Working in Humanitarian Healthcare – Guidance from our Experts
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Starting a career within humanitarian healthcare can be overwhelming and even the most experienced practitioners can feel intimidated when stepping into a humanitarian crisis setting. As part of our World Humanitarian Day series, we reached out to our Executive Committee and Faculty Advisory Board, asking them for advice for those interested in working in humanitarian healthcare.
Our experts have provided valuable advice on a range of topics, from how to keep a healthy perspective to practical advice on how to work effectively with local health workers. For further guidance on building a career in humanitarian healthcare, sign up for our free to access Introduction to Humanitarian Healthcare Online Course.
We also have two free webinars that may be of interest to those working or who wish to work in humanitarian healthcare:
- Approaches to Training for Humanitarian Deployment
Anisa Jafar – NIHR Academic Clinical Lecturer, Manchester Foundation Trust; Introduction to Humanitarian Healthcare Course Contributor
I’ll always remember something said to me by Dr Olivier Hagon. He emphasised the importance of maintaining good relationships at home and being cautious to avoid the trap of humanitarianism as a career to the detriment of all else. Those home-relationships will keep you grounded and maintain a day-to-day empathy, they prevent you seeing yourself as a hero or something special, they will keep you humble, and that humility will remind you to check yourself when you think you know best.
Emma Roberts – Independent Consultant; Introduction to Humanitarian Healthcare Course Contributor
Do your best and try and ensure that you leave a situation better than you found it. Recognise your limitations - be flexible, adapt and think outside the box!
Ram Vadi - Health Director, UK-Med
Be humble and remember that you aren’t here to save the world, but if you can make one life better today it was worth it.
Diana Maddah - Health Referent, Risk Communication and Community Engagement, UK-Med
Do not think that you can save the whole world! You should remind yourself that you cannot do everything yourself. This world is full of public health challenges, famine, poverty, illnesses, war, illiteracy, and so on... Whatever you do to help and to support will make a difference, make sure to work with strong ethics, and with passion!
Tarek Alkhalil - Senior Health Advisor, UK-Med
You’re not in Heaven Land, it’s never fair here and people are not angels. Manage your expectations!
Teresa Afonso - Senior Health Advisor, UK-Med
Attempt to get some field experience in the humanitarian sector and consider that personal compromises are part of the game. Choose your battles and manage expectations.
Jennifer Collins – Expert Infection Prevention, Control & Case Management, World Health Organisation; FRRHH Interim Faculty Advisory Board Member
I think the best piece of advice I was ever given starting this career was to be aware of your own limitations, it is quite cliché and sometimes obvious, but you cannot help others unless you are in a healthy position to do so, so being able to say ‘this setting is too much for me’ or simply ‘no’ to an opportunity is important. I think humanitarian workers want to help and often sacrifice a lot to do so, but should realize that everyone brings something different, some people can easily survive in a war zone and yet extreme temperature can affect them, we are all highly individual in our tolerances and being aware of that is how we can best help. I think the past attitude of ‘the more extreme we put up with, the more we are helping’ is slowly changing in this field and new humanitarian workers can be part of that change by actively thinking about this before committing.
Najeeb Rahman – Consultant in Emergency Medicine, Leeds Teaching Hospitals NHS Trust; Introduction to Humanitarian Healthcare Course Contributor
I was thankfully not prevented from seeking out opportunities that have helped to mould my career and interests, and was allowed to take various bits of time out of training which were critical in my personal and professional development. However, there is an old Arabic phrase I recall being adapted as a motivator. The phrase 'Fil harakah, barakah' which translates to 'in movement there is blessing', which we adapted to 'There is Barakah in the Harakah', ie: there is goodness and positivity in the emphasis of action and doing things. In my mind, it is a quintessential humanitarian axiom.
Paula Sansom MBE – Senior Consultant, The Operations Partnership; Introduction to Humanitarian Healthcare Course Contributor
When I first arrived to start my work in Gaza, I met an intensive care nurse who was conducting a follow up visit to a hospital in the Jerusalem. She recalled the first emergency and influx of patients that she and the other international nurses working in the ICU faced. As the influx started the international nurses, became quieter and more systematic, while the Palestinian nurses become louder and seemed more chaotic in their approach. By the time the emergency had calmed and was over neither group was speaking to each other. She said that when trying to diffuse the situation it became clear that both groups felt that the different response of the other group during the emergency had given the impression that they didn’t care. So, the advice – recognise that not everyone will react in the same way that you do, people cope differently, but it does not mean that they care any less or that their approach will not be as effective as yours.
