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Humanitarian Nurse | Nursing in disaster areas around the world
Helen is a Humanitarian Nurse, Emergency Nurse and Paramedic who has volunteered in disaster areas around the world.
I grew up on Groote Eylandt, a remote island in the Gulf of Carpentaria in the Northern Territory of Australia. I completed my Nursing and Paramedic studies in Darwin, where I worked in the Emergency Department. It was during my time there that I became involved with the Royal Darwin Hospital Response to the Bali Bombings. I have also volunteered in Iraq in IDP Camps, in Nepal after the earthquake and the Philippines after the Typhoon, as well as assisted during the Syrian refugee crisis on the border of Greece
I have worked in Emergency Departments in Tertiary hospitals; in Remote Indigenous Communities; attended Disaster Responses both locally and internationally, and worked with Asylum seekers and Refugees. More recently was my volunteer trip to Kenya on the Nurses in Action Program just before the pandemic. Straight off the plane from Kenya, I returned to critical care nursing in an Intensive Care Unit in Brisbane to support at an incredibly uncertain time.
Some other things that I am involved with behind the scenes that some people might not know about are that I am the Health and Disaster Management Advisor and founding member to the Commonwealth Business Women’s Network (CBWN). I am the national focal point for Global Networks for Civil Societies on Disaster Risk and the Regional Advisory Group for Disaster Risk Reduction for the Pacific Region.
I am a trustee and health advisor for Kitrinos Healthcare. I am passionate about issues that affect women and have the opportunity to be involved in women’s empowerment as the vice president of Business Professional Women Brisbane Southside. I am a fellow of the Royal Society of the Arts (FRSA) and Member of the Australian College of Nursing (MACN). This year I also have the honour of being the Ambassador for World Youth International’s Nurses In Action program.
In my spare time, I like scuba diving and bushwalking and often pick adventurous trips. Previously I have trekked to Everest base camp, climbed Mt Kilimanjaro, and rafted the Franklin river. However, I also like to unwind with a book or spend time in my garden. I love going to plant shops and buying plants for my house… then when I go away I come back to find that I have to start all over again!
What inspires you about the nursing profession?
Being a Nurse means that I can care and help people that are in their most vulnerable state; I love being able to help people. I love to advocate for patients and give them a voice that they otherwise wouldn’t have. Being a nurse means I can look after people all over Australia and the world. I have nursed in tertiary hospitals, in remote areas, in refugee camps, in countries after natural disasters and in countries experiencing conflict.
I like to inspire young people that want to get into nursing and also inspire student nurses and show them where nursing as a career can take them. I like educating nurses and patients, I feel that through education and learning, people can be empowered. I have loved watching how the nursing profession has evolved over the last 20 years and am proud of the standards that we have achieved.
How did you go from ED nursing to helping during the Bali bombings, working in Iraq IDP camps, Nepal/Tibet, the Philippines & Greece?
I think this just evolved with time, I was working in Darwin in the ED when the Bali bombings happened and I was a part of the Royal Darwin Hospital Response. From there as a Paramedic, I was involved with local responses to cyclones and floods and then Christchurch earthquake happened and I wanted to go and assist in the response.
I had registered with an organisation and was told that all the places were filled. I completely forgot about it and then Typhoon Hyan hit the Philippines, again I wanted to go and help and the organisation I had registered with a couple of years earlier contacted me and asked if I was available to go.
I had volunteered in Greece years ago with Medecine Du Monde (Doctors of the World) in a Greek clinic and was registered with them so when the refugee crisis hit it was a simple Facebook message to the manager, dates sorted and away I went. Whilst there I met a Doctor who started up ‘Adventist Help’ who a couple of years later was setting up a hospital in Iraq.
We had stayed in contact and he did a call out for volunteers so I ended up in Iraq outside Mosul while it was still under stronghold by Isis and conflict in progress. I ended up back in Greece and involved with a medical group ‘Kitrinos healthcare’ who focus on refugee health on the Greek islands. If you let people know that you are interested and passionate about something, it will eventually happen.
What was your role during these situations, and what did you learn about yourself as a nurse and the profession?
