Disasters & Humanitarian Crises

Skip anything

Every question is optional. No one has to retell painful events, name a diagnosis, or choose a religion or identity to begin.

Pause or stop

Stop at any point. Nothing is sent anywhere, and nothing is shared unless the person chooses it in the sharing review.

Whose words

Record who said each thing: the person, a caregiver or surrogate, or a professional. A caregiver's needs get their own field.

Support to take part

Extra time, a quieter place, pictures, an interpreter or a trusted person can help someone say what matters. Ask what helps.

Barriers are not preferences

Cost, travel, work, housing, caring for others and digital access are written down as barriers, not as what the person wants.

Meaning, religious or not

Hope, purpose, faith, relationships and identity can be part of the conversation if the person wants. None is assumed.

• Emergency or field health worker: Urgent care and what can continue.
• Nurse: Medicines, wounds and ongoing care.
• Support worker: Practical comfort and support after shock or loss.
• Disability or community liaison: Access, equipment and community links, where available.
• Chaplain or spiritual-care provider: Meaning, distress, hope and relationships, for people of any faith or none.
• Interpreter or communication specialist: Language and communication support so the person's own words come through.
• People the person chooses: Family, friends, or a community or faith contact, only if the person wants them. Never assumed safe, available or wanted.

Roles, titles and training differ by country and service. Not every role exists everywhere.

A small set of places chosen for contrast, not a ranking or a representative survey: Global, Sierra Leone, Japan, Australia, India, Jordan, United States, Norway, Colombia, El Salvador. Each example states what its source establishes and what it does not. Policy on paper is not proof that a service is available.

• Global · Guidance · 2018

  WHO's 2018 guide on palliative care in humanitarian emergencies says humanitarian principles preclude excluding from care people who cannot be restored to health, and that patients should never be abandoned, even if they are dying.

  What others could learn: The guide says palliative care must be provided for all patients triaged as expectant. After a death, it describes discussing preferences with family members, such as viewing the body, marking the grave and involving community members and faith leaders.

  Conditions, limits and source

  Conditions that matter:

  Depends on emergency medical teams and local clinicians trained to provide palliative care, an essential package of palliative care medicines and equipment, and social supports such as food, housing, transport and locally adequate funeral costs for families in extreme poverty.

  Cannot be inferred:

  Does not show that any response follows this guidance or what patients and families experienced. Does not set rules for allocating scarce treatment. Does not show that the burial and mourning wishes it lists can be met in a given emergency; it says they may be difficult or impossible to fulfil.

  Limits:

  Guidance, not an evaluation of any response. It sets principles and an essential package; it does not report how often humanitarian responses include palliative care. The PDF cover reads 'into the response to' while IRIS metadata reads 'into responses to'. IRIS item metadata shows no withdrawal or retraction flag.

  Source: World Health Organization, Integrating palliative care and symptom relief into responses to humanitarian emergencies and crises: a WHO guide (Chapter 1 'What is humanitarianism?', printed p. 6 (PDF p. 14); expectant patients in Chapter 2, printed p. 16 (PDF p. 24); family preferences after a death under 'Social supports' in Chapter 5, printed p. 38 (PDF p. 46)). Where: Global. Population: People affected by humanitarian emergencies and crises, including people who are dying, patients triaged as expectant, and their families. Published 2018-09-19; retrieved 2026-10-12.

• Global · Guidance · 2011

  WHO's 2011 psychological first aid guide for field workers, written with War Trauma Foundation and World Vision International, advises helpers to keep families together and help people contact friends and relatives for support.

  What others could learn: The guide lists understandable and correct information about the event, loved ones and services, being able to contact loved ones, and being consulted in important decisions among frequent needs. It notes people who cannot move on their own, or who have problems seeing or hearing, may have difficulty finding loved ones.

  Conditions, limits and source

  Conditions that matter:

  Written for staff and volunteers; the guide says psychological first aid is not something only professionals can do and is not professional counselling. Helpers need current information about services and are asked to take into account the person's culture, age, gender, customs and religion.

