Frantz Merisier (at left) and Lauren Spink, students from this year’s Humanitarian Response Intensive Course, discuss plans to help the refugee population with their teammates during the course’s simulated refugee crisis. Photo courtesy of Adina Davies.

Stephanie Kayden, MD, MPH, is preparing present and future humanitarian response workers one intense course at a time.

Director of BWH’s International Emergency Medicine Fellowship, Kayden has worked to improve emergency medical systems, humanitarian aid and international disaster response in more than 20 countries. In 2010, she helped establish a field hospital for survivors of the earthquake in Haiti.

Every spring, Kayden leads a two-week course on humanitarian disaster aid for physicians, medical residents, military personnel, aid workers and other responders to international humanitarian disasters. The Humanitarian Response Intensive Course, taught at the Cambridge campus of Harvard University, is focused on teaching students how to work through high-pressure challenges that arise when responding to disaster situations. This year’s course, which drew people from all over the world, was held April 15 through 27, featuring classroom-based learning, lectures and hands-on workshops. More than 500 students have taken the course since it began 12 years ago.

From left: Students Paula Roy-Burman, MD, John Noyes, Matthew Levine and Zhechen Hong erect a shelter for a refugee family during a simulated refugee crisis. Photo courtesy of Adina Davies.

Refugee Crisis Simulation

Every course concludes with a three-day simulated refugee crisis during which students camp in a North Andover state forest and respond to situations that would commonly occur during an international disaster.  However, calling the capstone scenario a ‘simulation’ doesn’t quite explain it. For many of the students, the scenario is one of the most intense and eye-opening experiences of their careers. Swatting gnats and cooking outdoors are the least of their problems.

“Going into the simulation, the students feel a sense of mastery over the material and feel they are going to be able to complete the scenarios with no problem,” said Kayden, who joined the Brigham in 2004. “But the point is to make them feel the stresses they would feel in real life. We do what we can to throw them off balance from the very beginning and prepare them for high-impact, low-probability events.” Some of the scenarios students contend with during the simulated refugee crisis include security incidents, run-ins with rebel fighters and medical emergencies.

“By the first 12 hours, you start to see significant performance issues in the teams that aren’t working,” said Kayden. “By 24 hours, most students don’t look terribly happy. They are stressed and facing difficulties. I’ve heard from people who have completed the course that when they were going through the simulation, they thought we were being too hard on them, but after they did their first deployment, it was exactly right.”

Students Saki Onda (at left) and Olufunke Fayemi (at right) help transport volunteer Scott Irvine, who played a refugee with war injuries, during a simulated refugee crisis. Photo courtesy of Adina Davies.

Training Standards

BWH’s Michael VanRooyen, MD, MPH, director of the Harvard Humanitarian Initiative, and Peter Walker, PhD, director of the Feinstein International Center at Tufts University, teach the course with Kayden. Along with them, international experts in water sanitation and hygiene, shelter, international human law and media interviewing assist in teaching various course segments.

“The biggest goal is teaching students how to recognize when aid is being delivered right and how to avoid major mistakes that harm people,” said Kayden. “What we know about humanitarian response is that good intentions are not enough to provide a safe, efficient response that helps people; you must be trained in the international standards, otherwise people can make mistakes in the field that either impair their ability to deliver aid or violate people’s dignity or human rights.”

Kayden stresses that the course is open to anyone interested in this work. There are very few places to get this type of unique and immersive training, she says.

“It’s the busiest two weeks of my year and also the most fulfilling,” she said. “Each student is going to help not just one patient, but tens of thousands of people who are experiencing the most desperate time in their lives. This is an opportunity for us to make sure the people who are going out to help are trained and ready.”

Learn more about the course.