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Working withhumanitarian

organisations:a guide for nurses,midwives and healthcare professionals

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2

ContentsForeword 3

 Acknowledgements 2

Introduction 4

The two strands of aid work 5Where might I be working? 6

What skills will I need? 8

How can I develop my skills? 10

Who do I want to work for? 12

How can my career develop? 14

Will I be paid? 15

What are the benefits and risks? 18

Conclusion 20

Useful contacts 21

References 23

 AcknowledgementsWith thanks to the members of the jointpublication working group:Margareth Ainley,Human Resources Officer, MSF UK Lucy Billings,

Learning and Development Officer, MSF UK Graeme Chisholm,Partnership Adviser, VSOMike Hayward,Professional Nurse Adviser, RCNSue Jacob,Student Services Adviser, RCMRobin Meldrum,Publications Officer, MSF UK Androulla Ozcivi,International Membership Officer, RCN

Refugee camp on the Turkey-Iraq border, where over half amillion kurds fled Iraq during the early 1990s. © MSF

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IntroductionThis guidance provides advice for health careprofessionals who want to work as humanitarianaid volunteers in emergency situations or inongoing development work. It was jointlydeveloped by the Royal College of Nursing (RCN),

the Royal College of Midwives (RCM), VoluntaryService Overseas (VSO) and Médecins SansFrontières (MSF).

A well prepared and trained volunteer is avaluable asset in the humanitarian sector –whereas well-meaning but poorly preparedvolunteers can be a liability to both themselves

and those they are trying to help.Many health care professionals from around theworld feel compelled to offer their help byvolunteering as humanitarian workers when theysee media coverage of disasters such as the 2004Asian tsunami, believed to have killed up to275,000 people, and the 2005 earthquake inPakistan which killed over 73,000 people and

made 3.3 million homeless. As a result, medicalhumanitarian organisations, the Department of Health and organisations such as the RCN andRCM receive a great number of enquiries abouthow to get involved.

This guidance answers some of the questions youmay have about working for humanitarian aid

agencies.

4 Since ancient times, many faiths, including Christian, Islamic, Hindu, and Buddhist, have maintained strong charitable

Helping people help themselves: teaching nursing for VSOin Malawi. © VSO/Aubrey Fagon

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The two strands of aid work There are two broad strands of overseasvolunteer work: humanitarian aid which respondsto crisis situations, and longer-term developmentwork. Of course the reality is less defined; thedifferences between the strands are frequently

blurred and development and aid often gohand-in-hand.

Responding to disastersDisasters and mass casualty incidents haveoccurred since time immemorial, in every part of the world. According to the International

Federation of Red Cross and Red CrescentSocieties (IFRCRCS, 2002), on average 220natural disasters, 70 technological disasters andthree new armed conflicts happen each year.

The World Health Organization defines a disasteras: “A catastrophic situation in which the day today patterns of life are disrupted and people areplunged into helplessness and suffering and, as a

result, need protection, water, food, clothing,shelter, medical and social care, and othernecessities of life”. (WHO, 1999)

This kind of humanitarian aid tends toconcentrate on specific situations, often withrelatively short timescales, providing immediatehelp to those who need it most. With today’s

speed of international telecommunications

bringing attention and help, and withimprovements in air travel, humanitarian aidagencies can often deploy aid to remote areasrelatively quickly.

Ongoing development work 

Although major disasters, such as earthquakes,are often the high profile face of humanitarian aidwork, a large majority of overseas medical aid isless headline-grabbing.

In the world’s poorest countries almost 30,000children under five die every day frompreventable diseases – dehydration fromdiarrhoea, malaria and measles (UNICEF, 2006).

International development involves helping ortraining people so that they are then in a positionto help others. International development hasconnotations of working for the longer-term, andoften aims to help a country, region or groupimprove their working practices by sharing skillsand teaching processes.

Working with humanitarian organisations: a guide for nurses, midwives and health care professionals

5traditions. In some instances, charity is considered a religious obligation.

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Where might I be working?In the developing world, there are many regionsor countries that have political stability but lackan adequate health service – for example, wherea health service is emerging but not yet fullyfunctional; where there has been conflict or war

and structures and systems have yet to berehabilitated; low-income countries where thereis not enough government revenue to provide afunctioning health service; or areas so remoteand hard to access that local health services areunheard of. In such situations, the poorest insociety who cannot pay for health care often haveto go without.