During the Bali bombings, I was a part of the Royal Darwin Hospital response to the bombings. It was and will always be a stand out event for me. I was a very junior nurse fresh out of uni. We had an incredible team and I was privileged to be a part of the response, at the time the ambulance service had rung me as well so I had to decide was I going to be helping in the response as an ambulance officer or a nurse.
I chose to help at the hospital. I learnt a lot about myself, about teamwork under pressure, about resilience and that PTSD does exist and pretty much all of us were experiencing signs of stress and PTSD in the months afterwards.
When I volunteered in Iraq I was nursing in the IDP camp. We would stay in the compound and drive 2 plus hours to get the zone we were working in and the hospital was still being built so there were lots of discussions on the layout and build and sorting of equipment. I spent a lot of time at one of the local hospitals treating a 10-year-old girl with burns and helping to facilitate her care and transfer out of Iraq.
In Iraq, I learnt about the complexities of negotiating in dealing with the healthcare of patients in another country. You can see a short Aljazeera interview about this via https://www.youtube.com/watch?v=LmHQf0D70XY
In Nepal, I was part of a disaster response team with NRNA that left Sydney. The team consisted of Nepalese speaking medical staff and myself. I learnt how incredibly important it was to have a team from the diaspora returning and assisting in their country in a time of disaster and how valuable it was to have medical team members that could speak the language of the disaster affected country. Triage and history taking was so much easier.
I also learnt that working in unpredictable environments can be frightening, that sad stories come out of disasters but also positive inspiring stories of survival too. I learnt that no matter how remote up in the Himalayas you are that the Internet is everywhere and that an entire village will and did line up to charge their phones on my solar panel battery charger.
In Greece, I spent 6 weeks on the island of Lesbos in winter where we were receiving 5000 arrivals a day of refugees fleeing the war in Syria. Numbers were overwhelming and amongst the chaos and stretched resources, we had a boat accident with 300 people where 11 children and 27 adults drowned. I spent days afterwards helping parents identify their deceased babies in the morgue and supporting them emotionally alongside the coastguard and police. I am bilingual so I was able to assist the authorities. See a short snippet of an interview here and also here.
You started 2020 with a trip to Kenya on World Youth International’s Nurses In Action Volunteer Program. Can you tell us about this?
In celebration of Year of the Nurse, I marked the beginning of 2020 with a trip to Kenya on World Youth International‘s Nurses In Action Volunteer Program. It opened my eyes like never before. I saw that we can empower the next generation of nurses by encouraging the sharing of skills and knowledge across cultures. By caring for some of the world’s most vulnerable people in Kenya, alongside Kenyan Nurses and Midwives, I learnt more than what I could physically give, particularly due to the lack of medical supplies, equipment and facilities.
I often couldn’t escalate care due to the limitations of the available equipment, and this was heartbreaking, but also highlighted that we have a long way to go in achieving the United Nation’s ‘Sustainable Development Goal 3; ensuring healthy lives and promote well-being for all.
Check out World Youth Internationals revised Nurses In Action Program here
What was the day to day process for nurses?
Most of my time in Kenya on the Nurses In Action program was spent at the Odede Community Health Centre, where we hosted sessions for the Centre’s permanent local nursing staff and community health workers, providing education on nutrition, diabetes and maternal health. This then empowered them to educate the Odede locals and encourage them to receive the care they needed at the Centre.
According to the World Health Organisation, the largest needs-based shortages of nurses and midwives are in South East Asia and Africa. Having the opportunity to work alongside Kenyan nurses and midwives, gaining insight and sharing skills has been invaluable to me.
We also made a positive impact when we ran health camps within remote/rural villages. For example, we set up a health camp in a fishing village and treated people that would find it difficult to get to a primary health care facility. During these health camps, we tested hundreds of people for malaria and HIV and treated them. We conducted observations on everyone and assessed them as they came through the health camp, we had testing stations and a pharmacy set up, and an area for dressings to be changed.
What was the most memorable experience from the program that you will cherish forever?
