Rebecca Singer

'With MSF, there is no hierarchy and everybody is an integral part of the team.'

What is your professional background and work experience?

I have a nursing doctorate and have worked as a nurse in a hospital and in a public health practice, where I did my doctoral research on torture survivors. Currently, I am the Director of Health Services for a center that provides services to torture and war-trauma survivors.

You had a career in publishing and public relations before nursing, what inspired you to start a career in nursing?

During the Balkan war, I heard a radio story on NPR about an MSF midwife and was inspired to study nursing so that I could work for MSF one day.

How did your nursing experience in the U.S. prepare you for field work?

When I worked in post-surgical care in the hospital, I had a very high workload and handled complicated cases. To be efficient and effective, I practiced good time-management, set daily priorities, sharpened my assessment skills, and learned to manage patients well. This discipline proved beneficial in the field. As much as I could in the field, I took a more proactive approach. I tried to focus on the most important things to be done that day rather than being distracted with the emergency in front of me. I tried to find ways to prevent situations getting to emergency stage, if possible.

Also, my experience working with torture and war-trauma survivors who come from some of the very humanitarian situations MSF works in provided me with a deeper understanding and sensitivity about refugee needs.

Describe the medical team dynamics in the field and at home.

In the U.S., the specialists don’t work together, so the doctor, nurse, physical therapist, and social workers act somewhat independently. With MSF, there is no hierarchy and everybody is an integral part of the team.

What were some of the most challenging aspects of your work?

It was always hard to reconcile seeing the overwhelming needs and knowing our limited resources. I had a patient with advanced breast cancer and all I could do was to give her some ibuprofen and send her home. What were her choices since she was born in the bush in Chad and not in the U.S.? When I felt helpless and frustrated about the ground reality, I had to remind myself that MSF was fulfilling such a huge need just by being there.

What were your responsibilities as a field nurse and was this your only role?

In Liberia, I developed a program for survivors of sexual violence as we saw the need for care. In that capacity, I did quite a lot of direct patient care and conducted training sessions for national staff. Of course, as a member of a large team, I also filled in for others where needed in both our inpatient and outpatient settings.

In Uganda I worked in an IDP (internally displaced person) camp supervising a small primary health care clinic that served 10,000 people. Since I was the only international staff working alongside 22 national staff, I was not only the nurse, but the medical team leader, field coordinator, logistician, and administrator. This was exciting and overwhelming at the same time because there were tasks I had no prior knowledge about, such as water and sanitation, but MSF has excellent guides and I harvested the knowledge of our national staff.

In these multiple roles, I managed the team, had global oversight on the medical activities, oversaw the pharmacy, made sure that the waste management system was in place and that we had adequate water supplies, in addition to assessing the changing political and security situations on a daily basis.

Describe your work as a sexual violence consultant for the MSF office in Barcelona.

MSF was already running programs for sexual violence survivors, but some needed to be boosted and new ones needed to be opened. Since MSF sees sexual violence in most of its projects, it was to its praise that it was prioritizing resources for providing care.

I was hired to help this operational center provide better care and support to survivors of sexual violence. I visited five field projects to assess, draft plans, train, set up programs, and conduct evaluations. In the office in Barcelona, I developed training material, shaped the advocacy message, wrote a report on the phenomenon of sexual violence in Liberia, created informational booklets for distribution in Liberia, as well as wrote scientific papers for publishing.

Besides the work in the field, what else can MSF do to help affect change?

MSF does a really meticulous job of collecting data; and with this revealing information it has published reports to speak for our voiceless patients.

What were some rewarding moments about your work with MSF?

When you’re standing in a place where there’s overwhelming need and you see one more kid survive malaria or one more person who avoided contracting HIV from sexual violence, it is in this moment when you feel this shared purpose resonate loudly and that you feel rewarded. Also, working with national staff is such a privilege. They give you a glimpse of what it’s like to be Liberian or Ugandan by sharing their personal histories and teaching you their customs and language.