Education

Sean M Kivlehan, Amy Allen, Olha Viun, Dmitry A Makarov, Daniel Schnorr, Sonny Patel, Sergii A Ryzhenko, Phuong Pham, and Timothy B Erickson. 6/14/2022. “Evaluation of change in emergency care knowledge and skills among front-line healthcare providers in Ukraine with the Basic Emergency Care course: a pretest/post-test study.” BMJ Open. Read PublicationAbstract

Objective: Evaluate the change in participant emergency care knowledge and skill confidence after implementation of the WHO-International Committee of the Red Cross (ICRC) Basic Emergency Care (BEC) course.

Design: Pretest/post-test quasi-experimental study.

Setting: Mechnikov Hospital in Dnipro, Ukraine.

Participants: Seventy-nine participants engaged in the course, of whom 50 (63.3%) completed all assessment tools. The course was open to healthcare providers of any level who assess and treat emergency conditions as part of their practice. The most common participant profession was resident physician (24%), followed by health educator (18%) and prehospital provider (14%).

Interventions: The 5-day WHO-ICRC BEC course.

Primary and secondary outcome measures: Change in pre-course and post-course knowledge and skill confidence assessments. Open-ended written feedback was collected upon course completion and analysed for common themes.

Results: Participant knowledge assessment scores improved from 19 (IQR 15–20) to 22 (IQR 19–23) on a 25-point scale (p<0.001). Participant skill confidence self-assessment scores improved from 2.5 (IQR 2.1–2.8) to 2.9 (IQR 2.5–3.3) on a 4-point scale (p<0.001). The most common positive feedback themes were high-quality teaching and useful skill sessions. The most common constructive feedback themes were translation challenges and request for additional skill session time.

Conclusions: This first implementation of the WHO-ICRC BEC course for front-line healthcare providers in Ukraine was successful and well received by participants. This is also the first report of a BEC implementation outside of Africa and suggests that the course is also effective in the European context, particularly in humanitarian crisis and conflict settings. Future research should evaluate long-term knowledge retention and the impact on patient outcomes. Further iterations should emphasise local language translation and consider expanding clinical skills sessions.

Building a Better Response: Ukrainian and Polish e-Learning Translations

Building a Better Response: Ukrainian and Polish e-Learning Translations

July 13, 2022

The crisis in Ukraine and the surrounding region is of a size and scope that has required a rapid and intensive scaling up of aid providers to meet the needs of the affected people and communities. More than 200 humanitarian actors – over half of whom are Ukrainian non-governmental organizations – are responding inside the country with lifesaving interventions. National and international organizations are also working to assist the millions of refugees in neighboring countries. Operating in a complex humanitarian emergency of this nature necessitates that all actors engaged in the...

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Valerie A. Dobiesz, Madeline Schwid, Roger D. Dias, Benjamin Aiwonodagbon, Baraa Tayeb, Adrienne Fricke, Phuong Pham, and Timothy B. Erickson. 4/2022. “Maintaining Health Professional Education During War: A Scoping Review.” Medical Education. Read PublicationAbstract

Purpose: War negatively impacts health professional education when healthcare is needed most. The aims of this scoping review are to describe the scope of barriers and targeted interventions to maintaining health professional education during war and summarize the research.

Methods: We conducted a scoping review between June 20, 2018, and August 2, 2018. The search was restricted to English publications including peer reviewed publications without date ranges involving war and health professional education (medical school, residency training, and nursing school), with interventions described to maintain educational activities. Two independent reviewers completed inclusion determinations and data abstraction. Thematic coding was performed using an inductive approach allowing dominant themes to emerge. The frequency of barrier and intervention themes and illustrative quotes were extracted. Articles were divided into modern/postmodern categories to permit temporal and historical analysis of thematic differences.

Results: Screening identified 3,271 articles, with 56 studies meeting inclusion criteria. Publication dates ranged from 1914-2018 with 16 unique wars involving 17 countries. The studies concerned medical students (61.4%), residents (28.6%) and nursing students (10%). Half involved the modern era and half the postmodern era. Thematic coding identified 5 categories of barriers and targeted interventions in maintaining health professions education during war: curriculum, personnel, wellness, resources, and oversight, with most involving curriculum and personnel. The distribution of themes among various health professional trainees was similar. The frequency and specifics changed temporally reflecting innovations in medical education and war, with increased focus on oversight and personnel during the modern era and greater emphasis on wellness, curriculum, and resources during the postmodern era.

