Humanitarian assistance training: Health Emergencies in Large Populations
The H.E.L.P. (Health Emergencies in Large Populations) is a multicultural and multidisciplinary learning experience created to enhance professionalism in humanitarian assistance programmes conducted in emergency situations. Since 1986, approximately 3'153 professionals have attended the course which is given in partnership with the World Health Organisation, with research institutions and universities all over the world.
PRESENTATION OF THE H.E.L.P. COURSE
The H.E.L.P. course: a multicultural and multidisciplinary learning experience.
The H.E.L.P. course was created in 1986 by the International Committee of the Red Cross to upgrade professionalism in humanitarian assistance programmes conducted in emergency situations.
These courses have been given in various parts of Latin America, North America, Africa, Asia, Western and Eastern Europe. Since 1986, approximately 3'153 health professionals and humanitarian aid workers from the International Red Cross and Red Crescent Movement, United Nations agencies, NGOs, ministries of health, armed forces medical services and academic institutions have attended the course.
A joint effort
The course is organized in partnership with academic institutions, WHO (World Health Organization), PAHO (Pan-American Health Organization) and National Red Cross Societies. Our current academic partners are:
In Nairobi, Kenya: Kenya Red Cross Society
In Ouidah, Benin: Institut régional de Santé Publique
In Doha, Qatar: Calgary University, Qatar Red Crescent Society
In Baltimore, USA: Johns Hopkins University, Bloomberg School of Public Health and School of Medicine
In Honolulu/Hawaii, USA: Center of Excellence in Disaster Management and Humanitarian Assistance, University of Hawaii.
In Geneva, Switzerland: University of Geneva, Faculty of Medicine
In Cuernavaca, Mexico: Instituto Nacional de Salud Publica Cruz Roja Mexicana
In Fukuoka, Japan: The Japanese Red Cross Kyushu International University of Nursing
In Beijing, China: The Peking University, Beida School of Public Health
In La Habana/Cuba : Centro Latinoamericano De Medicina de Desastres (CLAMED)
The H.E.L.P. course is a two weeks' course. The course focuses on public health activities, communicable diseases, epidemiology, International humanitarian law (IHL), security, humanitarian principles and ethics.
The course provides the public health tools necessary for making appropriate decisions in emergency situations involving large populations. The main topics include: economic security, water and habitat, environmental health, communicable diseases and epidemiology, and other subjects.
It covers also ethical issues that arise in humanitarian activities and provides an overview of the main legal instruments, particularly international humanitarian law and human rights law, professional codes and declarations that are the basis for decision-making in humanitarian operations that respect the dignity of the victims they seek to assist.
During the course the participants are encouraged to share their field experiences. The course prepares the ground for common approaches to public health among humanitarian organizations, thus contributing to better programme coordination in emergency operations.
An overview of the main steps of the planning process provides the participants with common terminology.
- identification of health problems;
- identification of constraints;
- selection of priorities;
- determination of objectives and strategies;
- mobilization of resources;
- implementation of activities;
- evaluation of results.
This planning methodology is applied throughout the course.
Nutrition and economic security
Malnutrition, lack of income and lack of economic security at household level are serious problems in emergency situations. An insufficient food supply and increased poverty create significant health risks. Proper planning for programme implementation, adequate surveillance and effective assessment of needs and constraints are essential for a pragmatic and realistic assistance programme.
The course focuses on the following:
- nutritional evaluation, including assessment of vitamin and micronutrient deficiencies, sampling techniques for surveillance, data collection and anthropometrics measurements;
- household security evaluations and rapid rural assessment methods;
- methodical guidelines for planning, implementation and surveillance of general and specific food-aid operations and feeding centres.
Survival without water is impossible.
The provision of an adequate supply of safe water is an absolute priority in any emergency action. Poor hygiene, overcrowding and pests are the main killers during emergencies.
The course addresses:
environmental conditions favouring the occurrence and persistence of various pathogens;
basic methods for emergency water supply, black water treatment, garbage disposal, vector control, emergency shelter and energy assistance.
Health information systems and epidemiology
Epidemiology is an essential tool in any relief operation. In an emergency situation the initial health assessment, the monitoring of assistance programmes and the evaluation of the impact of the relief operation must be documented by an effective health information system.
Basic epidemiological tools are reviewed:
- definition of epidemiological terms;
- selection of health indicators in emergency situations;
- methods of data collection in emergencies;
- data analysis;
- establishment of surveillance and health information systems.
Health systems in emergencies encompass environmental engineering, food and household economic security measures, primary health care, mental health and curative and preventive secondary health care services. These include community-based services as well as the international relief response. All these components together form a comprehensive health system.
During the course special attention is given to examining the interaction between these components and identifying the key elements needed to improve the functioning of health systems in emergency situations.
Communicable disease control
Control of communicable diseases is a major problem in disaster situations, especially where large concentrations of people are living in precarious conditions of hygiene.