  Cannot be inferred:

  Does not show that psychological first aid reduces distress or later mental health problems. Does not describe tracing or reunification systems for separated children or adults. Does not say how agencies coordinate information about missing people.

  Limits:

  Guidance for helpers, not an evaluation of field practice or outcomes. Published 2011; IRIS lists translations and related items (a 2013 facilitator's manual, Ebola-specific versions) separately, and these were not reviewed. IRIS item metadata records no licence and no withdrawal or retraction flag.

  Source: World Health Organization; War Trauma Foundation; World Vision International, Psychological first aid: guide for field workers (Chapter 3, '4. Connect with loved ones and social support', printed p. 28 (PDF p. 35); frequent needs box, printed p. 24 (PDF p. 31); people with health conditions or disabilities in Section 3.5, printed p. 35 (PDF p. 42)). Where: Global. Population: People recently exposed to a serious crisis event, including children separated from caregivers, older people and people with health conditions or disabilities. Published 2011; retrieved 2026-10-12.

• Sierra Leone · Service in operation · 2021

  Sierra Leone's Ebola database Family Reunification Program, run with CDC and Concern Worldwide, found a probable burial location for 65% of requests from families seeking the graves of people who died during the 2014-2016 epidemic.

  What others could learn: Burial records kept during an outbreak later helped families find graves. Callers were told at the start how their information would be used, and responses included condolences and a statement that findings might be inaccurate or incomplete.

  Conditions, limits and source

  Conditions that matter:

  Relied on burial logbooks and grave markers, a consolidated national database, trained family liaisons, toll-free numbers, radio messages in Krio, Mende and Themne, and data-confidentiality procedures. Team members who had also lost friends and family needed psychosocial support, which a shortage of mental health specialists made hard to provide.

  Cannot be inferred:

  Does not show how many bereaved families never contacted the program. Does not confirm that the burial locations given were correct. Does not describe how burials were carried out during the epidemic beyond record-keeping.

  Limits:

  Program description written by the teams that ran it; no independent evaluation. Caller satisfaction (85% of comments on 263 responses) comes from comments, not a structured survey. Burial location was missing in 43% of burial records. The abstract says the program continued as of February 2021; the manuscript text says June 2020.

  Source: Annals of Epidemiology (Bensyl D, Bangura B, Cundy S, et al.), Finding the graves: SLED Family Reunification Program (Results section of the PMC author manuscript (PMC10860640); confidentiality and call procedures in Methods). Where: Sierra Leone (Ministry of Health and Sanitation program). Population: Families and friends of people who died during the 2014-2016 Ebola epidemic and did not know where they were buried (306 requests, 222 families, July 2018 to September 2020). Published 2021-05-28; retrieved 2026-10-12.

• Japan · Measured outcome · 2013

  Among 715 residents of five nursing homes in Minamisoma, Fukushima, the first evacuation after the 2011 nuclear accident was associated with higher mortality than later evacuations (hazard ratio 1.94); evacuation distance showed no meaningful influence.

  What others could learn: Moving frail older people carries its own risk. The authors say facility-specific strategies, including in-site relief and care, may influence survival, and that where evacuation is necessary it needs coordination with other nursing homes, evacuation sites and government disaster agencies.

  Conditions, limits and source

  Conditions that matter:

  All residents were evacuated irrespective of individual health or care needs, amid fear of radiation and disrupted food, gasoline and medical supplies. The authors say Japan lacked the degree of oversight of facility evacuation plans that they describe in the USA.

  Cannot be inferred:

  Does not show that sheltering in place would have been safer here or in another disaster. Does not separate the effect of moving residents from loss of staff, supplies and medical care. Does not apply to older people living at home.

  Limits:

  Five of eight nursing homes in the city: one lost residents' records in the tsunami, one had insufficient data and one declined. Individual health status could not be fully captured, so confounding by poor health was adjusted only at facility level. The authors say the first evacuation 'caused' higher mortality; this record states an association.

