Fieldset
Innovation: A day in the life of a humanitarian nursing team – Arriving in Bangladesh

Josie is an experienced MSF nurse embarking on an innovative new project that aims to understand the vital role of nurses in humanitarian emergencies, using data to ultimately save lives. In this third part of her blog, she arrives in Bangladesh to test a newly developed app.

The drive from Cox’s Bazar to the hospital at Kutupalong is stunning. You drive mainly along the beach and then through rice paddies.

Stepping out of the car and being hit by the heat is a little less fun, but I’m finally at the hospital to start the study. 

We’re aiming to use a smartphone app to capture the work of nurses in the hospital here as part of a research project that will help humanitarian organisations like MSF make decisions about safe nursing levels. 

Worldwide, nurses deliver 80-90% of medical care, so this research has the potential to make a really positive impact.  

Local knowledge 

The first person I meet at the hospital is Lucky, the project nurse. She greets me with a big hug, saying she is so happy I am finally here. Lucky has worked in the hospital for nine years and I can already tell she is the fountain of all knowledge.  

We get straight to it. I introduce the study to her and give her one of the smartphones with the app I’ve designed to record her daily tasks on. She instantly starts playing and sharing her thoughts. 

The nurses are very enthusiastic and engaged, asking lots of questions. Some speed ahead, just swiping away on the phones. Others are a little more cautious, but they are all excited.

I am then given a tour of the hospital and see the wards for children under five-years-old and for children aged 5-15 years. I also meet the nurses working here who will hopefully be as excited about the study as Lucky and I am.

After the tour, Lucky and I go for tea. This is in a little wooden hut just outside the hospital and all the staff go here. There are fresh samosas, potato balls and tea made with condensed milk and sugar.

We discuss the study and Lucky tells me her plan to tell the nurses about the study and how to keep them motivated. The time seems to fly by!

Meeting the team 

The first training session for the nurses on how to use the app occurs the following day!

The nurses are very enthusiastic and engaged, asking lots of questions. Some speed ahead, just swiping away on the phones. Others are a little more cautious, but they are all excited. So much so that they take the phones home to continue to learn and practise.  

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A nurse treats a five-month-old for pneumonia at the MSF hospital in Kutupalong
A nurse treats a five-month-old for pneumonia at the MSF hospital in Kutupalong

One small dilemma that came up during the training was about where the nurses will keep the phones. They all wear salwar kameez, the traditional outfit that includes long trousers, a long-sleeved tunic that hangs below the knees and a scarf. But, unfortunately, no pockets.

I explain that we have a phone holder that they can clip to their trousers. However, as I go to show them how to do this, all the nurses begin to giggle and we realise that they cannot be lifting their tops up to get to their trousers.

I instantly call the logistical team to see if they can buy me small bags for the nurses to wear over their shoulders.  

Before I know it, the study officially begins!  

Nearly there… 

At first, I am slightly overwhelmed by the amount of multitasking the nurses do.

One nurse is preparing the ward round book as I see her communicate with the other nurse on shift, the cleaner, two caretakers, a doctor and a biomedical technician.  

Then, during a ward round, I watch a nurse take vital signs, give medication and take a patient’s blood sugar level.

I’m not sure how we will capture all this, but luckily Cesc, the project lead, reminds me that for now we just need to focus on the nurses logging their tasks and then we will go from there.  

Then suddenly a week has passed… The nurses are all trained, I’ve made a phone charging station on the ward and we are all ready to start the pilot.

Want to find out about the pilot? Read Josie's next post, here. Alternatively, click here to read the first post in this series. If you're interested in collaborating or learning more you can click here to get in touch with the team.

If you live in the UK, please donate to MSF UK’s winter 2018 appeal to support our work with Rohingya refugees in Bangladesh. If you live elsewhere in the world, please click here to make a donation.