Conclusions: There are overarching categories of barriers and targeted interventions in maintaining health professional education during war which evolve over time. These may serve as a useful framework to strategically support future research and policy efforts.

HHI Resilient Communities. 3/2022. Symposium Report: The Impacts of the COVID-19 Pandemic on Vulnerable Communities in the Philippines.Abstract

The COVID-19 pandemic has caused the loss of millions of lives, disrupted the global economy, and created secondary impacts on livelihoods, education, and mental health across the globe. No country or economic group has been immune to the direct impacts of the pandemic, but marginalized communities are particularly vulnerable to the secondary impacts including some public health measures like extended lockdowns. Marginalized populations are those excluded from mainstream social, economic, educational, political, and/or cultural life. They can be excluded or discriminated due to multiple factors such as their race, ethnicity, age, gender identity, sexual orientation, disability, religion, language, and/or displacement, among others. The Harvard Humanitarian Initiative's (HHI) Resilient Communities Program sought to understand how vulnerable or marginalized communities in the Philippines experienced COVID-19, and how communities coped and adapted in response to direct and indirect effects of COVID-19, including public health measures. To do this, HHI invited Filipino authors exploring this central question to submit papers for consideration to be selected to present and share in a symposium. In addition to its research objectives, the symposium sought to connect researchers and practitioners to create a network of professionals dedicated to serving the needs of marginalized communities in the country.

Watch the full symposium: https://www.youtube.com/watch?v=4zC1FzWRUuo

2021 Nov 02

Ahlan Simsim: Partnering to Educate Children in Humanitarian Crisis

11:00am to 12:00pm

Register at http://hsph.me/socialimpact3

On Tuesday, November 2, 2021 at 11:00 AM ET, the Harvard Humanitarian Initiative will host a webinar on "Ahlan Simsim: Partnering to Educate Children in Humanitarian Crisis." This session will be moderated by Irini Albanti, DrPH, MPH, MA, the Executive Director of the Harvard Humanitarian Initiative.

Panelists include:
- Ms. Marianne Stone, MENA Regional Project Director, Ahlan Simsim, International Rescue Committee
- Mr. René Celaya, Managing Director, Ahlan Simsim, and Vice President, International Social Impact...

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Sean M. Kivlehan, Kathryne Tenney, Samuel Plasmati, Vincenzo Bollettino, Katie Farineau, Eric J. Nilles, Greg Gottlieb, and Stephanie R. Kayden. 5/2021. “Humanitarian Training with Virtual Simulation during a Pandemic.” Disaster Medicine and Public Health Preparedness. Read PublicationAbstract

There is an ongoing and established need for humanitarian training and professionalization. The COVID-19 pandemic disrupted training programs designed to accomplish this goal, including the Humanitarian Response Intensive Course, which includes a three-day immersive simulation to prepare humanitarian workers for future field work. To provide program continuity, the three day simulation was quickly adapted to a virtual format using a combination of video conferencing, short messaging service, and cloud-based file storage software. Participants were geographically dispersed and participated virtually. Learning objectives were preserved while some components not amenable to a virtual format were removed.

A virtual humanitarian training simulation is a feasible, acceptable, and affordable alternative to an in-person simulation. Participants were engaged and experienced minimal technological disruptions. The majority of students felt the format met or exceeded expectations. However, feedback also emphasized the importance of providing sufficient time for team collaboration and deliverable preparation in the simulation schedule. The virtual format was more affordable than the traditional in-person simulation and diverse expert faculty who could not have attended in-person were able to participate. This format could be used to overcome other barriers to in-person simulation training, including geographic, financial, time, or security.