  Source: PLoS One (Nomura S, Gilmour S, Tsubokura M, et al.), Mortality risk amongst nursing home residents evacuated after the Fukushima nuclear accident: a retrospective cohort study. (Abstract, Results; limitations and facility context in the Introduction and Discussion of PMC3608616). Where: Japan (five nursing homes in Minamisoma city, Fukushima Prefecture). Population: Older residents admitted to five nursing homes in the five years before 11 March 2011 (715 residents). Published 2013-03-26; retrieved 2026-10-12.

• Australia · Measured outcome · 2022

  In a 2017 survey six months after river flooding in the Northern Rivers, New South Wales, respondents with disability had over twice the odds of having to evacuate compared with other respondents (OR 2.46).

  What others could learn: Respondents described warnings they did not understand; deaf people were reportedly given oral directions without sign language, and some could not hear sirens. Warnings and evacuation orders can be checked with people with disability and carers for whether they can understand and act on them.

  Conditions, limits and source

  Conditions that matter:

  The region has a higher share of people with disability and carers than the Australian average and a history of flood disaster declarations. Respondents linked risk to lower-cost housing in flood-prone areas, lack of transport and late evacuation.

  Cannot be inferred:

  Does not estimate how many people with disability in the region evacuated. Does not show which warning formats work. Does not show causes of the higher odds beyond the greater flood exposure the authors report.

  Limits:

  Purposive, self-selected sample not intended to estimate prevalence; self-reported data. Disability was identified only as being unable to work due to long-term disability or illness, and carers by eligibility for a carer's allowance, so some people with impairments were likely missed. Small numbers with disability and carers. The abstract and Results word the warning problems differently.

  Source: BMJ Open (Bailie J, Matthews V, Bailie R, Villeneuve M, Longman J), Exposure to risk and experiences of river flooding for people with disability and carers in rural Australia: a cross-sectional survey. (Results, 'Likelihood and experience of evacuation' (PMC9252212 full text); limitations in Discussion, 'Strengths and limitations'). Where: Australia (Northern Rivers region, New South Wales). Population: 2252 residents aged over 16, including 164 people with disability and 91 carers. Published 2022-08-02; retrieved 2026-10-12.

• India · Reported experience · 2025

  Authors of a 2022 interview study in Majuli, Assam, report that people with disabilities cannot be evacuated from floods by rope, and are carried on the backs of family or community members when boats are short.

  What others could learn: Where formal evacuation procedures are absent, family and neighbors carry much of the load. The authors report evacuation priority for people with disabilities, older people and expecting mothers, and that some families stay home because shelter on the embankment road lacks disability-friendly infrastructure.

  Conditions, limits and source

  Conditions that matter:

  National guidelines on disability-inclusive disaster risk reduction exist, but state and district plans mention people with disabilities in only a few sections, per the authors. Flood management committees initiated by a local NGO, and village heads, organize evacuation and relief.

  Cannot be inferred:

  Does not measure evacuation outcomes or injuries. Does not represent the north of Majuli or other districts of Assam. Does not show how often boats are short.

  Limits:

  Ten interviews with people with disabilities or their families, from villages in the south of Majuli near the embankment; family members were present in several. Snowball sampling, fieldwork time limited by COVID-19, and some interviews through a translator. Abstract read with full text; no conflict found.

  Source: Disasters (Doll V, Vij S, Warner J), How inclusive is disaster risk reduction? Perceptions and predicaments of persons with disabilities during disaster in Assam, India. (Results, 'Role of the early warning system and evacuation' (PMC12228016 full text)). Where: India (Majuli island and Guwahati, Assam). Population: People with disabilities and their families (10 interviews), plus disaster officials, NGO staff and disabled people's organizations (14 interviews). Published 2025-07-05; retrieved 2026-10-12.

• Jordan · Reported experience · 2023

  In 2018-2019 interviews in Amman with 50 patients with advanced cancer and 20 family caregivers, including 29 refugees, participants valued truth-telling and full disclosure, and voiced concern that information was not shared in case patients disengaged from treatment.

  What others could learn: Refugee participants hoped to receive treatment in Jordan and eventually return home, and some named help with medicine and living costs as a priority. A conversation about what a person wants to know can sit alongside these practical needs.

