In countries around the world, health care workers are responding to the COVID-19 pandemic. Doctors Without Borders/Médecins Sans Frontières (MSF) nurses and midwives are at the forefront, active at every level of our operations from patient consultations to infection prevention and control to health promotion to coordinating medical projects. They're also working to maintain our ongoing projects and keep caring for patients in need amid unprecedented challenges. Here, MSF nurses and midwives reflect on their experiences.
Inna Onyschenko, nurse
I live in the village of Stariy Krym, on the outskirts of Mariupol city, Donetsk region. Currently, I’m joining the response to COVID-19 in Mariinka Rayon, close to the front line in eastern Ukraine. Ukraine is the only European country facing an armed conflict. This situation has gone on six years already. We have two mobile teams to support the Ministry of Health in providing screening and home-based care for people with mild symptoms of COVID-19. We also collect samples and deliver to laboratories designated by health authorities to test for the virus.
Previously, I worked in another MSF project, also with mobile clinics. From 2015 to 2019, we covered 28 locations where people were trapped by the armed conflict. We treated diabetes, hypertension, and other chronic diseases. We also provided mental health support. In total, we followed up more than 7,000 patients—90 percent of whom were over the age of 50.
Our patients everywhere welcomed us not just as medical teams. We were, for them, members of their family. We knew who had a grandson going to school, or if something happened in their family. We became very close. They came to us and shared their problems and experiences. They happily discussed many issues with us too. Even now, walking around the city, we meet our former patients and they not only greet us but try to hug and kiss us.
When MSF called me to work on the COVID-19 response, my whole family supported me. Now I’m in another city, so I constantly call up my family. I see people very alarmed. Imagine what it is like now for those who also live along the front line. They need our support more than ever.
Ivorry Gomez, nurse
Since I was a child, my father had destined me to be a nurse. In fact, he wanted me and my younger sisters to all become nurses. Nurses were well-respected, admired, and had job security. However, I was born in Bluefields, Nicaragua, in 1982, and this was a major obstacle in me fulfilling this call.
Nicaragua was at war and there was (and still is) great poverty, with little access to education. I was four years old when my mother and I flew from Managua to Mexico City to cross into the United States. My father could not come with us, as he had to leave to find work. We had to have enough money for the flight and the “fees” for those who made a business out of helping others like us.
Once in Mexico City, our handlers helped us cross the river into Brownsville, Texas. We were caught by immigration as we tried to board our flight to Houston and put in a detention center. My mother remembers that the detention center was filled with other mothers and their children, and how she and I shared a cot together. We applied for and were granted asylum after four days in custody and allowed to unite with my grandparents in Port Arthur, Texas.
My childhood was much like any other immigrant child’s: My education was the single most important thing to me, and a contribution to my family. I knew my trajectory was nursing. I graduated cum laude and had a full scholarship to Lamar University’s nursing school and graduated in 2005 with my bachelor’s of science in nursing.
However, in 2008 my trajectory shifted and I found myself wanting to help others who were refugees, displaced, and in poverty. I was accepted into Baylor University’s Louise Herrington School of Nursing and received my master’s of science in nursing as a family nurse practitioner in 2010. I went on to get my doctor of nursing practice in 2013 because I felt I had to continue to advance my degree in order to better advocate for vulnerable people.
In my quest to be equipped to serve displaced people I earned my master’s of public health from Harvard’s T.H. Chan School of Public Health with an emphasis on global health and population studies. While studying humanitarian crises and global refugee care, I noticed that MSF was always at the forefront of critical responses. So, after graduation, I applied and was accepted for my first assignment in Ethiopia.
Cecibel Juarez, nurse
At the beginning of the pandemic, I supported an MSF mobile clinic in vulnerable communities affected by violence in Soyapango and San Salvador. The health centers have suspended outpatient consultations and only tend to people with suspected symptoms of COVID-19 and emergencies. Therefore, my job was to care for people who have been excluded from their services.
I have always liked nursing. It is a career of service, very human, that not only focuses on physical health but also on mental health—to comfort, to be empathetic with the patients.
I like teamwork because each member contributes his or her knowledge to provide the best possible care for the patients, taking into account the principles of MSF. I love my work. It's a team job—no matter what your political or religious beliefs are, your financial situation, et cetera. It's a service to the community, it's a human being with the patients. We don't have borders to care for others, and it allows us to act with impartiality with everybody.
Andrea Orozco, nurse
My name is Andrea Orozco and I am from Caracas. I work at the Hospital Vargas in Caracas as an infection control officer. Since I was a child, I always wanted to help others and that's why I decided to study nursing. It has been an exciting fight now that I can help my country, my people, and my colleagues.
The biggest challenge with the COVID-19 pandemic has been the economic and social impact that we must face. I would like to change the way we live and communicate. I live with the staff that fight every day for the wellbeing of patients and everyone. Here we are all the same, regardless of race or creed, no matter what country we live in, how old we are or what we do.