The course covers:
- strategies for controlling the main communicable diseases (diarrhoeal diseases, malaria, cholera, tuberculosis, measles, tetanus, intestinal parasites, HIV/AIDS, etc.)
- integration of various fields of activity such as environmental health, health promotion, community participation, disease prevention and basic medical care, bearing in mind the constraints that are part of any disaster situation.
The humanitarian organizations have become increasingly aware of the mental health needs which emerge among victims of disasters. This is a problem that was neglected for too long, and it is now a must to address it in a professional manner.
Participants therefore learn:
- to define the basics of the concept of mental health;
- to recognize the basic characteristics of mental health in individuals and communities;
- to know the differences between mental health problems and mental diseases;
- to identify factors that affect mental health and that give rise to mental health problems in conflict situations and among refugees and displaced populations, and to address priority needs;
- to identify the main resources for implementation of emergency mental health assistance programmes;
- to identify priority target groups for mental health assistance.
Dilemmas faced by professionals in humanitarian operations
Health professionals have to make difficult choices in armed conflicts. Some examples:
- triage of the wounded;
- deciding on the appropriate level of health care;
- providing assistance when there is limited control over its delivery;
- providing assistance in poor security situations;
- providing assistance in situations where it may facilitate violation of fundamental human rights;
- dealing with evidence of torture and mutilation used as means of punishment.
To help professionals take appropriate decisions on such matters, the relevant instruments in the fields of international humanitarian law, human rights and health ethics are studied.
International humanitarian law (IHL)
International humanitarian law (IHL) forms a major part of international law. It comprises the rules, which, in times of armed conflict, protect persons who are not or no longer involved in the fighting, and restrict the methods and means of warfare employed.
The course focuses on:
- application of IHL in international and non-international armed conflicts, and its applicability in new types of conflicts;
- identification of the main rules relating to the protection of health;
- rules for the protection of health professionals;
- the latest developments of IHL, specifically in the field of new weapons;
- the role of the ICRC in promoting and developing IHL;
- the use of the Red Cross/Red Crescent emblem.
Professional ethics and health
Ethics should play a predominant role in the development and implementation of health policy, so as to ensure equity, gender sensitivity, and respect for fundamental rights. Health policy should aim to empower people affected by disasters to become self-sufficient. An overview of the main ethical theories and approaches is given, and the main instruments governing ethics in the health professions are considered.
The course includes:
- a review of the main resolutions of the World Medical Association (WMA);
- identification of the principal ethical rules which are applicable in armed conflicts and dictate the behaviour of health professionals;
- consideration of the cultural values of victims and those of societies.
Responsibilities of health professionals in armed conflicts
The work of health professionals involves a wide range of responsibilities that go beyond just treating the sick and wounded, preventing disease and maintaining health. The course focuses on other responsibilities such as:
- preventing consequences of armed conflict which may have a major impact on health (e.g. the use of unlawful means of warfare, forced population displacements);
- identifying ethical dilemmas;
- making ethically correct decisions on health-related issues;
- protecting individuals from torture and mutilation;
- restricting the development and use of certain weapons;
- monitoring the health status of populations living u nder economic sanctions;
- forging a link between health and peace.
Participants consider how they can influence health policies within their own organizations to ensure better respect for ethical standards during relief activities. They also examine possible means of cooperation with professionals from other disciplines, such as lawyers, so that lessons learned from the health perspective can serve as the basis for the development of legal instruments.
Teaching concepts and methods
The course concentrates on concepts and approaches which have proved to be relevant for humanitarian field activities during emergency situations.
Various teaching methods, including lectures, and group discussions are used. An important part of the course is reserved for case studies, on a simulated case during week 1 and on actual situations during week 2.
Participants are invited to share their personal experiences as well as their cultural background.
Course dates, registration, fees and credits
For course dates, registration fees and credits, please refer to the specific information leaflets on the different courses. Please see the H.E.L.P. course calendar PDF for contact details.
The courses in Geneva, Japan, Baltimore, Nairobi, Honolulu are given in English.
The courses in Cuernavaca and La Habana are given in Spanish.
The course in Beijing is given in Chinese and English (consecutive translation).
The course in Ouidah/Benin is given in French.
The course in Doha is given in Arabic.
A total of 166 different nationalities and over 20 different professions have been represented in H.E.L.P. courses.
The course is intended first and foremost for health professionals: doctors, nurses, nutritionists, environmental health engineers, epidemiologists, and public health officers.
Other professionals holding decision-making positions in assistance or emergency programmes are also welcome.
Candidates working in countries affected by war or natural disasters will be given special consideration.
The target number of participants is 25. Certificates of attendance are issued to all participants at the end of the course.
Depending on individual cases and the partner-university, a student following a Master programme, can obtain up to 5 ECTS.
- P. Bouvier, ICRC Senior medical advisor, H.E.L.P. courses coordinator
- P. Schlageter, Assistance Division, HELP courses, email : firstname.lastname@example.org