Access to healthcare in humanitarian areas is crucial, and pharmacists are well-placed to use their skills to help in emergency situations with their background in care and knowledge of medicines. 

Last week (June 14), the Pharmacists’ Defence Association (PDA) hosted its ‘Pharmacists for humanity’ event that featured speakers working in this area. 

One of them included Ramisa Ahmed, who just finished her MPharm at the University of Portsmouth. She got involved in humanitarian pharmacy through the PDA’s Medicines to Ukraine campaign while she was studying.  

Read more: ‘Vicious cycles of war’ – how pharmacy is helping humanitarian crises around the world

She said that enthusiasm and dedication for humanitarian work is essential: “There's one thing you can take from my campaign work, it's that you don't need to have experience. You just need to have a passion.” 

Since she worked on the Medicines to Ukraine campaign, Ahmed has taken on other related roles. She is an International Pharmaceutical Students’ Federation (IPSF Europe) public health coordinator, and also Friends of Médecins Sans Frontières (MSF) president. 

But there’s more to understand about humanitarian pharmacy aside from having a passion for it.

Who can you work with? 

C+D previously chatted to charity International Medical Corps about their work in humanitarian emergencies, but there are specific pharmacy organisations who work in this field. 

One of them is Pharmacists Without Borders (PSF), a similar organisation to MSF where doctors provide humanitarian medical care.  

The PSF UK branch director is PDA chair Mark Koziol, who has visited the frontline in Ukraine to help deliver medicines there. 

Read more: Beirut: a pharmacy during conflict

Co-founder of Apotheker ohne Grenzen (the German branch of PSF) Jochen Schreeck said pharmacists will be managing supplies and giving advice on the best treatments. 

He also said working with the local authorities is essential. 

“Sourcing and procuring those medicines, and making sure they can transfer over several borders, involves a huge amount of work,” said Koziol. “It involves contacting the regulatory authorities, understanding the transfer rules between one country and another.” 

Read more: ‘I feel ecstatic!’: £14k raised by fasting pharmacist for Gaza during Ramadan

He highlighted specific knowledge and working it into a timeline that can serve a country in the best possible way. 

“It involves knowing that blood products, like albumin, are only produced twice a year in a particular country. When's the next production cycle? Does that fall in line with a request that's been brought sent to you by the World Health Organisation health cluster?  

“To some extent, working out in the field involves getting in front of patients, but some of the important work is just done on your phone or a laptop in an office, talking to colleagues, building up that expertise.” 

Pull over push system 

On his visit to Ukraine, Koziol went via the Polish border where he saw just how much stuff was donated to help the war effort.  

“People were sending parcels from all over the world to Ukraine. It contained everything from corduroy trousers and baby food to sandwiches from Gregg’s. 

Read more: Pharmacist raises almost £90,000 for Gaza humanitarian aid

“When I was speaking to Polish government representatives, they were saying to us that there is an epidemic. The boxes were everywhere.” 

He said medical equipment like ventilators sent by the USA had piled up despite Ukraine not needing them during wartime.  

There were unregulated deliveries of medicines too, something which falls under the push system that Koziol says isn’t the most effective way to introduce medication access to a humanitarian zone. 

Read more: PDA launches Medicines to Gaza campaign

“Don't use the push system. The UK sent two very large lorries full of paracetamol with only two weeks in date on them. That's of no use to anybody. In fact, it causes them a problem.  

“So, we have to use the pull system, where they tell us what they need, what they're short of. We then have to procure that, and we send in exactly what's needed.” 

How to prepare 

The PDA’s charity partner that it raises funds for in its Medicines to Gaza campaign is Salam Charity. 

Its programmes coordinator Osama Zein Al-Abdeen said part of humanitarian work is about conducting “proactive, not reactive” preparation. 

“There's a blockade on Gaza. The access of aid is trickling in. What was once 500 trucks a day, we're looking at maybe 10s of trucks a day now. 

Read more: Russia-Ukraine war: UK pharmacies and wholesalers mobilise to aid civilians

"As soon as the ceasefire happens, they open the gates for all the aid to go in. And part of humanitarian work is being prepared and not looking at the obstacles you have. It’s looking at what happens once you overcome those obstacles.” 

Organisations like the PSF will offer training before going out on a humanitarian mission. But Schreeck said that individually, you can start preparing your humanitarian work before joining. 

“You can try build your language skills, your knowledge about diseases and supply chains and logistics,” he said. 

Read more: A group of influential pharmacists travel overseas for charity

But Koziol warned going to the frontline has its challenges, and he sought out counselling after returning from his visit to Ukraine delivering medicines. 

“The Ukrainians were desperate to take somebody like me into their hospitals to see what happened. I was unprepared for what I saw. You cannot unsee it. So training and preparedness is something that I would advise very strongly.” 

Dangers and localisation 

Schreeck said the work can involve being in “dangerous” and “unstable” humanitarian zones but there are safety protocols that to protect you. 

He added that the work can impact your mental health and turn to trauma, as Zein Al-Abdeen explained the stark reality of what the work can entail. 

“We do work in war zones. One of the dangers is if there's a gathering for a distribution, then we become a target. So, the distributions have to take place within 10-15 minutes and then everybody has to disperse.” 

Read more: How can pharmacists and pharmacy teams help refugees from Ukraine?

Schreeck pointed out that while there are risks, the work that the PSF and Salam Charity does not happen if people are not willing to help those in need. 

And Zein Al-Abdeen explained how putting in the effort to work with and understand different communities across humanitarian zones is a pillar to making the work as successful as possible. 

“One thing we need to understand is that the people who are going through these crises, they know best.  

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“We learn from them directly, understanding what their needs are. We have to understand their culture.  

“Localisation in the humanitarian sector is the pillar of it all, because local organisations make our lives easier. And they have the knowledge that will take us decades to acquire before we can make a real impact.”