'It's about the people': why I work for MSF

Daniela is a nurse working in Sierra Leone, a country where the health system has been badly affected by civil war and the ebola crisis. She blogs about why she works with MSF...

I am often asked why I have ‘given up’ my life my life in Germany. Why do I go without so many amenities and put myself in danger of things like war and disease? And why do I work with MSF?

My life has changed greatly in the past year. Of course I do without many things in life, and the hardest thing for me is the distance from my friends and family. But I get so much back. For one thing, of course, the work is very different from my life as a nurse at a German hospital. My work in the project is more diverse, and I have more responsibility and autonomy, which I really appreciate.

MSF has put a lot of faith in me and has supported me every minute. I have gained a lot of self-confidence from the responsibility, which has really helped me both personally and professionally. And it has opened my eyes to new perspectives and possibilities.

The most valuable thing I could wish for

Every day I get to know many interesting people through my work. They make my life richer. I have learned a lot about myself from local colleagues and from patients: how rich I actually am in many things, and how secure my life in Germany is, where I always have enough to eat and drink, and no shortage of clothes. And when I’m ill, I have always taken it for granted that I can go to the doctor or hospital.

In all of my MSF assignments I have been received with open arms. I have been working with a lot of joy and commitment. And that is the most valuable thing I could wish for: satisfaction at work and belief that my daily activities make a difference. When I have that I am happy in my personal life, which in a project is different, of course.

Daniela and the team practise wearing their protective suits, in case of another outbreak of Ebola. She reports there are currently no new cases where she is in Sierra Leone.

Here we are preparing in case we need to do an Ebola response: 45 minutes in protective suits can be very stressful at enormous heat.

Life at the project

Of course, living conditions vary from project to project. In South Sudan, I stayed with a colleague in a tent, while in Sierra Leone we have our own rooms and bathrooms. There are currently no new ebola cases, but MSF pays great attention to the best possible security management. For me, that was an important part of my decision to work with MSF.

I love my little kingdom. My bed is great, unlike the one I had in Bentiu in South Sudan. Here I have a big bed with a great mattress. My bathroom is functional, with a shower and toilet. Each of us shares a small house with a colleague, where we have a veranda where we spend our evenings with music and good company. Although our evenings never go on that late, especially in the week, since we are all tired from work.

On weekends, from Friday evening to Monday morning, I enjoy my "return" to the rest of the international team in Magburaka where our MSF base and the nearest large hospital is. In the week I'm in the small town of Mile 91, where I live in the little house with my American colleague Maura, who’s a midwife. We have each a room, where it's always too hot to really sleep well at night.

The noise from the road is exhausting, but our communal coffee at 6am helps a bit. We enjoy our breakfast on our little porch, before we leave for the health centre.

Daniela and her colleague Maura share a hug

My colleague Maura and I. (C) MSF

Up to 250 patients a day

Maura then usually goes straight to the outpatient maternity ward while I meet with my colleagues from the Sierra Leonean Ministry of Health. We visit the children in our small ward who stayed overnight or were admitted. Drugs must be given or changed, further treatment plans discussed. Once they’re stabilised we may decide to relocate the children in the hospital near Magburakam, which is two hours away.

Then we quickly check and refill the emergency cabinet before our little patients arrive with their mothers in the ambulance. We have various areas in the health centre, including one for weighing and measuring children, one for malaria tests, and an emergency zone. The busy day has already started. We see between 150 to 250 patients.

I have many tasks in Mile 91. We have no doctor who sees the patients, so together with my colleague Peter from the Ministry of Health, I am responsible for ensuring that all processes run smoothly. Our nurse Mohammed, and Michael, also a colleague from the Ministry of Health, lead the examinations and treatments with our support. So it may be that I will repeatedly called away from my work to see especially seriously ill children or rare diseases, talking the team through the treatments.

The routine is shaken

The daily ward rounds are a good opportunity for me to help with learning and development for my colleagues. I can do individual interviews and explain important medical issues. The needs of the nursing staff and the assistants are different, but we do joint training on diarrheal diseases, lung diseases, malaria and hygiene. I am proud of how much my colleagues have taken on.

In amongst all this, emergency patients arrive who need to be taken care of immediately. That shakes up our routine, but the team is now very well positioned and copes very well with the interruptions.

Maura and I are trying to spend our lunch break at home, so we can have a real break. For security reasons we are not allowed to drive ourselves, so our driver takes us home, where we regain strength with a delicious lunch on the veranda. We often discuss what we have experienced, to get it out of our heads. Maura’s caseload includes many critically ill pregnant women and difficult births. I admire her for it, she works almost without rest. Here in Sierra Leone, maternal mortality is extremely high. Her work is so important for the families here.

Daniela tests a baby and a small boy for malaria

First I tested the baby for malaria. When the next boy saw that the test is quick, he lost his fear and was also tested.

Without people you trust, this wouldn’t work

I have learned a lot from Maura about obstetrics, and it is an honour to be working together with this great woman. It's often not easy if you are working so closely together for months and also live together. But over the months we have become good colleagues, friends and confidants. And at a stressful job you need someone by your side.

Sierra Leone is a wonderful country for me. The scenery is beautiful, and it makes me think about everything Sierra Leone has had to go through. After the Civil War the health system was on the floor, much of it was destroyed and there was slow progress with the reconstruction. And then came Ebola.

Ebola killed so many people, especially health workers. This meant the health care system was broken even further. Many people were no longer able to get the help they needed.

Ebola has changed the family

I am immensely proud of my team because they try everything to help their country, in spite of the difficult situation. Although we currently have no ebola, I can still see its effects. A colleague lost her husband to the disease and is now alone with their six children. Her family is trying to help as much as possible, but she carries the bulk of the burden. For five years she has worked as a nurse involved in the health centre. Since I've been here, she has never had a day off sick. Always highly motivated and on the spot.

Now I have written a lot, but I think it is clear why I do it all: they are the people who I can be together with. They teach me every day to be grateful for what I have, and that sometimes, very quickly, things can turn out differently. 

You can read all of Daniela's posts from Sierra Leone here