims’ functional capabilities. While life-saving surgeries and critical interventions are essential for managing the immediate impact of such catastrophes, prioritizing early physical rehabilitation is equally pivotal for reducing injury-related disability. The interconnectedness of preparedness and response components within the PRP’s emergency rehabilitation strategy underscores the necessity for proactive planning and coordination to effectively address and recover from emergencies.