Medics from Palestine, Qatar, and the UK Convene to Help Treat Pain in Children in War Zones

29 April, 2024. Doha, Qatar -- The World Innovation Summit for Health (WISH), the global health initiative of Doha-based Qatar Foundation (QF), has announced the development of a new Pediatric Trauma Pain Management Manual in Arabic and English to support clinicians in conflict zones. The manual will provide clinicians with medical guidance to assist children who have suffered life-changing injuries.

Approximately one in six children live in conflict zones.[1] Children exposed to blast events in conflict are often severely injured. We know from conflict zones worldwide that they are more severely injured than adults and are more likely to die. Pain management is a fundamental basic in the care of an injured child, but we frequently underestimate and undertreat pain in children. Untreated pain leads to poorer outcomes and lifelong physical, psychological, and social impact. Until now, no comprehensive manual has existed to offer focused guidance for clinicians treating children in conflict despite more and more children being exposed each year.

The manual is being developed in conjunction with the UK-based Paediatric Blast Injury Partnership, who in 2019 produced a Paediatric Blast Injury Field Manual^[2]. The Arabic version of this manual was developed by WISH with the support of the Translation and Interpreting Institute (TII) of QF’s Hamad Bin Khalifa University.

After initially being used in Syria and Yemen, more than 1000 copies of this version have been distributed to medics in Gaza since November 2023. WISH also facilitated the translation of the blast injury manuals into Ukrainian and Russian, and copies of these versions have been distributed across Ukraine by the charity Save the Children

The new manual will address how clinicians can manage children’s pain not only at the point of their blast injury, but through the acute care pathway and in the months and years following injury. Doctors undergoing training in Hamad Medical Corporation (HMC) from Gaza, along with pain experts in Qatar, will join other clinicians and academics in pediatrics and pain management from Bristol Royal Hospital for Children, the University of Bath, and Kidconfident.org. in producing the manual.  Initially targeting clinicians in Gaza, Arabic and English versions are being developed simultaneously.

As part of the manual’s continued development, on 27 April, WISH convened a Pain Management Clinical Focus Group in Doha to further guide the content of the manual to better support clinicians in Palestine and conflict zones worldwide. Around 30-40 Qatar-based clinicians with first-hand experience in Palestine and conflict settings attended, including pain experts from Sidra Medicine and HMC, as well as doctors from Gaza and the West Bank who are currently enrolled in the fellowship training in HMC as part of a program organized by Qatar’s Ministry of Public Health.

Speaking at the Pain Management Clinical Focus Group meeting in Qatar, project lead Dr. Paul Reavley, Pediatric Emergency Medicine Consultant at Bristol Royal Hospital for Children, said: “Pediatric care in conflict zones is often delivered by clinicians who have little experience in treating children.  We are looking to give doctors working on the ground in conflict zones both the tools and the confidence to treat children experiencing the horrific and painful consequences of blast injuries, which in turn will allow for better assessment, treatment, and communication with children, from injury to rehabilitation and beyond.”

The manual will be officially launched at the WISH 2024 international healthcare summit, taking place on 13-14 November at the Qatar National Convention Centre in Doha.

Dr. Abdullatif AlKhal, Deputy Chief Medical Officer and Director of the Department of Medical Education at HMC in Doha, Qatar, said: “For many years, Qatar’s Ministry of Public Health has brought physicians from Palestine to Doha to help them develop the necessary skills and competencies in different specialties leading to board certification that they can then take home with them and use to treat their patients back in Gaza and the West Bank. Their first-hand knowledge of working on the ground in extremely challenging conditions gives them a valuable perspective on delivering care. Working together with the Paediatric Blast Injury Partnership and WISH, we have the best chance of developing a Pediatric Pain Management Manual that will provide vital support to healthcare professionals working on the ground in conflict zones in Gaza and elsewhere.”

Sultana Afdhal, Chief Executive Officer, WISH, said: “Given the suffering of the growing number of severely injured children in Gaza, we knew that there was a chronic need for a focus on pain relief. Speaking with Paul Reavley made it clear that developing a follow-on manual to the Paediatric Blast Injury Field Manual would be an effective way to provide help.

“With the support of Qatar Foundation and Qatar’s Ministry of Public Health and the brilliant clinicians and researchers from Gaza, Qatar, and the UK, we are determined to play our part in the development of this vital manual and supporting the training of clinicians in Gaza and elsewhere."

-ENDS-

References

[1] Østby, G., Rustad, S. A., & Tollefsen, A. F. (2020). Children affected by armed conflict, 1990–2018. Conflict trends, 1.

[2]https://www.imperial.ac.uk/media/imperial-college/research-centres-and-groups/centre-for-blast-injury-studies/PBIP-BlastInjuryManual2019_I_web.pdf

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