Delivering a baby was exciting because I really had a good rapport with the lady in labour and I supported her for some time. When the baby arrived, a little girl, she named the baby after me. It was such a special moment and I was relieved it all went smoothly. I was amazed at the resilience of the woman and also what little equipment there was available. There are so many little stories like this that I will cherish; it’s the people that you remember, their warm nature and their big smiles. You really know you have made a difference to someone and it is so rewarding.
What was the most challenging experience during your program in Kenya?
It was very difficult seeing the incorrect treatment being administered and wanting to assist. I treated a 3-month-old baby with 60% full-thickness burns, which was very confronting. I had the opportunity to advocate for her, educate the nurses on current treatment for burns and was able to hold educational sessions to educate the doctors and nurses on burns treatment. Education is a big part of nursing, through health promotion, by teaching colleagues best practice guidelines, by teaching patients on their condition and explaining treatment. Through education, we can empower.
What were your previous experiences volunteering and how did your last experience with the Nurses In Action program compare to previous volunteering placements?
I have been on a number or volunteer missions where I have had little warning and attended disaster areas like the Nepal earthquake, Philippines post-typhoon Hyan, Iraq outside Mosul during the conflict, and the refugee crisis. These were often in unpredictable unstable environments, in tent accommodation. The refugee crisis was a slow-moving disaster that unfolded over a period of time that overwhelmed specific countries that could not cope with the influx of people and it exceeded the capabilities of existing resources and infrastructure.
The refugees were on the move and fleeing conflict, they were not living in homes; they were in refugee camps and they were traumatised. I needed to support with healthcare issues including chronic conditions but also emotional trauma.
The Nurses In Action program in Kenya was different because it is in a developing country where poverty exists across the board. Deeply seeded systemic issues in health care mean that people have a lack of access to medical facilities or they cannot afford to seek treatment. There are endemic diseases such as Malaria and HIV affecting people on a large scale, with limited funding or resources available. On a more personal level, the program was much more organized than my previous placements; I had booked it in advance, stayed in a house, there were showers with running water and the area was safe. I felt safe.
Would you recommend volunteering abroad to other Australian nurses?
Yes – volunteering feeds your soul. Giving to others, treating vulnerable people – it is so humbling but also it’s a reality check as we realise how good we really have it in Australia, and that it is by sheer chance that we are born here into this life and not in a developing country or an area experiencing conflict.
When we volunteer, we grow and develop by learning new skills and adapting to new and sometimes uncomfortable situations that are outside of our everyday lives. Making the decision to volunteer overseas (or within your own country) is a bold step; it requires you to set a goal for yourself, perhaps take a step into the unknown, and to contribute your own time (and sometimes money) for the service of others. The rewards of doing so, however, can be much more beneficial to your personal life satisfaction than you might have expected.
Every humanitarian nursing volunteer placement is an experience and is considered not just admirable from a philanthropic sense but also from a professional sense. If you are able to volunteer in a developing country it shows character, capability, resilience and motivation. These attributes stand out on a CV. Once we realise the many benefits of volunteering, we can also find it’s an activity which can quickly become addictive. Helping others at home or abroad improves our lives as much as theirs, and finding meaningful work to do while travelling the world is a true privilege.
What makes a good humanitarian nurse?
After 20 years of being a nurse and paramedic and having been on so many volunteer trips, I believe its really important to learn to be flexible and adjust to being able to deal with any situation or environment. If you are the type of person that needs order and stability then this may not be for you. I also believe having insight on yourself and your limits, and knowing when you need some time out or self-care is important.
You are always learning and you don’t know it all, accept that every workplace will be different, things might be done differently or to different standards than what you are used to. Also, be realistic to know that you can’t save everyone.
What are some common misconceptions about the humanitarian nursing sector?
A common misconception is that you need to have critical care skills or emergency knowledge. Yes, these are nice to have but more often than not it is chronic medical issues that you are dealing with so if you think you aren’t skilled enough you might be surprised that your skillset might actually be beneficial. If you have worked on a surgical ward and have good knowledge of dressings and wounds that could be something that a team might be looking for. Everyone brings something to the team, it could even be language.
How do you cope with the trauma you experience as a humanitarian nurse?
