The Journey of an MSF Nurse in the Central African Republic

Everybody has a personal reason for joining… I was born under the bombs of the Lebanese civil war. I remember when I was seven years old, continuously nagging my father to get out of the public underground shelter in Achrafieh to check our house. One calm day, he went out and he submitted to my requests to join him. Everything was seriously damaged, with a big hole in the ceiling. I still remember the joke I made when I first entered the living room: "Ah! Look daddy the TV is still intact!" When I think about it now, I am surprised that I was not scared. In fact, I wanted to see more, I was curious enough to want to witness the reality. I remember the day when the reporter on TV (the same TV that survived the bombs) declared the end of the war. My parents were ecstatic, and everyone celebrated this so-called “happy ending”. The reality of this war, the indifference, the dispassion is still in our hearts, minds, and souls. As a child, I saw what I was not supposed to see. I heard what I was not supposed to hear. I witnessed the anxiety of my parents when approaching checkpoints. Ever since, I knew that I needed to assist, to witness, to give something of myself to others. It shaped who I am today. That component encouraged me to join humanitarian organizations like the Lebanese Red Cross, and later on Médecins Sans Frontières (MSF).   [h3]A Change of Perspective[/h3] My story, unfortunately, continues to be the reality for millions of children living and experiencing war, hunger, inequality, discrimination, and racism all around the world. The long civil war in Lebanon resulted in tens of thousands of dead, wounded, orphaned, widowed, kidnapped, and forcibly disappeared. It was a huge defacement of our city, our country, our society. Young and old of all factions and parties became militants, attempting to defend their particular borders and communities against everyone else. The question, ‘what is the hidden opportunity within what I experienced?’, changed my perspective from a narrow, self-centered one into a much wider view. I have learned that when you ask yourself this question, ‘does someone have it worse on this planet?’, the answer will definitely not result in positive thoughts—yet I understood throughout my life that I have much to be grateful for, compared to others. [h3]To Assist, to Witness, to Work with MSF[/h3] I specialized as an operating theater nurse, completed a Masters degree in Community Development, and began my eye-opening experience with MSF in 2014. During my first project, I worked in Chatila, Beirut, a Palestinian refugee camp that also hosts Syrian refugees, domestic workers, and even low-income Lebanese families. My role there was a Primary Health Care Clinic supervisor. I wanted to use my skills and experience in a humanitarian context, and MSF brought together my passion for life medicine, cultures, and languages. More recently, I was dispatched for a short time to an MSF project in the Central African Republic (CAR). The first time I read the name Project ‘Bangassou’, I quickly searched for the location (you willprobably do the same). Where is Bangassou on the map? What are the living conditions there, and the culture? I wanted to find out more—even though MSF provided me with information about the context and the project I was being sent to—and I searched for pictures to understand more about where I was going to spend my days. Despite all the pictures and all the documents I had amassed, what I experienced first-hand in the field was still surprising and illuminating.   It is very challenging working with MSF, especially after returning from your missions, but you walk away with immense satisfaction. I felt that I made an impact. When you are in the middle of your daily tasks, your supervision, and training responsibilities, you are motivated to help and do your utmost.   [h3]Be Prepared to Work in Places that are Different in Every Aspect[/h3] If you want to work for MSF, be prepared to work in places that will be considerably different from your everyday life in nearly every aspect imaginable. You need to quickly adapt to different cultures, contexts, living conditions—if you want your job to be like an intense camping trip, you will definitely adore the experience. But it is not a hobby or simply an experience of pure fun; you have to have the right skills, experience, and most of all, the right attitude and mentality.   I learned to work quickly, treating every surgery as though it were an emergency. I learned to watch, listen, and understand the rhythm of work and the personal productivity of others, and help the team to increase the level of their preparedness when an emergency occurs. Everyone who has the same experience agrees that humanitarian work can be an extremely stressful experience, from the living conditions to the security measures within a project. The most stressful situation I can recall was when I was in front of a patient that we couldn’t help at all, because it was too late. In CAR, people often come to the hospital very late—because in some cases the distance patients have to travel to reach a medical center is very far from their homes, while, in some cases, they try traditional medicines through a traditional healer. One of the most shocking sights I witnessed was a pregnant woman who was close to term being transported on an old, broken-down bicycle on worn-out dirt roads. MSF’s projects in CAR are an attempt to support the population due to the chronic health conditions afflicting the country. The political crisis and violence that has shaken CAR since 2013 has further exacerbated the problem, along with the shortage of skilled medical personnel, particularly in the provinces like Bangassou. The war in CAR may be over, but the challenges for the population remain.   MSF supports Bangassou Regional University Hospital to assist the medical departments—heavily disrupted due to the crisis—in resuming their activities. Today, the hospital has a capacity of 118 beds and has internal medicine, maternity, pediatrics, neonatology and surgery departments. The hospital provides primary and secondary healthcare to an estimated population of 200,000 living in the region. In addition to providing support for the activities of peripheral health centers, MSF set up a referral and ambulance system between the hospital and health facilities in four sub-prefectures in the prefecture of Mbomu (Bangassou is the capital of the Mbomu prefecture). I felt fortunate in terms of living conditions, because only moments away, there were people living in terrible conditions. I learned that working well with others is crucial in reducing stress and ensuring the best possible care for people in need. There is a great sense of community and friendship among MSF teams that you need to nurture. This was crucial to keep each other going. [h3]Are You Happy Here?[/h3] While I was working and talking with people, I kept asking myself if they were happy in Bangassou. Were they satisfied with the limited living conditions? My internal response was always: ‘Of course not.’ sl Yet, one day I asked Quentin, a nurse from CAR, "Are you happy here?" He smiled, and answered politely, "Yes, I am. We are safe." I was impressed by his response. I realized I had come to associate happiness with how much money one accumulates, the products one owns, and that was probably why I was certain that the people in CAR were unhappy, in light of their limited means. Quentin’s answer was enough to help me understand that people's need for safety and security far outstrips their considerations of personal possessions. I am saw parallels with my parents. I felt that, if I had asked them the same question after the Lebanese civil war, they would have had a similar response as Quentin. All of these life experiences I had—from my childhood in Beirut to my work in Central Africa—define who I am today. I am proud to say that I did make a difference, no matter how small.