Muandze Ngui-pang Yi-menyi, nurse
My name is Muandze Ngui-pang Yi-menyi. I’m Cameroonian and I’m an MSF nurse at the Mora project. Nursing is a very noble profession—I feel like a heroine. After all, superheroes are those who save lives, so I consider myself one.
The proof is that at this time of COVID-19, the whole world is counting so much on nurses and nursing personnel in general. The pandemic requires us to wear masks while working, so giving patients confidence with a smile becomes difficult. Lately, I was smiling at a patient who was not reacting, and it made me uncomfortable. But later I realized that the patient wasn’t seeing the smile because of the mask. There is a barrier that has been created between me and the sick.
But I know that God is protecting me. Humanity so far has survived many pandemics, and sooner or later a solution to COVID-19 will be found.
Joseph Byenda Nyakahekwa, nurse
It was in my fourth year of humanities studies that I made the decision to become a nurse and not a doctor. I was sick and suffered from severe malaria. I was hospitalized in a room with other patients. Seeing the time the nurses spent taking care of us—especially their proximity to me—I made the decision that one day I would have to do the same for the others. I was struck by their dedication—that’s what motivated me to be able to do the same one day to help others.
I have been working with MSF since 2008. I was recruited during a measles and cholera epidemic in the Mweso health zone in North Kivu. We were saving lives in difficult conditions and amid armed conflict. From 2009 to 2011, we treated many sick people who were shot during the war.
In the city of Goma, where I currently live, the government has taken some measures in response to COVID-19: Social distancing, wearing a compulsory mask, movement restrictions, et cetera. The price of food on the market has gone up a notch. With this situation we are obliged to assist friends and brothers for their survival.
MSF set up new patient circuits in supported health structures and organized training and even planned collaboration protocols with the Ministry of Health before the situation got worse. What makes me happy is having a forecast of our activities, and it gives courage and hope for life. We participate in various meetings organized by the Ministry of Health and the other partners so as not to go it alone, because it is said that unity is strength.
Mulugeta Mekonne, midwife
I am from Asela, Ethiopia, and I am the MSF midwife activity manager for the Kule project in the Gambella region. I became a midwife because of my mom. When she was in labor to give birth to my youngest brother the nurse of the health center told her that she needed a referral to a hospital due to complications. She gave birth on the way to hospital and it was a male nurse who assisted the delivery and resuscitated the baby, who was fine after a few minutes.
My mom was happy with the very supportive nurse. So after I completed my high school education and wanted to join university, my test results obligated me to choose one of the following fields: Laboratory technician, pharmacist, clinical nurse, or midwife. I asked my mother for advice and she suggested midwifery.
I graduated and I am happy and proud that I am a midwife, because I am helping laboring mothers and I am the first person who sees or holds a newborn, even before the mother. Always when I go to the ward and see the smiling faces of the mothers it helps me to work with passion.The coronavirus pandemic has affected our ability to provide outreach activities in the refugee camps. Previously we would conduct awareness raising in gathering places such as schools, woman-friendly spaces, food distribution areas, et cetera, and these places were closed down or are too crowded. Even some health actors stopped their activities completely. I do this work because I am happy with my profession and because MSF is a real humanitarian organization.
Nancy Kamara, nurse
My name is Nancy Kamara. I am a nurse at the pediatric ICU in Kenema, Sierra Leone, working for MSF. I chose the profession as a nurse to help people who are suffering from any kind of disease regardless of race, position, religion, or cultural beliefs. With this reason, since we are fighting against coronavirus worldwide, I could not see myself staying at home when we nurses are needed most. With this background I will be very happy as a nurse to participate in the healing of patients and helping their hopes be restored when they return to join their families.
My name is Aissata, and I work at MSF’s Conakry HIV project as a midwife responsible for prevention of mother-to-child transmission of HIV. I am proud to be a midwife because I have two lives to save—that of the mother but also that of the child.
Coming to the aid of my sisters who are in need is a tremendous pleasure for me. With the COVID-19 pandemic we follow protective measures to protect the mother and child, but also to break the chain of transmission in order to eradicate this disease from the world.
Tindano Seydou, nurse
I am a nurse supervisor and I work with MSF in Kaya, in the region that receives the most internally displaced people in the country. I chose the profession of nurse because I want to help people recover their health. I find moral satisfaction every time after offering care to patients in order to relieve their suffering.
This COVID-19 pandemic greatly affected my life and that of my loved ones, but I continued to work to help others. The coronavirus, added to the context of my country, is very difficult. One day I received an internally displaced person who had lost all hope of living, but after medical and psychosocial care, this person wanted to believe in life again—it’s this kind of meeting that makes us happy during this difficult time.
