We’re currently witnessing an almost unprecedented refugee crisis in the Middle East and Europe as hundreds of thousands of people flee their wartorn home countries.
Nurse Jess Lovel has just returned from working with Syrian refugees in Iraq at a Médecins Sans Frontières (MSF) clinic. Jess set out to improve her skills before going, as she knew she’d be working a lot with children, without a doctor on site.
I had always found the thought of paediatric nursing quite daunting, but I knew that if I was going to survive in the field as a nurse with Médecins Sans Frontières I would need to build my knowledge and skills. So before I applied to MSF, I moved to the Northern Territory to a little town in northeast Arnhem Land. Not only is this now my favourite place in Australia, but it enabled me to work with Indigenous communities, improve my paediatric skills and become more confident in acting independently when there wasn’t a doctor on site.
One of the reasons I became a nurse in the first place was so that I’d be able to work for MSF, which provides medical care to those most in need. So it was no surprise when I applied to work with them. However my first sighting of Domeez, a refugee camp in Iraq on the border of Syria, certainly was a surprise.
At the time of my arrival, Domeez was home to around 40,000 Syrians. When I think of a refugee camp, images of starving children, unsanitary water and overcrowded tents immediately come to mind. Domeez might have been like that in the beginning, but what greeted me was a bustling little city, with shops, schools, restaurants, even hairdressers. It was humbling to see how people who had lost everything strived for a life of dignity.
Jess talks about her experiences.
To meet the health needs of people living here, there was a Primary Healthcare Centre (PHC), a mental health clinic and a maternity facility. My role was as the expat nurse in the PHC, working with a team of incredibly motivated and inspiring Syrian nurses. Together we would see and triage all medical emergency and non-emergency patients.
Jess with Syrian nurse colleagues.
It was the childhood burns I found most challenging.
Burns are common in camps like these as people use kerosene lamps to boil water and keep warm in winter. In cramped conditions, kids trip over them all too easily.
Prior to coming to Domeez, I had very little experience with burns in general and paediatric burns in particular. Here, our team of nurses would do up to 100-120 dressings per day and around half of these were children. I learnt a lot, as I found myself having to train staff on how to prioritise treatment and care for burns with limited resources, as well as training our health promotion team to educate the camp population in burns first aid. Thankfully I had the trusty MSF protocols and support from the Head of the Medical Unit to help me through.
There was one little boy who was brought in screaming, with second degree burns running from his shoulder to his feet. I think the lamp had actually exploded. He hadn’t been cooled at all, so he was continuing to burn.
We didn’t have so much as a shower to cool him. So thinking on our feet, we quickly used an empty garbage container as a trough and ran saline over him for 20 minutes before dressing his wounds. He was then referred on to the hospital in Dahook, about 20-30 minutes away, wrapped from head to foot.
I never got to see that boy again, but I heard his wounds healed well, with few complications, and I have no doubt he only survived because of the swift response of our team. Even though, for language reasons, we couldn’t directly communicate with each other, we just knew what we had to do.
And this is what I found so inspiring. The Primary Healthcare Centre was staffed with all Syrian refugees, from logistics through to the nursing team and the doctors. I learnt as much from them as they did from me. They were determined to help their communities and because MSF had come to offer support, they were determined to help MSF too.
There is no doubt that the time in Iraq accelerated the development of my paediatric skills and has made me a better nurse. It has also made me a more confident manager.
But at the end of the day what I found most unexpected was my own perspective.
Prior to starting with MSF I thought I would need to abandon my Australian standards because they would be unattainable in these challenging contexts. What I found was the opposite. MSF strives to provide the highest possible standards of care and that’s what we should work towards as individuals too.
If I can give any advice, it would be to always work with high expectations. The populations we work for deserve it.
Médecins Sans Frontières Australia is currently looking for nurses with paediatric and neonatal experience to work in the field. To find out more visit www.msf.org.au/recruitment.