Krzysztof Goniewicz, Mariusz Goniewicz, Frederick M. Burkle Jr., and Amir Khorram-Manesh. 10/2020. “The Impact of Experience, Length of Service, and Workplace Preparedness in Physicians' Readiness in the Response to Disasters.” Journal of Clinical Medicine.Abstract
With an increasing number of natural and man-made disasters, the need for preparedness in all levels of management is obvious. Among healthcare professionals responding to these emergencies, physicians are of particular importance due to their significant roles as leaders and frontline workers in minimizing morbidity and mortality of the affected population. This study analyses the preparedness of 549 physicians from all medical centers in Lublin, Poland to formulate their observations, suggestions, and recommendations concerning the improvement of the chain of response in disaster management. The results of this study show that the perceived preparedness of physicians for disaster management and response is not as high as it should be, and the majority of the respondents perceived their disaster preparedness insufficient. Training of physicians in disaster management and principles of disaster medicine is needed, by focusing on the specificity of rescue response to emergencies following disasters, and medical and non-medical aspects of the response with particular emphasis on a management approach covering all hazards.
Adrienne Fricke and Rahaf Safi. 3/2021. Window of Hope: Sustaining education of health professionals in northwest Syria.Abstract
This report is based on a comprehensive needs assessment carried out remotely by the HHI team in Syria in 2019. The OSF HESP grant was awarded to a larger project to understand the impact of humanitarian emergencies, including armed conflict, on students enrolled in medical and nursing programs. The goal is to produce a needs assessment toolkit to help support professional health care education programs during conflict. In addition to Syria, where the conflict is ongoing, the project examines Colombia, a recent post-conflict setting, and Rwanda, a developed post-conflict setting.
Patrick Vinck, Phuong Pham, Eric Stover, Andrew Moss, and Marieke Wierda. 2007. Research Note on Attitudes About Peace and Justice in Northern Uganda.Abstract

In light of human rights violations in Northern Uganda, this research note presents preliminary data on Ugandans’ attitudes on peace and justice. The findings reflect the respondents’ desires for truth reconciliation as well as their desires to hold perpetuators of violence accountable for their actions. However, the findings show that justice is not a top priority for Ugandans in comparison to more tangible needs for health, peace, money, and education. A majority of Ugandans in the North are open to the reintegration of former LRA members in society, albeit conditionally on diminished social and political rights for past LRA leaders.

Ismail Lubbad, Allan Hill, and Cari Jo Clark. 6/2006. Population Projections for Socioeconomic Development in the Gaza Strip.Abstract

By all accounts, demographic pressures in the Gaza Strip — in terms of population density, age structure, and growth rate — are extraordinarily high compared to neighboring countries and regions. This population pressure, combined with limited resources and territorial isolation, places immense strain on public services, social and political institutions, and the natural environment. At the same time, insecurity resulting from a deteriorating political context leads to further poverty and unemployment. Together these conditions require both immediate attention and long-term development planning, both of which are, admittedly, difficult in an environment of continuing political uncertainties. Since September 2000, the Gaza population has suffered periods of protracted closure imposed by the Israeli authorities. This has had deleterious consequences on the socioeconomic situation in the Gaza Strip. Currently, 30.3% of the Gazan workforce is unemployed. Concomitantly, poverty is rampant. As of 2004, 37.2% of Gazan families were below the poverty line, 26.0% of whom experienced extreme poverty suggesting that the majority of poor households in Gaza are unable to meet their most basic needs. These challenges to human security are exacerbated by the fact that approximately 64% of the Gaza population are refugees , approximately half of whom still reside in camps.

6/2018. “An Innovative Global Diplomacy Public Health Student Program – Lessons from the Field in a Post-Conflict Medellin, Colombia”.Abstract

For over fifty years, Colombia has been embroiled in conflict, displacing nearly seven million people, second only to Syria for the highest number of internally displaced persons (IDPs) in the world. Most are displaced to urban environments into dense informal settlements with inadequate water, sanitation, shelter and power infrastructure. The city of Medellín, has become home to over 200,000 IDPs in informal agglomerations. Medellín’s transformation to a city of progress and innovation through the promotion of “social urbanism” is an example of how collaboration between city institutions and government sectors can address issues of poverty, violence, equality, engagement, and reintegration of displaced populations in Colombia.

The Post-Conflict Colombia Public Health Project is a collaborative academic exchange program aimed at bringing together public health students from the United States and Colombia for the purpose of understanding between the people of both countries. The project aims to educate students while also providing direct service and fostering long-term cross-cultural relationships and sustainable projects. Seminars, skill building workshops, cultural experiences, and community engagement are used to build professional competencies and inform policy recommendations for future projects. Despite the limited research on the educational impact of short-term global emersion programs, small scale evaluations point to an increase in learners’ cross-cultural adaptability. The believed benefit to students’ professional and personal development must be balanced with ethical considerations including preparedness of students, health and safety risks, cultural sensitivity, and issues of sustainability. In order to address these concerns, programs should be developed collaboratively through bi-directional participatory relationships, incorporating both education and direct service components, and promoting local capacity building and long-term sustainability.

