Humanitarian nurse responds to medical emergencies in crisis-affected countries

South Sudan. Afghanistan. Turkey, Jordan, Syria, Iraq, Bangladesh, Sierra Leone and Ethiopia – for the last seven years, nursing alumna Melissa How has worked in all of these crisis-affected countries with Medecins Sans Frontieres (MSF). As a medical emergency coordinator at MSF, she contributes to the medical strategy, leading and managing responses on missions.

How says each country she works in has a ‘mission’ and each mission, generally speaking, can be anywhere between one to five projects.

“Every mission has had its own unique and incomparable experiences,” she explains. “A project can be anything from a full-scale secondary level hospital as big as 380 beds, to a TB-HIV program, to outreach mobile health clinics, a vaccination campaign, response to a refugee crisis, major outbreak or epidemic, to opening an emergency stabilization centre for war wounded so we can get them to a surgical hospital.”

On her first MSF mission in South Sudan in 2012, she spent six months doing everything from planning a cholera vaccination campaign, managing a malnutrition program, supervising health posts, starting a routine vaccination program, and facing a Hepatitis E epidemic.

While in Ar Raqqah, Syria in October 2017 with another MSF employee, when active fighting ceased, How was able to access the destroyed city before people began returning to their homes. Anticipating that traps and unexploded devices would remain and be potential dangers, she led a team and found a safe strategic location to train medical staff in trauma stabilization. They also set up a well-equipped emergency department to stabilize patients with blast injuries for transport to the surgery hospital.

“This gave us the capacity to be ready in advance of people returning, and able to provide much needed emergency care to blast-injured people in the first days when no other facility was available. In addition to the ER, we had a vaccination outreach team, and opened a primary health-care centre.”

How first began her nursing career at the Alberta Children’s Hospital, where she was the first emergency department nurse accepted on the paediatric Critical Care Transport Team. She’s also worked as a clinical nursing instructor with the University of Calgary and Mount Royal University. From 2010 to 2012, she was an outpost nurse at various remote nursing stations in northern Manitoba.

She is currently working on a Masters of Public Health with the London School of Hygiene & Tropical Medicine.

What motivates your work?

“What I love about my work is a bit of the unknown of what is coming next (must be my emergency nurse side coming out), but also that I can shape a mission with the team, manage programs, effect change, and hopefully inspire new people to do and continue such work in the future.

“Working as a humanitarian nurse has opened a door of privilege to go where the majority never will, because they are not exactly tourist destinations. I have the privilege to work with amazing people that offer their trust to me in their most difficult times in places where health care is often inaccessible, or unavailable, and resources are limited to scarce. Had it not been for being a nurse, I likely would not have had these opportunities. Every bit of nursing education and work experience prepared me for my humanitarian career.”

What’s a memorable experience you had at UCalgary Nursing and why is it significant to you?

“I very clearly remember the first day of third-year for our community health semester. It was 9-11, and the first time I began to hear about, or pay attention to countries like Afghanistan. Everyone was in shock and a bit confused about what had happened only a couple hours prior. In the same year, MSF came to the nursing faculty and put up a display. I knew immediately I wanted to be a part of the organization in the future. Little did I know that exactly 12 years later, I would be in Afghanistan on my second mission with MSF.”

What most excites you about the future of nursing or changes coming in the profession?

“The next generations of nurses to come and the creativity, ingenuity and innovation that I know they will bring. Nurses are paving new paths and raising the bar.”

Is there a nursing issue you are especially passionate about or you would like to change?

“Vaccination. I have seen firsthand the absolute worst consequences of vaccine-preventable diseases such as measles, diphtheria, polio, pertussis, pneumococcal pneumonia, etc. We play a pivotal role in advocating for, and influencing health-seeking behaviour when it comes to childhood immunization, truly saving lives, and fighting the reemergence of these infectious diseases. I have seen people walk for days, purely to have their child vaccinated. No child should be condemned to pay such a harsh price as losing their life to something preventable. Vaccines are not a luxury. Neither are children. Just because people don’t see these diseases so much in Canada, does not mean it can’t, and won’t, happen again.”

What advice do you have for aspiring nurses?

“Find an aspect of nursing that you feel excited and passionate about, and you will surely be successful. Think big. Think outside the box. Not only will you benefit from enjoying what you do, but the positive impact it will have on others will be tremendous.”

All through 2019, we'll be highlighting 50 Faces of Nursing and profiling outstanding nursing members in celebration of our 50th anniversary. If you know someone noteworthy (faculty, staff, alum, students, partners, etc.) who you would like us to feature, tell us more with this short online form. For more, visit nursing.ucalgary.ca/50