Working for a humanitarian organisation ornon-governmental organisation (NGO) you canprovide health care on the ground almostanywhere in the developing world. You could betraining local staff so they continue to benefitfrom your experience for years to come andassisting local managers in setting up a durable

and sustainable infrastructure.Alternatively, you could be part of the responseto an emergency, again almost anywhere.A situation is commonly considered to be an‘emergency’ when the crude mortality rateexceeds 1 death per 10,000 people per day. As acomparison, in 2005 the crude mortality rate inEngland and Wales was 0.26 deaths per 10,000

people per day.

An emergency however, is more than just amathematical calculation. Most countriesmaintain a balance between the population’shealth needs and the society’s ability to meetthem. A crisis can occur anywhere where thereis a sudden disruption to this balance, broughtabout perhaps by political instability or a

natural disaster.

Recent examples include political instability andconflict in Darfur, the ongoing conflict in theDemocratic Republic of Congo, the earthquake inPakistan or the tsunami in the Indian Ocean.

61863: Red Cross Movement founded. Jean Henri Dunant, a French doctor, was horrified by the sight of thousands of dead

and dying in a series of Napoleonic battles –

Below: In 2005, thousands of families found refuge fromfighting on floating islets in the swamps of Lake Upemba,Democratic Republic of Congo. © John T

Right: Bringing aid by helicopter to the victims of the 2005

Pakistan earthquake. © Bruno Stevens/Cosmos

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Case study –earthquake with MSFMiriam Bord (26) left her job as a paediatric nurse inthe cardiac unit at London’s Great Ormond StreetHospital, flying into Muzaffarabad in Pakistan byhelicopter just days before Christmas 2005. In herown words, “Coming over by helicopter you couldsee the scale of the damage from the earthquake –quite scary”.

Driving out to remote villages in four wheel drivevehicles, Miriam was involved in setting up clinics –an essential first step as the earthquake had

wreaked havoc on many of Kashmir’s health facilities.As winter drew in, living conditions in the isolatedmountainous areas became extremely harsh. Therewere increasing cases of hypothermia, respiratoryinfections, skin infections and diarrhoeal diseases.Working in the temporary clinics, Miriam was part of MSF’s team of more than 120 staff treating peoplewho were unable to travel to Muzaffarabad.

Miriam had joined an aid project earlier in 2005 towork in the jungles of Belize and Guatemala,following taking a course in tropical medicine atLiverpool’s School of Tropical Medicine. With asharpened appetite for working abroad, sheapproached MSF and was invited to help with theKashmir relief efforts.

“It’s a huge opportunity to use my skills and qualifications to help others.” 

Working with humanitarian organisations: a guide for nurses, midwives and health care professionals

7but, watching the wounded help each other, regardless of which side they were on, he was inspiredto found the Red Cross Movement in Geneva.

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1864: Building on his success, Dunant persuaded 12 states to sign the first set of Geneva Conventions. These recognised8

What skills will I need?Different organisations have differentrequirements for different postings. Some skills,however, are generally desirable for most

organisations:

• relevant professional experience and expertise(usually a couple of years)

• teamwork, tolerance, flexibility andinterpersonal skills to live and work togetherwith people of all nationalities and cultures

• willingness and experience to train others

• ability to cope with sometimes stressful situations

• an open mind to different ways of doing thingsand to potentially rapid changes in projectcircumstances

• language skills can be an advantage for someorganisations/postings.

Depending on the role, some skills orqualifications are particularly sought-after.These vary considerably depending on the roleand organisation; as you research differenttypes of posting, you should try to gatherinformation on what sort of further qualificationsmight be useful.

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that soldiers have a basic human right to life and that neutral medical aid should be allowed, unhindered, in conflict areas.

Often particularly relevant are qualifications in:

• tropical health

• midwifery

• paediatric care

• health visiting

• immunisation

• public health

• teaching.

Due to the nature and immediacy of the work,opportunities for newly registered professionalsare rare. If you are an inexperienced health care

professional who wants to gain some experience,then you may be able to find short-term posts asan unpaid volunteer, funding your own travel.This is often through contact with local UKcharities and religious organisations.

Depending on your individual circumstances,experience and the needs of the organisation,there are a wide range of options ranging from

short-term contracts to longer-term placements.Short-term placements are more suitable forthose with previous overseas humanitarianexperience. Longer-term contracts can last up totwo years or more.

