Children in Crisis

Founded: 2019
Faculty Lead: Michelle Niescierenko, MD, MPH
Status: Active Program
Regions of Focus: Liberia, Bangladesh, Greece, Occupied Palestinian Territories
Research Theme: Risk, Resilience and Response

Description

The Children in Crisis (CiC) Program focuses on addressing the critical needs of crisis-affected children and youth in humanitarian contexts. The impact of humanitarian crises on children has reached catastrophic proportions; today, nearly 50 million children have been displaced from their homes due to violence, poverty, or natural disaster. Because of their inherent vulnerability, children are disproportionately affected by war, social unrest, disaster and economic crisis. Within settings of conflict and crisis, they are susceptible to harm due to the loss of adult care-providers, disruption of social structure and protections, environment of violence and exploitation and, often, a lack of health infrastructure equipped for pediatrics. The CiC program strives to confront the complex and unique needs of children whose lives have been upended by humanitarian crisis. With one in every four children in the world living in a country afflicted by conflict or disaster, it is essential for the international community to understand more fully children’s unique needs in order to prevent, mitigate, and address these detrimental health consequences.

Specific Program Goals Include:

The Children in Crisis program informs approaches to reduce the vulnerability of children in humanitarian settings and to support national-level resilience strategies. The program’s goal is to translate the knowledge gained from working with affected communities into timely, effective and sustainable programs and policy. CiC reduces the impact of conflict or crisis on children through:

  • Defining and supporting pediatric care needs in the humanitarian context, working towards ensuring effective health services reach children
  • Conducting operational research and scholarship to inform humanitarian action around effectiveness of youth-focused health interventions
  • Collaborating with NGO’s, UN agencies, Ministries of Health, and academia to address identified pediatric healthcare needs
  • Educating the next generation of humanitarian actors to have the knowledge and skills to provide services for children in complex humanitarian crises
  • Convening national and international stakeholders to advance research and programmatic priorities context and share best practices for the healthcare of children in humanitarian settings

Featured Projects

Liberia Ebola Response

Programming supporting infection control was implemented in all 23 Liberian government hospitals in partnership with Liberia College of Physicians and Surgeons’ to provide emergency response.  This project supported local healthcare workers to help develop and fully implement this multisector and multidisciplinary approach to hospital safety for patients and healthcare workers through training, improvement of water and sanitation, supply provision and mentorship. 

Bangladesh

Working with local NGOs and academic partners, an assessment of the learning needs of Rohingya community health volunteers in Cox’s Bazar, Bangladesh was completed, generating recommendations for ongoing training to enhance and expand existing service for the 1.2 million people including 683,000 children. Our work included developing a scope of practice specific to pediatric care, as well as emergency and mass casualty response integrated within existing emergency frameworks. 

Kos Refugee Camp, Greece

Migrant or refugee children face untold challenges during their journey; protection and health dangers are often combined with lack of access to services suited to need their specialized needs, detention and family separation. In this collaboration, we worked with an international NGO and the ministry of health to provide education to local nursing staff on pediatric primary and emergency care to improve healthcare services to the Syrian, Palestinian, Pakistani and Iraqi refugees in the camp. 

Occupied Palestinian Territories

The Palestine resuscitation project is a collaboration with local Palestinian healthcare workers and an NGO with the objective to train physicians and nurses in pediatric advanced lifesaving skills and implement a context-specific pediatric early warning scoring system to aid in early identification of patients at risk for clinical deterioration​ in two pediatric oncology departments in the occupied Palestinian territories. 

UNICEF Nutrition Project

Working with UNICEF and the Ministry of Health, we are providing technical support and data management/analysis for a randomized trial to evaluate the efficacy of cash transfer and nutrition education in Rural Liberia. Community health assistants are assessing the changes in dietary diversity, meal frequency, anthropometrics and healthcare utilization among children 6 to 23 months of age.

Filling the knowledge gap in pediatric practice for humanitarian settings

The need to Identify children at risk for serious bacterial infections and subsequent responsible antibiotic use is a major challenge in humanitarian and resource-limited contexts. We are currently working on a systematic review requested by a humanitarian healthcare NGO to evaluate the use of biomarkers to provide quick, reliable identification of children at risk of serious illness to improve the quality of care, responsible use of antibiotics and allocation resources.

Program Streams

Operational

Support NGOs, UN agencies, and health ministries to more effectively respond to child health needs in emergencies by providing technical guidance, programmatic guidance and monitoring.

Research

Define the immediate and long-term needs of children in acute and protracted humanitarian crises and to identify best practice interventions.

Education

Engage in educational activities including online education, professional education, and Harvard University courses.

Team