Seyni Saley, nurse
My name is Seyni Saley and I work in the fight against COVID-19 in Niamey, the capital of Niger. I always dreamed of being a nurse to help people. Daily, I make my contribution in improving the management of coronavirus cases. Today, I’m part of the Niamey Commune One Rapid Response Team. I am particularly involved in the transfer of unstable cases. Despite the risk of contamination, my family supports me enormously. This pandemic has really changed our daily lives.
I chose to work at MSF to preserve life and care for it without prejudice. MSF’s values give me hope. With the coronavirus I was able to mobilize the knowledge I received through training to educate patients about the chain of transmission and how to prevent the spread of the virus. As we are in partnership with colleagues from the Ministry of Health, we have made a donation of soap, masks, and other supplies.
My most significant experience at MSF was during my supervisory work in the health centers of the Koutiala region during the onset of Mali's political crisis in 2012-2013. When conflict escalated, the number of mothers who brought their babies to us for care decreased because of the risks. We contacted the village chief to arrange accompaniment for the women on their journeys. The consultations returned.
What makes me happy is a patient who gets better after receiving his treatment. It’s also about helping to achieve something good and the satisfaction of seeing my children when I come home.
Douly Anal, nurse
I am a nurse from Manipur, India. I work with MSF in the Manipur Project in Moreh, India. I have been working for the past nine years in an MSF clinic in Moreh town, which is located at the India-Myanmar border. Right from the beginning of setting up this clinic in a place where there was no care for HIV or tuberculosis (TB), I have been seeing people from varied backgrounds. When you work in the same place for this long, you get to see the same patients for a very long time. So the memorable experiences are always seeing those patients at the clinic who have improved health conditions.
One among these patients was an infant who was in respiratory distress and severely malnourished. The mother had been told there was minimal chance of survival by the previous health care provider. She had heard about the new clinic in town and as one last attempt she came to our clinic. Eventually, the infant was diagnosed with HIV and TB and with paramount care given to her by the MSF team she started improving. To see her now as a beautiful and healthy girl coming to the clinic has been very rewarding.
Seeing these kids grow up to be hale and healthy young people gives me an energy boost to carry on with my tasks at the clinic.
Israa Hussein, nurse
I’ve been working with MSF as a noncommunicable diseases nurse for the past three years, taking care of home-bound elderly patients in MSF’s Ain al Helweh project in southern Lebanon. Ain al Helweh is the biggest Palestinian refugee camp in the country.
Since the pandemic began, I started working on the front lines of the COVID-19 response, starting with the newly opened isolation site in the town of Siblin, jointly run by MSF and United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA).
Starting May 20, MSF began running mobile clinics in the suburbs of Beirut, where confirmed and suspected cases among migrants and refugees spiked. I was part of the mobile team unit and visited the buildings to run medical check-ups, take testing samples, give education and awareness sessions, and provide moral and mental support to the migrant and local communities in the areas.
Working on the COVID-19 response is a remarkable experience. The most memorable event was when, on my first day working with COVID-19 patients, a young kid was scared when he saw me in full personal protective equipment (PPE). I had to explain what PPE does, and I even showed him a photo of me not wearing PPE. He smiled and gave me the okay to run my nursing assessment
Ali Abdullah Ahmed Alzuwaid, nurse
I am from Mosul, and live in Mosul. Even during the war I was in Mosul. Eighty percent of people stayed during the ISIS seizure of the city. It’s a large city—2.5 million stayed, and life was ongoing. But life then was without meaning and we were threatened with death all the time, even for smoking a cigarette or talking on the phone. I was working as a nurse then, because there were patients among the city’s original citizens.
Since 2018 I am now a nursing supervisor in MSF’s postoperative care facility, treating all chronic and acute injuries. I have a huge responsibility overseeing 29 nurses plus seven nursing assistants. I oversaw all procedures and wound care.
When the COVID-19 outbreak started, we were working with the Iraqi Directorate of Health. They requested support because tackling the outbreak exceeds their hospital capacity. We built 40 isolation rooms to prepare them to receive patients, and we transformed our post-operative care center into a
COVID-19 facility caring for patients and suspected cases.
As a supervisor before I had a lot of responsibilities, exchanging emails and schedules. I didn’t see patients that much. Now I take shifts with patients. It is important for the psychological support of patients, and also for my team, that I be engaged. There are some nurses that fear dealing with COVID-19 patients. I as a leader had to show them that I’m on the front line with them. So I enrolled myself in the patient care schedule three times a week, taking full shifts.
There are challenges, including stigma. I live with my parents, my sisters, and my family. Now I have stopped hugging or kissing my family, for fear of infecting them. I isolate myself even during meals. Now I eat alone. They ask me why, and I tell them this is to protect them. It affected me psychologically a bit, but I will get over it. Mostly.
Summer 2020: Nurses and midwives on the frontlines
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