Working with humanitarian organisations: a guide for nurses, midwives and health care professionals

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Left: Children under five are particularly vulnerable tomalnutrition, but can recover quickly, as at this MSFfeeding centre in Chad. © Gael Turine

Case study – midwiferyteacher with VSOLinda Brownlie spent almost 30 years working asa midwife and lecturer in Fife before she decidedto take the plunge and volunteer with VSO inMalawi as a midwifery tutor.

“In Scotland I was employed purely as a midwifeteacher,” Linda says. “Here in Malawi, my role is

 far broader and I teach anything and everything,including paediatrics, working as a clinicalteacher across the hospital. There are fewer medical staff than I had expected. Most of the

hospitals are really kept going by clinical officersand medical assistants, neither of whom are fully qualified doctors. In total, the number of fully qualified doctors in hospitals or health centres inthis area is about six.

“By helping to train student nurse techniciansand midwives, I and my colleagues are workingto try and relieve this situation in the long-term.Volunteering with VSO has been hugely rewarding. It’s made me more adaptable and ableto manage with less. I’ve also gained new skillsthat I will be able to take back to my work inScotland.

“I think it’s definitely made me a more tolerant 

 person and it’s certainly widened my horizons.” 

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1939-1945: World War II. Among many significant humanitarian developments during the war, Oxfam’s founding is one of the most important.

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How can I develop my skills?There are certain specialist courses andeducational programmes which help equip healthcare professionals for humanitarian work in thefield. These range from one day courses throughto masters level degree programmes. Most NGOs

provide in-house training and pre-deploymentpreparation.

RedR-IHE provides training to individuals who areinterested in developing a career in humanitarianpractice, from one day taster courses toresidential courses on a range of humanitarianissues. RedR-IHE also provides a recruitment

service for international humanitarian agenciesseeking particular expertise in humanitarian

practice. A regular jobs supplement is sent tomembers of RedR-IHE setting out details of current vacancies (also available on theirwebsite). RedR-IHE is part of a widerinternational federation of other RedRorganisations in India, Australia, South Africa,Canada, New Zealand, Eastern Africa and

Malaysia.

Working abroad has many challenges for nurses,midwives and other health care professionals. TheRoyal College of Nursing and the Royal College of Midwives both have International Departmentswhich can advise members on aspects of international work. The RCN has a usefulinformation leaflet entitled The RCN’s internationalwork for nursing and nurses (RCN, 2004).

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Initially, Oxfam raised funds to send food through the Allied blockade to starving civilians in Nazi-occupied Greece.Oxfam has become one of the largest organisations combining development and humanitarian work.

Contact the organisations for more details.

London School of Hygiene and Tropical

MedicineKeppel StreetLondon WC1E 7HT

Tel: 020 7636 8636Fax: 020 7436 5389

Email: [email protected]/

Hospital for Tropical DiseasesMortimer MarketCapper StreetOff Tottenham Court RoadLondon WC1E 6AU

Tel: 0845 1555 000Fax: 020 7388 7645

www.uclh.org

Liverpool School of Tropical MedicinePembroke PlaceLiverpool L3 5QA

Tel: 0151 705 3100Fax: 0151 705 3370

www.liv.ac.uk/lstm

RedR-IHE1 Great George StreetLondon SW1P 3AA

Tel: 020 7233 3166Fax: 020 7222 0564

Email: [email protected]

UCL Institute of Child Health30 Guilford StreetLondon WC1N 1EH

Tel: 020 7242 9789Fax: 020 7831 0488

www.ich.ucl.ac.uk

University of Glamorgan

(MSc Disaster Healthcare)GlyntaffPontypriddSouth WalesUK

Tel: 01443 483133

www.glam.ac.uk/

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Left: Teaching hygiene can be fun. Community healthworkers working for MSF in Assam, India, where 150,000people have fled their homes because of continuing  violence. © Henk Braam

Courses relating to aid work 

Finding care and respite fromthe chaos after the fall of the

Taliban in Afghanistan© Mike Hayward

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Who do I want to work for?The humanitarian and development sector ismade up of many different NGOs operating fromcountries all around the world. They vary in size;some have affiliation to a religion or politicalmovement, and some are secular and

independent.

