Opinion: Research vital to inform humanitarian crises response
July / August 2021 | Volume 20 Number 4
Opinion by Fogarty Director Dr Roger I. Glass
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UN Photo/Luke Powell
With tens of thousands of refugees
fleeing Afghanistan, earthquake survivors
struggling to survive in Haiti and terrible
wildfires burning across Greece, we
are reminded that humanitarian crises
touch us all and can cause severe health
consequences. For example, forced
migration can result in malnutrition,
flooding can lead to polluted water that
causes infections and illness, and smoke
from fires can exacerbate asthma and other lung conditions.
As the number of people experiencing humanitarian crises
continues to climb worldwide, Fogarty’s Center for Global Health Studies has been leading an effort to examine how
research can be done in the midst of these emergencies to
improve response effectiveness.
Although each disaster may
involve different health factors,
they share many common
characteristics that make
research difficult.
Read recent
opinion pieces from Fogarty Director Dr. Roger I. Glass.
Recently, the humanitarian
project team commissioned and
published a collection of case
studies to highlight the results of
scientific studies conducted
in the context of crises—such as
armed conflicts, natural disasters, forced displacement and
disease outbreaks. Unlike traditional research papers, the
project examples go beyond what research was conducted
to explain why the research was important and how it was
conducted in these extremely challenging settings. The
papers also identify scientific areas of high public health
significance that can best be addressed through research
during these events.
Together with our partners from across NIH, NGOs and
academia, we are exploring how we can further support
this critical type of research. We presented highlights of the
article collection during a recent Fogarty advisory board meeting,
where it sparked a robust discussion. We were encouraged
to consider the mental health aspects of crises, as it is most
often the case that people who are already vulnerable are the
ones who suffer the most. It was also suggested that we help
address the communication challenges that can arise due to
power and cell service disruptions during disasters. It was
noted that researchers must proceed with care during crises and consider forming partnerships with organizations that
have built up community trust and best understand local
needs. Finally, we observed that investigators must remain
cognizant of the purpose of their research and who it is
intended to benefit. Governments require not only evidence but real-time, real-world applications that can immediately reduce suffering
and save lives.
The group also agreed that research in humanitarian crises
taps into two key areas where Fogarty has substantial
expertise—ethics and implementation science. Conducting
research in this context poses unique ethical issues making
it important to recognize the power differential that exists
between scientists and vulnerable populations. Also,
there may be greater than normal
potential for risk of suicide, physical
or sexual abuse, or other harm.
Researchers must anticipate and
plan how to respond to these risks
before their studies begin. They
might establish community advisory
boards to better understand cultural
norms and gain input to help them
shape the studies. Informed consent
is another complex issue that
requires careful consideration when
working with vulnerable populations.
Researchers must also consider how they will deal with
requests for medical or other assistance that may come during data collection.
Of course, once best practices have been developed, they
must be adapted to suit the individual circumstances, local
culture and available resources. We call this implementation
science (IS), or the study of methods to promote the adoption
of evidence-based practices, interventions and policies. Fogarty
has been building research capacity and the knowledge base
for IS for decades now so brings substantial expertise to this
effort.
The next step under this initiative is a networking and mentorship forum that will be held in November 2021 to help
build a cadre of researchers capable of tackling these
difficult issues. That’s never been more relevant, as the
humanitarian crises we face are becoming more common,
complex and interrelated.
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