Inside the world of humanitarian healthcare

When Sonia Brockington worked as a humanitarian health practitioner in a large Internally Displaced Persons camp in Sudan, she found her role vastly different than working in Australian hospitals.

‘You need to be very resourceful. You need to be able to operate with less when your supply chain isn’t the same,’ Brockington says. ‘If I didn’t communicate with our logistician, I couldn’t do what I needed to do to support children who were malnourished.’

‘In Australia, I had everything at my fingertips to provide the care I needed to give to patients. I didn’t even think about the supply chain and the logistics of that, because it just happened,’ she says.

Now a lecturer in humanitarian health at Deakin University, Brockington is helping prepare future frontline humanitarian health workers for the role they’ll play in assisting disadvantaged communities – no matter where in the world.

Life in humanitarian work

Brockington says working in humanitarian environments is ‘so different to what people would experience in more developed countries’.

When working in a humanitarian context, your role is broad, communication is constant, and teamwork is imperative. It’s a career where the challenges are endless, but the rewards far outweigh them.

‘It’s about preparing the students for that; knowing that they probably won’t have the resources at their fingertips,’ she explains. ‘They’ll have to be resourceful, they’ll have to make difficult decisions, they do need to understand the local context.’

The coronavirus pandemic has created a shift away from traditional humanitarian models, and Brockington explains where the future is heading and the skills the next generation of humanitarian health workers will need to help disadvantaged communities all over the world.

How the coronavirus pandemic has changed the frontline for humanitarian workers

International travel bans have interrupted and blocked supply chains and have prevented many international surge support staff from traveling to provide support. This has pushed forward the need for non-governmental agencies to focus on ‘localisation’.

‘Localisation is a transition away from what we would understand as the traditional humanitarian world, which is one where you have international humanitarian actors going into a humanitarian crisis or environment,’ she says. Instead, localisation promotes and supports local leadership and agency to lead humanitarian response, rebuild and prevent future humanitarian crises.

However, this creates other challenges. ‘There are several different circumstances that are realities for humanitarian settings that aren’t true for well-developed strong healthcare settings and economies.’

For example, while the coronavirus pandemic has highlighted the shortage of frontline medical practitioners all over the world, that extends into humanitarian crisis contexts. Brockington says the health workforce may not exist, or if it does, ‘It’s not to the capacity that would be ideal.’ In addition, limited medical supplies and equipment that are commonplace when working in humanitarian emergencies.

There are many issues around public healthcare communications as well.

Brockington reflects on recent work she has undertaken with Save the Children recently. A Rapid Needs Assessment to determine how COVID-19 was affecting local communities found over 200 people included in the assessment ‘held one or more myths related to coronavirus’.

‘They also found that while people were aware of what was happening with the coronavirus, there were a lot of differences in the way that information was interpreted,’ Brockington says. ‘For example, people knew it was happening and knew what some of the symptoms might have been, but they weren’t clear on what they needed to do if they were symptomatic.’

What part does technology play?

In 2020, cutting edge technologies can assist in critical humanitarian work. However, Brockington points out that while these technological developments are helpful, it is not a case of one-size-fits-all, and we need to take a multi-pronged approach.

‘I think technology will play an important role, but one of the interesting things is the digital divide found in many communities,’ Brockington says. ‘As we’ve seen here in Australia, there is a digital divide, and not everyone has access to devices and the internet. Other nations such as Indonesia and the Philippines have highlighted the importance of using a range of different media to provide information.’

Using a multi-faceted approach to disseminating vital public health information as well as correcting misinformation is necessary to ensure communities and different groups are not missed or left in the dark. Brockington suggests using influential people in the community and easy to understand communication messages to spread the information to those who may not have access to other mediums.

While technology will play an important part in understanding the information around COVID-19, Brockington says we also need to be conscious that not everyone has access to technology-based information.

‘We need to think of other avenues, like community and faith-based leaders, radio and visual posters, for that information to be shared among vulnerable people in that humanitarian context,’ Brockington says.

Skills to help take action in those communities

The effectiveness of humanitarian action relies heavily on clear, accurate and impactful public health communication. In the case of the COVID-19 pandemic, Brockington says these skills couldn’t be more crucial.

As seen all over the world, doctors and nurses have played such an imperative role –they’ve been at the frontline, diagnosing and treating people with COVID-19.

‘Then there’s also the public health messaging, which is possible through many different avenues. In a humanitarian context, that public health message will always need to be presented alongside other sectors.

‘Whether that’s through health with education, health and nutrition, health and programming, or health and water and sanitation. You have an integrated approach.’

Other necessary skills for effective humanitarian aid may be less obvious but are not any less vital. The ability to implement positive mental health and self-care practices are needed to be successful in this field.

‘We’ve seen a lot around frontline health workers working around the clock to provide care to people, but I think the idea of self-care is so important for building resilience because eventually that resilience will be tested.’

A willingness to learn

It takes humility to be open and receptive to feedback, suggestions and new ideas. For people interested in the humanitarian health field, Brockington explains that they need to be at peace with the idea that they may not have all of the right answers.

‘They need to be there to learn as well, and must be willing to partner with local communities, to learn about and understand the context so they can be most effective wherever they find themselves.’