Many NGOs specialise in certain types of humanitarian work such as emergency medicalrelief, caring for victims of war/conflict, on-goingmedical support and public health, diseaseeradication, famine and nutritional support, re-construction/infrastructure support, education

and vocational training. The important thing is tochoose one that you think is right for you.

MSF and VSO are examples of two different typesof NGO, with different approaches to providingmedical aid: one in response to crisis, oneproviding longer-term development. There areprojects and placements from organisationsworldwide which will suit anyone who feels he or

she has skills to offer and a desire to experiencelife overseas.

Whichever approach you choose, it is importantto understand the differences between thevarious humanitarian NGOs and the role theyeach play. Part of reaching your decision shouldinvolve carefully exploring the goals, purpose and

philosophy of each organisation. Some NGOs arefaith- or religiously-based groups and have

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Getting to know the locals at an MSF feeding centre inCherrati, Ethiopia. © Ake Ericson/World Picture News

1945: United Nations founded. The birth of large-scale international development, in response to the massivereconstruction needed in the aftermath of World War II.

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certain expectations of their volunteers, such asdaily worship and belief in particular religiousdoctrines.

Working for a non-UK based NGO also needscareful consideration; there may be strongcultural and country-specific influences on theway the organisation works. An example is thesuccessful Italian medical NGO, Emergency, whichis based in Milan and welcomes suitably trained

international volunteers. Although the workinglanguage of the organisation is English, trainingis carried out in Italy and a large proportion of itsfield volunteers are Italian.

Taking adequate breaks between postings will beessential to your health and well-being, but thiscan sometimes be a financial burden, so youneed to plan carefully with the NGO before youembark on this career choice.

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Médecins Sans Frontières

MSF was founded in 1971 and is focused onbringing medical relief to victims of war, disastersand epidemics wherever the need is greatest.

This means that MSF frequently operates inregions that are considered high risk – theorganisation is often seen as being “first in –last out”.

However, MSF also has extensive operations inplaces that would not normally be consideredhigh risk; where an inadequate local healthservice or difficult and remote terrain mean that

such diseases as tuberculosis, malaria orHIV/AIDS are left untreated. Without clinics setup by organisations like MSF, these populationswould have no access to life-saving health care.MSF and other similar organisations often handover their activities to other NGOs or the localministry of health when the worst of the‘emergency’ is past.

 Voluntary Service Overseas

VSO was founded in 1958 and offers a variety of ways for people to use their skills abroad. Itsprimary focus is on development rather than

crisis relief. With 2,000 skilled professionalscurrently working in over 30 countries, VSOresponds to requests from governments andcommunity organisations throughout Asia andAfrica. VSO recruits professional and experiencedvolunteers usually for one to two years, butshorter-term placements suitable for highlyexperienced professionals are becoming

increasingly common.VSO’s emphasis is on the value of passing onexpertise to local people so that when volunteersreturn home, their skills remain. VSO’s partnersvary considerably in location and type – in themedical field there are positions that require avery hands-on approach and others whichemphasise ward-based supervision. Some jobs

require classroom teaching or involve curriculumdevelopment.

The UN, with its Universal Declaration of Human Rights, the World Bank and the Marshall Plan areall testimony to a new desire to build solid platforms for future growth in impoverished regions.

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1950: United Nations High Commission for Refugees (UNHCR) founded to safeguard the rights and well-being of refugees.It strives to ensure people can seek asylum and find safe refuge in another state.

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How can my career develop?Working with an NGO can be a one-off experienceor a career choice, depending on the organisationand your preferences. For some, one posting is allthey can commit themselves to, for family orfinancial reasons; others embark on a lifetime of 

humanitarian work, while some volunteersalternate between their regular clinical job andperiods of overseas humanitarian work.

First postings begin with team members workingin roles such as project nurse, midwife or clinicalteacher. With more experience, volunteers candevelop to more senior leadership roles such asteam leader, medical co-ordinator, head of posting or head of country. This experience canalso open opportunities of working for largeinternational organisations such as the UnitedNations, UNICEF and the World HealthOrganization as well as management in the NHSand working in the headquarters of other NGOs.

Many NGOs offer internal and external training to

help health care professionals develop theirexisting knowledge and skills.

Getting time out from UK employmentOne of the barriers to volunteering forhumanitarian work is the difficulty of being

released from employment, or findingre-employment on returning from a posting.

