In general, there are three distinct conflict phases that education should cover:

(Adapted from Giannou & Baldan, 2019)

*Note: The establishment and organisation of a first aid post is part of the first aid education for this phase.

Planning for first aid education in a conflict context

• When possible, develop the content together with group leaders so that it is defined, understood and used in a way that reflects the local reality. Select content that responds to the needs that have been identified.
• Inform the relevant authorities and leaders of the course content and learning methods. Seek their support and approval for the programme in advance.
• Communicate that communities should select participants based on their ability to participate in the education and to act as first aid providers for emergencies.
• Guarantee absolute safety and security for facilitators and learners during the sessions (including their arrival and departure).

Context considerations

• First aid learners in conflict contexts will likely have different priorities and considerations compared to learners in other contexts. Programme designers should take these differences into consideration.
• Weapon bearers will always assess their tactical situation for threats before providing first aid as they may be required to return fire. To be accepted by this specific group of learners, educators must understand that this assessment is critical to survival and takes priority over providing first aid.
• Reducing or eliminating enemy fire is more important to the injured person’s survival than immediate care by the first aid provider. Attempts to help the injured may expose the first aid provider to enemy fire. The provider must avoid entering a situation if it places them in immediate danger.
• In active fighting, the most likely threat to a person’s life is from Severe bleeding (Giannou & Baldan, 2019). It is therefore important that individuals learn how to manage bleeding as it may buy time for others to provide additional care later.
• Essential first aid equipment in conflict contexts includes three-sided bandages, tourniquets, deep wound packing and other materials to stop Severe bleeding or to manage an Amputation.
• First aid programmes for a conflict context should include ways to find or create cover or shelter (e.g., using smoke as cover).

Facilitation tips

• Sequence educational sessions to develop an environment of trust. Start with discussions to develop knowledge and progress to role-play and scenarios as learners become more familiar with you and build trust among each other.
• Devote time to practical exercises that explore possible and probable scenarios according to the type, length and scale of the conflict. Conflict environments are ever-changing, and scenarios will help to prepare learners for a variety of situations.
• Emphasise the aim of the first aid technique, rather than technique itself. For example, emphasise the need to stop bleeding, rather than how to tie a bandage. While this is true for any first aid education, this approach will help to address the kind of stress a learner might experience in a conflict context.
• Stress the importance of learners applying all the first aid steps which are possible to reduce pain and suffering and further harm, even when it is not possible to apply all the steps in a particular context or situation.
• Use visuals such as drawings or graphics, rather than text, to develop educational materials. This is not only helpful for communication purposes but can also help to support learners with a low literacy level. It can also remove any risk of misinterpretations or using unintentionally triggering language.
• As for any first aid providers, avoid using medical, anatomical or physiological terms for teaching medical techniques (including using drugs or giving injections).
• Emphasise that first aid providers must assess their own safety first. In conflict contexts, the ill or injured person plays a bigger role in responding to an emergency. For example, if the provider cannot reach the person, they can instruct the person to apply pressure to their own wound.
• Impress how important it is for first aid providers to spread awareness, educate and mobilise the community with regards to preventing and responding to emergencies.
• Encourage learners to consider the local healthcare system and what is available to them within their situation. (There may be a lack of medical care or transport options.)
• Ensure as much as possible that the programme is consistent with first aid education and the practices implemented by the local Red Cross Red Crescent National Society.