  Conditions, limits and source

  Conditions that matter:

  Palliative care was not routinely available across Jordan, per the authors. Refugees described cost barriers and social networks fractured by being away from their home country.

  Cannot be inferred:

  Does not show how often clinicians withhold information. Does not represent refugees outside Amman or in camps. Does not establish what any individual patient wants to know.

  Limits:

  Two sites in one city. Few refugee caregivers (7 of 20), and breast cancer and Syrian participants were overrepresented, per the authors. Views were not uniform: one refugee caregiver quoted in the Results opposed telling the patient a terminal prognosis.

  Source: Frontiers in Oncology (Guo P, Alajarmeh S, Alarjeh G, et al.), Providing person-centered palliative care in conflict-affected populations in the Middle East: What matters to patients with advanced cancer and families including refugees? (Abstract, Findings (theme 1, 'Information, communication, and decision-making'); refugee priorities and limitations in PMC10083486). Where: Jordan (two sites in Amman). Population: Adults with advanced cancer and family caregivers, Jordanian and refugee (22 refugee patients, 7 refugee caregivers). Published 2023-03-27; retrieved 2026-10-12.

• United States · Measured outcome · 2024

  In a 2020 trial, California residents shown a 6-minute explainer video on a University of California scarce resource allocation policy answered 5.6 more of 20 knowledge items correctly than controls and reported more trust.

  What others could learn: A short plain-language explanation of how scarce-resource rules would work, scripted at a sixth grade reading level and subtitled in six languages, did not raise reported anxiety in this trial.

  Conditions, limits and source

  Conditions that matter:

  Requires a published allocation policy to explain, production and translation of the video, and a way to reach people online before a crisis.

  Cannot be inferred:

  Does not show how patients or families respond when an allocation decision affects them. Does not evaluate the allocation policy itself. Does not show effects outside an online survey or beyond the follow-up period.

  Limits:

  Snowball sample, about 75% women and more educated than California's population. Outcomes self-reported about 10 weeks after baseline. Two authors reported a copyright or licence for an educational video on scarce resource allocation policy. The policy is specific to the University of California system; such policies vary across jurisdictions.

  Source: JAMA Health Forum (Buhr RG, Romero R, Wisk LE), Promotion of Knowledge and Trust Surrounding Scarce Resource Allocation Policies: A Randomized Clinical Trial. (Abstract, Results; video design in Methods and limitations in Discussion of PMC11489882). Where: United States (California residents; non-California participants allocated to control). Population: Adults in a web-based COVID-19 survey cohort; 770 randomized participants with baseline and follow-up responses, 73.5% female. Published 2024-10-04; retrieved 2026-10-12.

• Norway · Reported experience · 2018

  Parents and siblings bereaved by the 2011 Utøya attack, interviewed in 2013 about visiting the island, named seeing the actual place of death, seeking factual information and learning to know the island as important.

  What others could learn: Families described the police account on the island, of where their relative was found, as painful but helpful. Written information and photographs were used beforehand to prepare families, and personal effects were returned with care.

  Conditions, limits and source

  Conditions that matter:

  A national expert group recommended the visits. Police, Red Cross volunteers and health teams took part, and families could visit before others, particularly the media.

  Cannot be inferred:

  Does not show that visits reduce prolonged grief or other outcomes. Does not show whether findings hold after deaths from suicide, accidents or homicide, per the authors. Does not show how families who were not interviewed experienced visits.

  Limits:

  One event in one country. The authors do not know how representative those who consented were, and parents were fairly well educated. Visits were also linked to distressing reactions such as intrusive thoughts.

  Source: European Journal of Psychotraumatology (Kristensen P, Dyregrov K, Dyregrov A), Can visiting the site of death be beneficial for bereaved families after terror? A qualitative study of parents' and siblings' experiences of visiting Utøya Island after the 2011 Norway terror attack. (Abstract, Results; visit arrangements in the Introduction and limitations in the Discussion of PMC7803072). Where: Norway (bereaved families from all parts of Norway; Utøya Island). Population: 22 parents and 16 siblings of young people killed in the 2011 Utøya terror attack. Published 2018-04-25; retrieved 2026-10-12.

