Episode: "Country Nurse"

Full name: Registered Nurse
Nationality: USA
Profession: Registered Nurse
Birthplace: Hicksville, New York, but was raised in Vermont.
Hobbies: Bodysurfing, running, downhill skiing, horseback riding, hiking, parachuting.
How many years with MSF? 4
Missions for MSF? Nigeria, Uganda, Sri Lanka, Sierra Leone, Tajikistan, and Mexico. Going to Liberia in August 2003.

What prepared you for MSF / sparked your interest in humanitarian work?
I have pediatric intensive care experience. I’ve worked in almost every emergency room in the Los Angeles area, which prepares you for long shifts, long hours, and who knows what is coming through the door. You never know what the next case is going to be. I help triage patients, make some quick assessments—your physical assessments get really good. But in terms of your capacity for treatment, you know that the patient who you would resuscitate “like that” with the technological capacity of an American emergency room you may not be able to resuscitate in the field.

My other experience in the States is dealing with terminally children at home. I would see them come out of the unit and take care of them at home and see them going through the dying process of cancer or HIV. So being able to see that side also helped me to prepare for patients that normally you could save in an emergency room but in a situation like in Sierra Leone, you have to watch die. You’re in the bush, you have a little emergency kit, you have some drugs available, you can’t drive out that night, and what you do is light the kerosene lamp and watch and wait and make the patient comfortable and make the family comfortable. You think you can buck up or you have to buck up but you never get used to it.

Most memorable moment with MSF?
I got malaria and the national staff took such good care of me. I was in a clinic in the middle of nowhere and when you start getting the fever and chills, you really don’t know what’s going on. The national staff surrounded me with love, and cold towels, and discussions and that kind of stuff. I really can’t imagine being a five-year-old or a pregnant woman who would get that fever every month. Every month they feel like that. You can’t [survive] malaria without proper treatment. And they die. Those kids will die. But that was the first and only time I got malaria.

In retrospect, what was your overall impression of your mission in Sierra Leone? What made the mission special?
One of the things that made Sierra Leone special was bonding with my national counterpart, John, and the more homey things we did which were sharing food with people in the community, meeting with the village chief who supplied us with a chicken and a bag of rice that we cooked up that night. Being part of the neighborhood. Just knowing that I’m taken care of. I was there 13 months although my initial contract was six months. I jumped at the opportunity to stay longer. And MSF doctor Toshi Yamamoto was one of the most committed physicians I’ve ever seen. All he wanted to do was give the training back to the local people. He really loved his patients and the nurses he trained.

What do you feel was the role you were performing in Sierra Leone?
Our focus was community health care and reopening clinics. We saw a lot of obstetric emergencies, we saw a lot of pregnant women late in presenting or with difficult labors or deliveries actually happening. We saw a lot of critically ill children because of the underlying tropical diseases, like malaria, parasites, and skin diseases. The children were compromised severely when they did get sick because of anemia and nutritional deficits they had had for years. So when they got a little cold, a little respiratory thing going on, and because they were so severely anemic, the anemia is what pushed them over the edge to severe illness. If they had a little bit of reserve, a little bit of blood in them that was well oxygenated, they could have handled that respiratory problem. The malaria was horrible.

I came in just as the thought of peace was coming round the corner. There were still road blocks and checkpoints where you had an RUF guy named Alligator with a big Uzi and then the next checkpoint was a government checkpoint a mile down the road. This was on the road to get further north. We were in Mile 91 which was a safe area that everyone ran to. I never actually heard any guns go off. We didn’t see any war injuries. We saw more emotional trauma cases. Some people hadn’t had medical attention in twenty years so they were way behind the 8-ball so to speak and sometimes in really bad shape. In spite of the safety, we did see some ex-child soldiers and we did initial assessments to make sure they were physically well. But it was one of the safer environments I’ve been in. I felt very safe and very comfortable.

What are your hopes for the population you were serving in Sierra Leone?
I hope that the optimism that often comes after a peace settlement sticks and holds. And I’m hoping that some of our interventions showed they are of value, of worth, and that their own people take on the responsibility of caring for their own.