illustration la prise en charge de l'enfant douloureux
Analysis

Management of the suffering child: a medical and operational challenge

Elba Rahmouni
Elba
Rahmouni

Since April 2018, Elba has been in charge of dissemination at CRASH. Elba holds a Master's degree in History of Classical Philosophy and a Master's degree in editorial consulting and digital knowledge management. During her studies, she worked on moral philosophy issues and was particularly interested in the practical necessity and the moral, legal and political prohibition of lying in Kant's philosophy.

Olivier
Guillard

Paediatrician at the Paris Urgent Medical Aid Service (Service d’aide médicale urgente – SAMU in French) since June 2020. Olivier Guillard also holds a Master’s in political science, development and humanitarian aid. During his professional practice, he worked in teaching positions in paediatric cardiology and cardiac resuscitation units (hôpital Necker – Enfants malades and hôpital Marie Lannelongue), at Doctors Without Borders, and as project manager at the Samusocial de Paris. He develops technical assistance projects at the Paris SAMU in partnership with the department of international relations at AP-HP (Paris public hospitals authority), the City of Paris and the Samusocial de Paris. In addition, he supports the inclusion of social sciences in research on prehospital emergency care. 

Based on the example of the hospital in Moïssala, Chad, the two authors reflect on the management of pain in children at Médecins Sans Frontières. This article was first published on March 25th 2022 in the journal Alternatives Humanitaires.

Although acute pain has a diagnostic value and can play a positive role as a warning sign to promote the body’s own survival, there is no question that it is necessary to treat and prevent it, particularly in the context of care. It is both a medical necessity, to avoid complications, and an ethical necessity, based on the principles of benevolence and primum non nocere (“First, do no harm”)Conseil national de l’Ordre national des médecins, Code de déontologie médicale, février 2021, https://www.conseil-national.medecin.fr/sites/default/files/codedeont.pdf. It is also a social necessity: injuries can lead to chronic pain which can then lead to disabilities« Loi n° 2005-102 du 11 février 2005 pour l’égalité des droits et des chances, la participation et la citoyenneté des personnes handicapées », Journal officiel de la République française, 12 février 2005, https://www.legifrance.gouv.fr/jorf/id/JORFTEXT000000809647. In France, care has been a legal obligation since it passed the Kouchner Act in 2002« Loi n° 2002-303 du 4 mars 2002 relative aux droits des malades et à la qualité du système de santé », Journal officiel de la République française, 5 mars 2002, https://www.legifrance.gouv.fr/jorf/id/JORFTEXT000000227015. The responsibility for it falls to both medical professionals and health institutions.

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To cite this content :
Elba Rahmouni, Olivier Guillard, “Management of the suffering child: a medical and operational challenge”, 27 avril 2022, URL : https://msf-crash.org/en/publications/humanitarian-actors-and-practices/management-suffering-child-medical-and-operational

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