Teaching spirituality to humanitarians.

There is an increasing interest in humanitarian missions in medical institutions in high-income countries (HICs). It is now widely accepted that humanitarians should undertake a course on ethics and human rights before embarking, and debriefing after, humanitarian missions to low/middleincome countries (LMICs).1 2 However, the teaching of religion, spirituality and morality is generally not included in ethics courses. It is now recognised that religious and spiritual concerns are important for understanding health-related behaviours and sources of social support to patients, which makes it important for humanitarians to appreciate and understand these nuances in their work. Religious institutions and clergy, both in HICs and LMICs, often function as gatekeepers for individuals seeking healthcare, particularly mental health, among poor and disenfranchised populations.4 Religious practices and moral codes vary widely in different parts of the world which may affect both the humanitarian and recipient of global health. In addition to religious beliefs and moral codes, the younger generation of healthcare workers, both in HICs and LMICs, have increasingly adopted spirituality and metaphysics. Humanitarians travelling from HICs to LMICs may face questions regarding their practices of meditation, yoga, mindfulness, and spirituality which may cause conflicts within themselves or in their dealing with their counterparts and the population seeking their attention in LMICs. Humanitarians, who in the past, avoided contentious topics such as child marriage, genital mutilation, female infanticide, structural racism and white supremacy in Western medicine5 in their interaction with their counterparts in LMICs, should be prepared to debate these through the lens of compassion and spirituality, even if they are not directly connected with their work. I propose that a course on anthropology to include religious and spiritual practices, and moral codes of the population of the host country be included in the pre-departure briefing of humanitarians. A grounding in spirituality could provide a robust ethical and moral framework that may help humanitarians to negotiate the complexities of structural racism, nationalism, militarism and greed.6