Brigham emergency physician Catalina González Marqués (seated at table, foreground), who served as curriculum director for a humanitarian response training program in Jordan, listens to student presentations.

For more than 15 years, Brigham emergency physicians on faculty with the Harvard Humanitarian Initiative (HHI) have welcomed colleagues from around the world to Cambridge for an intensive, two-week course on delivering humanitarian aid amid war, displacement and disaster.

Last year, organizers excitedly began planning to host the December 2023 course abroad for the first time — in Amman, Jordan – in partnership with the World Health Organization.

However, as the war in Gaza escalated and fear of a wider regional conflict grew, concerns emerged about whether the trip to Amman still could or should occur.

“Given the location, our team had some talks about ‘Can we even do this? Do we need to cancel?’” said Brigham emergency physician Sean Kivlehan, MD, MPH, director of the Global Emergency Medicine Fellowship, who spearheaded the trip. “We quickly decided we had to move forward with the course because the training was now more important than ever.”

In late November, five Brigham colleagues boarded a plane to Jordan to teach HHI’s Humanitarian Response Intensive Course. In addition to Kivlehan, the Brigham cohort consisted of Catalina González Marqués, MD, MPH, Katie Murray, LLM, Lea Sinno, RD, MPH and Jonathan Strong, MD, MPH. They were joined by Massachusetts General Hospital nurse Catherine (Skeeter) Welder, BSN, RN, along with a team from Boston Children’s Hospital and HHI staff.

The curriculum seeks to equip future humanitarian leaders from around the world with the skills needed to prepare for and respond effectively to complex humanitarian emergencies. It culminates into a three-day, immersive simulation that replicates a complex emergency scenario. The HHI team collaborated with the WHO’s Eastern Mediterranean and African Regional Offices to bring the course to Jordan with a specific focus on training students from those regions.

Active and evolving humanitarian crises affecting this year’s registered attendees, including the Gaza war, required the team to adapt on the fly. After several students withdrew from the course after being deployed to Gaza and other emergencies, Kivlehan and his team provided local partners, including the International Organization for Migration and the Jordanian Ministry of Health, the opportunity to invite additional staff to participate. The team also reached out to the Palestinian Red Crescent Society, which sent five members to the training.

Ultimately, the HHI and WHO team trained 65 students from 52 countries, all of whom currently work in the humanitarian sector.

Adapting and Learning 

González Marqués, who served as the curriculum director, said the four humanitarian principles — humanity, impartiality, neutrality and operational independence — took on added importance during the course.

“Humanitarian organizations must be neutral and impartial,” González Marqués said. “When you work on a humanitarian assignment, no matter your feelings on a conflict, you’re there to meet a need. So, there was a need for training in the region, anticipating that it’s going to be a really difficult time there.”

From left: Jonathan Strong, Catalina González Marqués and Sean Kivlehan of the Brigham, along with Hama Othman of the Harvard Humanitarian Initiative and Michelle Niescierenko of Boston Children’s Hospital, prepare for the next day’s simulation exercise.

While the instructional curriculum was straightforward to adapt over the team’s timetable, the simulation portion of the course was more challenging. It traditionally requires over 150 volunteers to properly run.

“We needed to go to medical schools across Jordan and recruit students who would be willing to participate,” Strong said. “Not a lot of them have experience with humanitarian issues, and none of them had ever participated in anything like this before.”

While they were the instructors, the team emphasized they also became students themselves during these trainings, as there is always much to learn from health professionals in other parts of the world.

“I always learn from my colleagues,” González Marqués said. “They have more expertise in the region, so I think letting them guide how our response should be is always the most important part. I learned so much from them because you can never expect to do things in another part of the world in the same way that they are done here.”

Strong, like many of the other physicians on the trip, has completed several humanitarian assignments before, including a recent trip to Ukraine with Kivlehan. He reflected on the complex emotions that this work can bring up.

“The intervention itself — teaching and seeing students learn and grow not only as health care providers but also as humanitarians — is really important to me. I think there’s a sense of pride and a sense of hope,” he said. “However, I do think it’s, in a way, sad that we have to do these trainings and that the trainings are so important because the world seems to be in a tough place right now.”