I have been dealing with trauma for 20 years as a paramedic in a pre-hospital setting and also as an emergency nurse. As a humanitarian nurse, the difference is you are away from your usual supports so you create new ones, whether that is a place you go to reflect, perhaps a café. In some instances you don’t have time to venture out so have alone time in your bed even if you are sharing with 10 others in a tent or a room, bring earphones and listen to music, podcasts etc to try and have a break. Often, I felt too tired to write anything down but I would jot dot point in an email to myself so I wouldn’t forget. Upon my return to Australia, I would see my GP if I felt I needed it, and sought counselling.
How do you manage your safety in warzones/crises zones? What supports did you have?
This is why it is important to volunteer with a reputable organisation, as a lot of the safety is run by the team leaders who deal with authorities to ensure your safety in and out of checkpoints and zones, have safety briefings on arrival and knowing which areas have been checked so you can avoid stepping where there could be land mines. It was important to always communicate with team members to let them know if you are leaving a compound and taking a chaperone with you. This is all part of educating yourself on the culture of the country you are going to before you depart.
What are the most rewarding and most challenging aspects of humanitarian nursing?
Nursing has come so far in the last 20 years; I have seen the implementation of best practice guidelines, more nurses being involved with research, and in leadership positions. We really built on what Florence Nightingale started 200 years ago. There is something special about caring for someone who is at their most vulnerable, being able to comfort them, reassure them and knowing you are doing your best to deliver the best holistic care for that patient.
I find it inspiring that nursing is not confined to a hospital setting, that you can provide nursing care in communities, in remote areas, even overseas in a remote village after an earthquake. It is really empowering as a nurse to be able to advocate for your patient, giving them a voice, and knowing you have made a difference to your patient’s life.
The biggest challenge to accept is the disparities in health care of developing countries compared to Australia. However, I was also reminded that it is the people faced with real poverty that are often the kindest and happiest. The people that I met while on Nurses In Action in Odede, Kenya was always happy and smiling and so generous with their time. I really feel like I have made some life-long friends and hope to go back there one day.
What advice do you have for Australian nurses who are thinking about moving into humanitarian nursing more broadly?
Choose the organisation that you are going to go with carefully, and ensure you have had the right training for where you are going and what type of deployment you will be going on. Make sure you have your immunisations up to date for the countries you are going to and also the medication you might need like anti-malarial tablets. Be prepared and take everything you will need to be mostly self-sufficient if the area or deployment requires it. Spontaneous volunteers in a disaster are a burden, register with an organisation. Here is a link to a blog with more information.
How do see your role during the International Year of the Nurse and the Midwife? During the pandemic?
International Year of the Nurse means a lot to me; I was there when they announced it at the World Health Assembly in Geneva. I remember feeling really proud to be a Nurse and felt we were being recognized in the community for the work that we do. Then I was invited to be an Ambassador for Nurses in Action and I was excited to partner up with them.
Throughout the year there were plans to travel throughout Australia and abroad speaking at various conferences and events sharing my experiences and insights, however, all these plans were postponed due to the pandemic and travel restrictions.
I was in Kenya watching what was happening in China and honestly did not expect it to spread this far or for it to affect the globe the way it has. The COVID-19 outbreak has had an impact on World Youth International, as their key business is facilitating unique international volunteer placements for nurses and other health professionals.
However, based on reports coming through from the government, they are confident that their programs will commence again as of March 2021 and they are accepting applications in advance. As the pandemic continues to impact the globe, many communities will not be able to recover without the help of humanitarian nurses/volunteers.
Disasters such as this affect us all, but those living in poverty are always the most vulnerable as it makes it even harder for them to break the cycle. If we can’t help these communities gain access to healthcare, who will? If you’re passionate about supporting others and want to plan future trips, particularly when some of the communities we work within will need more support than ever while the world is recovering, consider signing up in advance to the Nurses in Action Program.
My role now is to stay at home on the Gold Coast and to work where my skills are needed, doing what I love. I never imagined that the Year of the Nurse would take on such a different meaning and that we would need to unite and become stronger than ever.
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