The Department of Health has produced theuseful document, International Humanitarian and Health Work: Toolkit to Support Good Practice(DH, 2003). This toolkit aims to raise awarenessof the issues surrounding the release of healthprofessionals from the NHS to work abroad onhumanitarian and health development initiatives.

It looks at the benefits such work could bring tothe NHS, patients and to the professionaldevelopment of individuals.

Lord Crisp’s recent report, Global HealthPartnerships, (Crisp, 2007) made some importantrecommendations:

“New partnership arrangements with voluntary

organisations should be set up to support staff wishing to volunteer abroad for a period and thenreturn to the NHS by:

• reviewing arrangements to improveopportunities and remove disincentives forhealth workers to volunteer with VSO, andtarget them on the identified needs of developing countries – for systemstrengthening, staff training, public health orservice delivery

• negotiating revised arrangements with the NHSPensions Agency – perhaps based on the pilotin Scotland – to allow individuals whovolunteer as part of these arrangements tomaintain pension continuity

Right: The risks: road conditions travelling to aidcentres can be appalling, as in Afghanistan in 2004.© Mike Hayward

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It now covers internally displaced persons who would otherwise be considered refugees, but who remain intheir country of origin.

• setting up arrangements in each country(through strategic health authorities inEngland) to ensure continued employment orre-employment for NHS staff who volunteer aspart of this scheme

• considering how to extend these sorts of arrangements to other voluntaryorganisations.”

NHS Scotland and VSO have developed agroundbreaking partnership which gives NHSstaff the opportunity to work in Africa and retainjob security, pension and employment benefitsback in Scotland (Scottish Executive, 2006).

Will I be paid?Traditionally, people involved in many aspects of humanitarian work did so in an unpaid, voluntarycapacity. Many organisations still use the term‘volunteer’ – but nowadays it can mean differentthings to different organisations and is the sourceof some disagreement.

Many organisations recognise that in order toattract high quality personnel, and to retain themfor more than one posting, then they must paythem. So some organisations now have a basicremuneration structure which usually increaseswith experience and seniority. This is particularlycommon for many non-UK NGO organisationssuch as Emergency in Italy and most large

US-based organisations.

However, there are many organisations that payonly a basic cost of living allowance or ‘per diem’rate relating to the economy of the country wherethe work is. So you must explore the variousoptions available from different organisations andensure that you are able to commit to their termsand conditions.

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1958: VSO founded. One of the first independent organisations in the international development arena. Volunteers taughtlanguages and others skills to their hosts and at the same time learned about new approaches to life and work,

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Case study – a range of postings

 Janet Raymond (45) qualified as a general nursein 1981 and as a registered midwife in 1997. Shehas spent much of her subsequent career abroad,working as an agency nurse at the North DevonDistrict hospital between overseas posts. Shetook VSO courses in teaching skills and healthcare in developing countries. Writing from theChad/Darfur border region in 2005 she said:

“I love living in the middle of nowhere: the further into the bush the happier I am! I can’t seemyself coming back to work in the UK yet or if ever! I love what I’m doing and I’m definitely not ready to stop yet.” 

 Janet’s placements have included:

 VSO Clinical Instructor in Tanzania, Africa,

1993–1995 “I was in a remote area of northwest Tanzania. Communication was by means of radio

and the sparse hospital equipment meant constantly adapting with limited resources.” 

The post involved teaching practical nursing

procedures to 90 student nurses in all areas of the 180-bed hospital, including theatres,paediatric and maternity wards, and mother andchild health clinics.

MSF Nurse/Midwife in a remote province of Cambodia, 1998–1999

Working with the Cambodian Ministry of Health toimplement a new Health Coverage Plan. “Working

with Khmer and international colleagues, my roleincluded co-ordination of health centre training,informal training of nurses and midwives in a60-bed rural hospital, and co-ordination of training for traditional birth attendants. I also

 supervised the day-to-day running of the district  pharmacy and hospital and health centre pharmacies. Another aspect of the role was

co-operating with the World Food Programme for  food support for TB and leprosy patients.” 

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epitomising the trend of skill-sharing running through international development. VSO evolved to concentrate more onexperienced professionals who want to serve abroad for up to two years.

WHO Short term Consultant on Polio EradicationProgramme, Pakistan, 2000–2001

“My main role was assisting in preparation and monitoring of campaigns for nationalimmunisation days conducted in remote areas of North Western Frontier Province.” 