Our course pairs 16 carefully selected graduate-level public health and medical students from Harvard and Universidad de Antioquia, who will serve as both student and citizen ambassadors, to come together and share about their culture, values, and experiences through the lens of diplomacy and dialogue to make a meaningful impact in the people and country of Colombia. The course examines the social development model of Medellín and its impact on advances in peace, social equity, and health. Beyond the theoretical concepts, students will learn to apply them to the Granizal community in order to create practical solutions that are sustainable, scalable, innovative, and measurable.

As other disciplines move away from curricula limited to rote learning and fact-based content, public health and policy education will also benefit from incorporating experiential and competency-based learning with an emphasis on skill building in leadership, management, policy-making, and research.5 The Institute of Medicine’s 2003 report, Who Will Keep the Public Healthy? Educating Public Health Professionals for the 21st Century, recommends eight content areas as essential to graduate level public health education programs: informatics, genomics, communication, cultural competence, community-based participatory research, global health, policy and law, and public health ethics.6 The report further acknowledges the importance of developing international relationships between academic institutions, community organizations, and health agencies for collaboration in interdisciplinary and community-based research, learning, and service. Health disparities, issues of social justice, and public health threats from infectious disease are less and less confined by political and geographic boundaries. The future generation of leaders in public health and policy must be able to bridge nations and cultures through diplomacy and be equipped to develop innovative strategies and partnerships across professional disciplines and on a global scale.

While several public health approaches have been documented in the literature, we describe a model for a multi-institutional and cross-cultural collaboration based on The Post-Conflict Colombia Public Health Project, a three-week intensive course developed in partnership between the Harvard Humanitarian Initiative, the Open Hands Initiative, and the University of Antioquia. While this model is a public health course focusing on Colombia, the concepts and educational strategies can be applied across academic disciplines and to other countries and communities.

 

Vincenzo Bollettino and Claude Bruderlein. 10/2008. “Training humanitarian professionals at a distance: testing the feasibility of distance learning with humanitarian professionals.” Distance Education.Abstract
Training is an essential part of the professional development of staff working for international humanitarian organizations. While humanitarian workers are being deployed around the world to provide life-saving relief assistance in often-hazardous missions, it is imperative for organizations to ensure that staff members understand the mission and protocol of their organizations and that they develop an appreciation for the impact their work has on beneficiaries. Demand for such training has been expanding exponentially over the last decade with the growing number of humanitarian organizations and personnel. In the United Nations alone, an estimated 37,000 civilian personnel are being employed as part of UN humanitarian operations, an increase of 54% since 1997; 75% of this personnel is composed of national staff of the countries of operation (United Nations, 2008). With the increasing reliance of humanitarian organizations on national staff to manage their field operations, the professional development of staff members poses an ever-growing challenge due to the remoteness and distribution of staff, limiting organizations’ ability to maintain the coherence and cogency of their mission and methods. Although many international humanitarian organizations have adopted some form of distance learning into their staff training, few organizations have evaluated the effectiveness of their distance learning programs. This research briefly evaluates the literature relevant to the use of distance learning for training professional staff in the humanitarian field, assesses how distance learning programs are being used among select humanitarian organizations based in the USA, and reviews the results of a pilot distance learning course offered to mid-career professionals working on international humanitarian issues in a professional capacity.
Phuong Pham, Patrick Vinck, and Tino Kreutzer. 6/2011. Talking Peace: A Population-Based Survey on Attitudes about Security, Dispute Resolution, and Post-Conflict Reconstruction in Liberia.Abstract

Liberia has made progress in peacebuilding and reconstruction in the aftermath of a 14-year long civil war, but the country continues to face challenges in overcoming the results of a legacy of violence. This study, undertaken in November and December 2010, provides insight into Liberians’ current priorities for peacebuilding, their perceptions of post-conflict security, and existing dispute and dispute resolution mechanisms.  The findings suggest that while Liberians are generally positive about the country’s prospects for peace and security, the fears and inequalities perpetuated by years of civil strife continue to reverberate throughout the country. This study provides recommendations to address the existing problems of gaping socioeconomic disparities, limited access to information, a weakened security sector, and the diminished quality of current dispute resolution systems. It also supports inter-ethnic national dialogue on truth, reconciliation, and the underlying causes of the war.

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