• Colombia · Reported experience · 2026

  In a study of Colombian communities hit by flash floods in Salgar (2015) and Mocoa (2017), the authors report churches and schools served as spaces for emotional support; one participant said several churches joined to provide psychological assistance.

  What others could learn: Participants described neighbors warning each other by knocking on doors and by WhatsApp; the authors call this the most effective warning strategy during the Salgar and Mocoa floods. Families, neighbors, churches and schools carried emotional support in recovery.

  Conditions, limits and source

  Conditions that matter:

  Early warning systems were installed, but residents reported alarms that did not sound or were not heard. The authors describe limited municipal staff and resources, and slow housing reconstruction in Mocoa.

  Cannot be inferred:

  Does not show the reach or content of church-provided psychological assistance. Does not measure mental health outcomes. Does not establish that faith organizations offered support in every community studied.

  Limits:

  Data were collected 2021 to 2023, years after the floods, so accounts rely on memory, per the authors. The churches finding rests on one sentence and one quoted participant. Quotes appear in English; the interview language is not stated in the text read.

  Source: Frontiers in Public Health (Monsalve LFD, Londoño PAV, Casilimas CAS, Posada-Pérez N, Rojas-Betancur MA, Torres GEL), Social capital and community resilience in disaster contexts: a multiple case study from Colombia. (Results, 'Social capital in disaster recovery', subsection 'Recovery of physical and mental health' (PMC13246728 full text)). Where: Colombia (Salgar and La Primavera, Antioquia; Mocoa, Putumayo). Population: Social leaders, community members and external actors in three communities (96 semi-structured interviews, 10 focus groups). Published 2026-05-26; retrieved 2026-10-12.

• El Salvador · Reported experience · 2019

  Adult relatives of children who disappeared during El Salvador's 1980-1992 civil war, interviewed in 2005-2006, described what the authors call unresolvable loss during separation, and immediate relief at reunion often followed by ambiguous reunification.

  What others could learn: Relatives described peace of mind on learning a child was alive. Separations that were a parent's "forced choice" under wartime coercion were especially painful. Support from adoptive families eased reunification; the authors call for psychosocial support throughout separation and reunification.

  Conditions, limits and source

  Conditions that matter:

  Asociación Pro-Búsqueda was founded in 1994 by mothers of disappeared children. Most children were separated in infancy or early childhood; families had been apart 15 years or more, and reunions took place on average about ten years before the interviews.

  Cannot be inferred:

  Does not show how well tracing programs work or how to run them after a sudden-onset disaster. Does not report the children's own views, which appear in a separate study, or families not linked to the organization.

  Limits:

  Small purposive sample of families in regular contact with one organization and living in El Salvador; only three adoptive fathers. Events were recalled many years later. Interviews were transcribed in Spanish; quotations in the article are in English.

  Source: Human Rights Quarterly (Barnert E, Lopez N, Bourgois P, Ryan G, Chung PJ, Stover E), My Child's Journey Home: Perspectives of Adult Family Members on the Separation and Reunification of the "Disappeared" Children of El Salvador. (Abstract (Hum Rights Q 2019;41(1):91-114); Methods, Findings and Limitations in PMC6641541 author manuscript). Where: El Salvador (San Salvador and rural areas; families in contact with Asociación Pro-Búsqueda). Population: 20 adult relatives: 14 biological relatives of reunited youth (7 mothers, 1 father, 2 grandparents, 3 aunts or uncles, 1 older sibling), 3 adoptive fathers and 3 relatives still searching. Published 2019-02; retrieved 2026-10-12.

• The sourced examples include guidance, service in operation, measured outcome, reported experience. Each quote was matched to the source text; that is not independent expert review.
• The prompts and fictional case are original. They have not been tested with patients, caregivers or clinicians.
• Whether this workflow helps anyone is an open research question.
• Content is in English. Interface translations are not reviewed for this topic.