MSF Consultant in border region betweenSomalia and Ethiopia, 2002–2003

 Janet was responsible for an assessment of thefeasibility of a maternal and child health (MCH)project for nomadic people. It is a volatile regionwith a complex Somali hierarchical clan structure,and Janet had to be evacuated for one five-weekperiod for security reasons.

“This isolated semi-desert region is under-developed from all points of view and livingconditions were very basic. I assessed many aspects of the existing and potential MCH 

 services, including identifying problems, potential actors and counterparts, and  suggesting an appropriate approach. I concluded that an MSF project would be feasible and this

 project was subsequently implemented.”

MSF Nurse Supervisor of a Therapeutic FeedingCentre in Ethiopia, 2003

“I worked for six weeks as supervisor of anemergency feeding programme, setting up and 

 supervising the centre with 250 – 300 children. It was also interesting to be involved alongside the

co-ordination team on the political issues that 

were possibly underlying the problem of malnutrition in this area of Ethiopia.” 

MSF Field Co-ordinator and Midwife insouth-western Ethiopia, 2003–2004

The project was based in another remote area of Ethiopia, bordering Kenya and Sudan, with a

nomadic population made up of 13 differentethnic tribes. Janet’s main responsibilitiesincluded setting up a new primary health careproject with an emphasis on training, and co-ordinating, managing, monitoring and evaluatingthe project. The role required negotiation withlocal authorities and other NGOs and facilitatinggood communications within the field team.

“One pregnant woman came in with the baby’shand waving out from between her legs, as it had been for three days. So we immediately transferred her in our car to the nearest hospital(six hours’ drive). I was very worried... however,after an emergency C-section both mother and baby were fine. Four days after the operation

 she WALKED back to her village (a two-day trek)

and later came into our clinic with her babyand her father to give us a goat to say thank you.It’s things like that that keep me doing this kind of work.” 

 Janet is currently a member of MSF’s EmergencyResponse Team, a rapid response unit thatconducts short emergency projects.

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Left: Overgrazing in the Somali region of Ethiopia hasleft only desert, and herdsmen must search for grazing since they have no other form of income. In many areas,two-thirds of the population rely on food aid for survival.

© Dieter Telemans

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1971: Médecins Sans Frontières founded. French doctors working with the Red Cross in the Nigerian civil war werefrustrated about their inability to speak out about the atrocities they were witnessing.

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What are the benefitsand risks?The benefits

Working as a humanitarian health care volunteercan be extremely rewarding. For many it is a life-

changing experience. Working for a humanitarianorganisation also gives professionals differentexperiences to those they gain working in anorganised, developed health service. Aid workdevelops autonomy and enables practitioners tomake decisions and clinical judgements inisolation. You will become extremely resourcefuland probably develop a whole new skill set.

 You will also be able to see your skills andknowledge making a direct impact on individualsand communities deprived of access to even themost basic health care provision. Some of theless tangible benefits are the personal skills andattributes that you develop whilst working indifficult, isolated and poorly resourced areas –

 see box .The risks

Although there are personal rewards andprofessional development opportunities, thereare many challenging aspects to the work of which volunteers need to be aware.

There are the obvious dangers. Considering the

amount of humanitarian aid work that is

delivered every day across the world, in manychallenging and dangerous places, seriousincidents and death for aid workers are stilluncommon. But, by the very nature of the job andthe operating locations, there are many morerisks associated with humanitarian work than arefound in most jobs. These include exposure totropical diseases, exposure to the dangers of war,risk of serious injury through travel accidents andrisk of violence, abduction, rape or even deaththrough conflict.

So we recommend that you thoroughly researchthe organisations you consider applying for tolook at their record, and do your research on the

regions you expect to work in.

Right: Dealing with the unexpected – Mike Haywardtreating a critically ill Afghan tribesman © Mike Hayward

Personal skills enhanced and developed byhumanitarian work 

Flexibility

Adaptability

Resourcefulness

Tact

Diplomacy

Patience

Conflict resolution

Cultural awareness

Personal insight

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They left the Red Cross to found MSF (‘Doctors Without Borders’), to provide independent medical carein response to crises.

Case study – project nurseMike Hayward, an experienced emergency andmedical nurse, completed a master’s degree indisaster relief nursing at the University of Glamorgan.He worked for the UK-based medical aid agency

MERLIN as a nurse in Taloqan, North East Afghanistanafter the fall of the Taliban.