Shaenna Loughanne – Trustee, Bridge2Aid; FRRHH Interim Faculty Advisory Board Member
The best piece of advice I was given was to try not to be someone else. You may be following in someone else’s footsteps, or working with other inspirational people, but it is important to be our true, authentic self. They can be them and you need to be you. You may approach your work differently to other people, but it doesn’t mean that it’s wrong. Believe in yourself, and what you have to offer.
Teodoro Forcht-Dagi – Professor of Neurosurgery, Mayo College of Medicine & Science; FRRHH Interim Faculty Advisory Board Member
The best advice I received was very short and very pointed. Medicine and surgery ought to be focused on the best interests of the patient. We must never stop working towards those interests with kindness, competence, compassion, and devotion.
Professor Tony Redmond OBE - Founder of UK-Med, Emeritus Professor of Emergency Medicine, Keele University and Professor of International Emergency Medicine, University of Manchester; FRRHH Executive Committee Member
You can't do everything. Do what you can, where you can, when you can.
Nigel Rossiter – Consultant Trauma & Orthopaedic Surgeon & Chair of Trustees, Primary Trauma Care Foundation; FRRHH Interim Faculty Advisory Board Member
Always ask: “why”? Whenever starting something - have an exit strategy before you start the job is the least important thing to look at when looking for a post - look at the location, the management and your colleagues first in that order. The job is the only thing you can change. Spend 3 years getting your feet under the table as a consultant before taking on internal or external roles. Don’t rush these and you won’t burn out (as I did). If something bothers you - do something about it: don’t complain - find a solution. Don’t be afraid to speak out if you know you’re right even if you think you’re in the minority, but also admit your mistakes.
Benjamin LaBrot – Founder and CEO, Floating Doctors Inc; Clinical Professor, University of Southern California Keck SOM; Compliance Advisor, Roche Pharmaceuticals
The best piece of advice I was given when I started out was reminded that I will never ever save a single person; all I will ever be is an instrument, and my job is to perform as an instrument in the service of my patient as best I can with all the resources, knowledge and skill that I can access at that moment. Once I have performed as well as possible as an instrument, then the outcome is not up to me, no matter how much I often wished it was. Sometimes you can do everything right and the patient will still die. And so consequently, I’ll never be able to claim that I ever saved a single patient, but I also don’t take responsibility and inappropriate guilt or outcomes that have nothing to do with me. If I’ve performed well as an instrument in the service of my patient, the outcome just isn’t up to me. In short, I’m not God. Many doctors suffer the ego damage of feeling responsible for things over wish they had no real control, and that only leads to severe mental and emotional strain or robot-like disassociation, neither of which I think make for a good quality of life or a good quality of practice ability.
Sarah Richardson – SpR Emergency Medicine, Royal Infirmary of Edinburgh; International Clinical Lead, Safeguard Medical; FRRHH Interim Faculty Advisory Board Member
Unfortunately, politics whether local, national or international have an impact on interventions, patient care and often whole health systems. To work in humanitarian healthcare, you need to be aware of these significant limitations, the impact of culture, corruption and all other external factors that may limit clinical care provision.
Main words of wisdom:
- If it wouldn’t be accepted in your home country, it shouldn’t be accepted elsewhere.
- Focus on local need, not on your want to deliver.
- If a setting asks for something listen, you will never fully understand the culture in which you are working.
- Reflect any issues you come across to a European/US setting. If you as a UK physician tried to do the same thing in a European country wouldn’t anyone, accept it? If the answer is no, then stop.
- You will leave wherever you are whether that be in a week or a year or ten. All interventions cannot rely on your presence. Focus on interventions that develop systems and local capability sustainably.
You may also be interested in reading other blogs from our World Humanitarian Day 2022 series:
World Humanitarian Day 2022: Celebrating Humanitarian Healthcare Workers | RCSEd
How Do You Get Started Working in Humanitarian Healthcare? | RCSEd
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