War in Europe: palliative care in a humanitarian crisis

As we write this editorial, we are saddened and horrified by the events in Ukraine unfolding across our newspapers and TV screens. We have seen the images of bombed maternity wards and children’s hospitals, of hospital patients, both children and adults, being cared for in hospital basements, of cities being bombarded and people struggling with a lack of the most basic supplies. We have also heard stories of bravery and humanitarian efforts, such as 150 Ukrainian children with cancer and their families reaching Poland and other destinations to
continue their treatment (St Jude’s Research Hospital, 2022), or the work of Eugenia Szuszkiewicz helping to move terminally ill children from Kahrkiv (Damon et al, 2022).

We know of palliative care professionals swapping their white coats for army fatigues to fight for their countries, and of others doing their best to care for adults and children needing palliative care in such difficult and stressful circumstances. Global organisations with expertise in humanitarian aid and specialists in different areas of disaster response have come together with governments and rallied to the cause (these include the International Red Cross, United Nations High Commissioner for Refugees (UNHCR) and Unicef). Global palliative care
organisations have received many emails from palliative care professionals and organisations who are watching and wanting to help. We are in touch with those working in Ukraine and the surrounding countries.

Our friends and colleagues in Ukraine have worked hard over the years to develop palliative care services for both adults and children, along with education, access to medicines and legislation. Now they are trying to evacuate those with palliative care needs. Municipal hospitals
across the country are receiving palliative care patients, teams are providing telephone consultations and palliative care programmes in surrounding countries are stepping in to provide necessary care and support. As nurses, we stand in solidarity with all healthcare professionals working in Ukraine, not just those working in palliative care, indeed all those working across the globe in conflict situations.

We would also like to spare a thought and acknowledge our palliative care colleagues in Russia. The International Council
of Nurses (ICN) has launched its #NursesforPeace campaign (ICN, 2022) to call for peace, condemn attacks on healthcare and support nurses on the frontlines. Likewise, other oragniations, such as the International Society of Paediatric Oncology’s (SIOP) Nursing Network, have signed a joint statement from the ICN, the European Federation of Nurses Associations and the European Forum
of National Nursing and Midwifery Associations, to condemn the invasion of Ukraine, calling for, among other things, an immediate ceasefire and that nurses and other healthcare workers should be able to deliver care and treatment without
fear (ICN et al, 2022).

They also support the global palliative care community’s statement on the humanitarian crisis in Ukraine (Global Palliative Care Community,
2022), endorsing the World Health Organization (WHO) position that palliative care should be integrated into humanitarian responses. Palliative care provision is an essential component of the humanitarian response, and yet at times like this it feels so hard to know how we as the palliative care nursing community should and can respond.

While for many of us it is the horrors of war in Ukraine that we are seeing on our TV screens, we are however mindful that there are too many areas of the world where this is the reality of daily life, where those needing palliative care, and those caring for them, are living in fear and highly volatile situations. We express our solidarity with all palliative care nurses and health professionals in such countries, particularly in Ukraine right now, who are working tirelessly under great threat to their personal safety to provide palliative care.

Published with permission by Mark Allen: Please find link here: https://www.magonlinelibrary.com/doi/abs/10.12968/ijpn.2022.28.3.106