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van Boetzelaer E, van de Kamp J, Keating P, Sharma S, Pellecchia U, Browne JL, Sheather J, Franco OH. Involving older people in the preparedness, response, and recovery phases in humanitarian emergencies: a theoretical framework on ageism, epistemic injustice, and participation. THE LANCET. HEALTHY LONGEVITY 2024; 5:e76-e82. [PMID: 38183999 DOI: 10.1016/s2666-7568(23)00244-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/17/2023] [Accepted: 11/20/2023] [Indexed: 01/08/2024] Open
Abstract
Humanitarian emergencies disproportionally affect older people. Although defining an older person by an age range can help alert us to emerging or changing needs and potential vulnerabilities during humanitarian emergencies, ageing is not necessarily synonymous with increasing vulnerability, and individual variations exist due to the heterogeneity of older people. In general, reduced access to safety, health services, clean water, and appropriate food puts older people at increased risk of poor health outcomes during humanitarian emergencies, including disability, injury, malnutrition, and mental health issues. The theoretical framework presented in this Personal View explains how ageism, further compounded by intersecting oppression, leads to the exclusion of older people from the preparedness, response, and recovery phases of humanitarian emergencies. The exclusion of older people is discriminatory, violates core humanitarian and bioethical principles, and leads to an epistemic injustice. We suggest that humanitarian actors implement participatory approaches with older people in humanitarian contexts. Through these approaches, solutions will be identified by and together with older people, leading to community-driven and context-appropriate ways to include the needs and strengths of older people in the preparedness, response, and recovery phases of humanitarian emergencies.
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Affiliation(s)
- Elburg van Boetzelaer
- Médecins Sans Frontières, Operational Centre Amsterdam, Amsterdam, Netherlands; Global Public Health and Bioethics, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands.
| | - Judith van de Kamp
- Global Public Health and Bioethics, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
| | - Patrick Keating
- Médecins Sans Frontières, Operational Centre Amsterdam, Amsterdam, Netherlands
| | | | - Umberto Pellecchia
- Médecins Sans Frontières, Operational Centre Brussels, Brussels, Belgium; Médecins Sans Frontières, Luxembourg Operational Research Unit, Luxembourg, Luxembourg
| | - Joyce L Browne
- Global Public Health and Bioethics, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
| | - Julian Sheather
- Médecins Sans Frontières, Operational Centre Amsterdam, Amsterdam, Netherlands
| | - Oscar H Franco
- Global Public Health and Bioethics, Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, Utrecht, Netherlands
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