“Although I had a great and very rewarding experience,I think that there were many harsh realities that I

 probably wasn’t well enough prepared for,” Mike says.

“The first thing was the incredible social isolation and distance from your family, friends and cultural peers.

 Afghanistan is a dangerous place for many Westerners and therefore we lived in a small, securewalled compound. We were subjected to a nightly armed curfew, which meant we were essentially livingin very cramped and restricted accommodation themoment we returned from the field. The generator could only be used for short periods which meant that, come nine o’clock at night, there was no light 

and no power.“Living and working in such confined and restricted circumstances meant that there were often issuesaround team dynamics. Working very long hours, six days a week and with huge amounts of travel acrosschallenging physical terrain, in temperatures of over 

 40 degrees, was another huge challenge.

“Although it was hard work both mentally and 

 physically, the experience was hugely rewarding.”

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ConclusionAs health care professionals in the UK, weare fortunate that we live in an affluent andpolitically stable country. However, there aremany societies and individuals across the worldwho do not enjoy the same luxury and have little

or no access to health care. There will always bea need for experienced professionals to sharetheir knowledge and skills with those in need,whether it’s responding to urgent disasterssuch as a catastrophic earthquake or providingexpert help in ongoing disaster relief ordevelopment projects.

However, one of the fundamental tasks facingyou if you are thinking about volunteering forhumanitarian work is to make sure you areadequately informed, prepared and trained.A poorly prepared volunteer becomes ahindrance rather than a help and is thereforecounter-productive.

This guide has set out some of the things you

will need to think about when you are looking athumanitarian aid work and how best to prepareyourself. With some planning and discussion,you should be able to match your skills andaspirations to a relevant organisation – and goon to help deliver high quality humanitarian aid.

1992: USA led the UN Operation Provide Relief to bring food aid to Somalia. When Somali militias looted the supplies,Operation Provide Relief was terminated and Operation Restore Hope started, with overwhelming military force.

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Thousands of newly arrived refugees gather in Dubie,Katanga Province, Democratic Republic of Congo. Four million people have died in Congo since 1996, many of preventable diseases, as the civil war has caused thecollapse of the health care system.© Per-Anders Pettersson/Getty Images

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The resulting fighting culminated in the 1993 battle of Mogadishu – showing the potential for problems whenmilitary and humanitarian objectives are combined.

Useful contacts Action Against Hunger1st Floor161-163 Greenwich High RoadLondon SE10 8JATel: 020 8293 6190Email: [email protected]

British Red Cross SocietyUK Office44 Moorfields, London EC2Y 9ALTel: 0870 170 7000Fax: 020 7562 2000Email: [email protected]

Christian Aid35 Lower MarshLondon SE1 7RLTel: 020 7620 4444Fax: 020 7620 0719Email: [email protected]

Progressio(Formerly Catholic Institute forInternational Relations) (CIIR)Unit 3, Canonbury Yard190a New North RoadLondon N1 7BJTel: 020 7354 0883Fax: 020 7359 0017

Email: [email protected]

Church Mission SocietyPO Box 1799, Oxford OX4 9BNTel: 0845 620 1799Fax: 01865 776 375Email: [email protected]

EmergencyVia Meravigli 12/1420123 MilanoTel: (+39) 02881881Fax: (+39) 0286316336Email: [email protected]

Concern

(Temporary address)Alpha House100 Borough High StreetLondon SE1 1LBTel: 0800 032 4000Fax: 020 7863 3082Email: [email protected]

Goal UK7 Hanson StreetLondon W1W 6TETel: 020 7631 3196Fax: 020 7631 3197Email: [email protected]

Health UnlimitedUnit 6, Park Place, 12 Lawn LaneLondon SW8 1UDTel: 020 7840 3777Fax: 020 7840 3770Email:[email protected]

International ServiceHunter House57 Goodramgate York YO1 7FXTel: 01904 647799Fax: 01904 65 23 53

Email:[email protected]

International Voluntary Service(IVS)Four offices around the UK, see:www.ivs-gb.org.uk

Medical Aid for Palestinians33a Islington Park StreetLondon N1 1QBTel: 020 7226 4114Email: [email protected]

Working with humanitarian organisations: a guide for nurses, midwives and health care professionals

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2000: Millennium Development Goals signed by 191 countries. Of the eight goals three are specifically medical: reducechild mortality; improve maternal health; and combat HIV/AIDS, malaria and other diseases.

