Paper details

Paper authors	Molly Gilmour
In panel on	Ethical Exits and Future Trajectories: Reimagining Closure, Localisation and Humanitarian Practice
Paper presenter(s) will be presenting	In-Person / Online

Abstract

Humanitarian medical projects are designed as temporary interventions, focused on rapid response and adaptable closure based on shifting crises. However, the impact of closing such projects, especially on non-communicable disease (NCD) care in conflict-affected settings, is rarely examined from both patient and staff perspectives. This article explores
how national staff navigate the ethical challenges of medical humanitarianism and the
tension between humanitarian principles and biomedical ethics during project closure.
Through an examination of an international humanitarian paediatric thalassemia unit (2018–
2023), I examine national staff experiences of power dynamics, continuity of patient care,
and the ethical challenges of withdrawal. Based on four years of participatory ethnographyby-proxy, findings reveal how hierarchical decision-making fosters moral distress by
association among national staff. Using inductive sociological analysis, this article highlights
the ethical and emotional tolls on national staff, who mediate between affected families and
inequitable power structures. These insights underscore the need for continuity-focused, localized approaches in humanitarian NCD care, proposing recommendations to better align organisational practices with the realities faced by national staff and their thalassemia patients. This work advances discussions on localization, advocating for more equitable, context-sensitive humanitarian healthcare frameworks

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