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Médecins du Monde UK14 Heron QuaysLondon E14 4JBTel: 020 7515 7534Fax: 020 7515 7560Email:[email protected]

Médecins sans Frontières UK67-74 Saffron HillLondon EC1N 8QXTel: 020 7404 6600Fax: 020 7404 4466Email: [email protected]

Merlin

12th Floor, 207 Old StreetLondon EC1V 9NRTel: 020 7014 1600Fax: 020 7014 1601Email: [email protected]

Oxfam John Smith Drive

CowleyOxford OX4 2JYTel: 0870 333 2700Fax: 01865 472 225www.oxfam.org.uk

Raleigh InternationalThird Floor, 207 Waterloo RoadLondon SE1 8XDTel: 020 7371 8585Fax: 020 7504 8094Email: [email protected]/overseas/st_medics.html

Royal College of Nursing International Department20 Cavendish SquareLondon W1G 0RNTel: (+44) 020 7647 3597Fax: 020 7647 3413Email:[email protected]

The Salvation Army101 Queen Victoria StreetLondon EC4P 4EPTel: 020 7332 0101Fax: 020 7236 4681www.salvationarmy.org

Save the Children Fund1 St. John’s Lane, London EC1M 4AR

Tel: 020 7012 6400Fax: 020 7012 6963www.savethechildren.org.uk

Skillshare International126 New Walk, Leicester LE1 7JATel: 0116 254 1862Fax: 0116 254 2614Email: [email protected]

www.skillshare.org

Tearfund100 Church RoadTeddington TW11 8QETel: 0845 355 8355Email: [email protected]

United Nations VolunteersPostfach 260 111D-53153 BONNGermanyTel: (+49 228) 815 2000Fax: (+49 228) 815 2001Email:[email protected]

 Voluntary Service Overseas (VSO)

317 Putney Bridge RoadLondon SW15 2PNTel: (020) 8780 7200Email: [email protected]

World Vision UKOpal DriveFox Milne

Milton Keynes MK15 0ZRTel: 01908 841000Fax: 01908 841001Email: [email protected]

www.worldvision.org.uk

Right: Bathing a newborn child in Sierra Leone.© [email protected]

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The Goals show the international desire to provide aid, reflected in the proliferation of international NGOs –in 1990 there were 6,000; by 2000 there were over 26,000.

ReferencesCrisp N (2007) Global Health Partnerships. The UK contribution to Health in developing countries,London: COI

Department of Health (2003) InternationalHumanitarian and Health Work: Toolkit to Support 

Good Practice, London: DH

International Federation of Red Cross and RedCrescent Societies (IFRCRC) (2002) World DisastersReport: Focus on reducing risk, London: Eurospan

Royal College of Nursing (2004) The RCN’sinternational work for nursing and nurses,Publication code: 002 285. London: RCN

Scottish Executive (2006) Voluntary ServiceOverseas (VSO) and NHS Scotland Partnership.NHS: HDL (2006) 8

UNICEF (2006) Excluded and invisible: The State of the World’s Children 2006, New York: UNICEF

World Health Organization (1999) Development of a

disaster preparedness tool kit for nursing andmidwifery, in Report of a WHO meeting, Coleraine,UK, 20-21 August 1999. European Health 21, Target18. Geneva: WHO

 June 2007

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Review date June 2009

Published by theRoyal College of Nursing

20 Cavendish SquareLondon W1G 0RN

020 7409 3333

© 2007 Royal College of Nursing. All rights reserved. No part of thispublication may be reproduced, stored in a retrieval system, ortransmitted in any form or by any means electronic, mechanical,photocopying, recording or otherwise, without prior permission

of the Publishers. This publication may not be lent, resold, hiredout or otherwise disposed of by ways of trade in any form of bindingor cover other than that in which it is published, without the priorconsent of the Publishers.

www.rcn.org.uk 

The RCN represents nurses and nursing, promotes excellence in practice and shapeshealth policies

Publication code 003 156ISBN 978-1-904114-41-3

 A midwife examines a pregnant Sri Lankan womanat one of MSF’s mobile clinics.© Karsten Bidstrup

Front cover: Mother and child care at a Médecins SansFrontières health centre, Iridimi, Chad, where 14,000displaced people have gathered © Gael Turine