Tedx Robina: creating change: Lessons from a humanitarian nurse

A life lesson from a Humanitarian Nurse
I wanted to share with you today a message I received on Facebook.  It was from a 14-year-old boy I met when I was volunteering as a Nurse overseas in a refugee camp:
SLIDE 1:  Facebook Message
“Hi, I don’t know if you can remember me, but I will never forget you.  I remember one day, when I was in the unaccompanied children’s section of the refugee camp, your shiny smile and your kind words stopped me from killing myself.  Thank you for saving my life with your amazing words.  Heaps of respect and love for you, I wish you all the great things in life”

I cried when I received that message.
Can you believe that? My ‘my shiny smile and my kind words’ stopped a boy from killing himself!
How did I come to be volunteering in a refugee camp overseas in the first place?

Volunteering starts at home.
It starts with your neighbours and extends into the local community.  Volunteering then expands out to the international community.
I’ve volunteered overseas as a Nurse and a Paramedic helping some of the world’s most vulnerable people.  I’ve volunteered in disaster responses such as the Philippines after typhoon Hyan and Nepal after the earthquake.  I also volunteered in Greece during the Syrian Refugee crisis and in Iraq during the conflict.
But
My pursuit of being a volunteer started at home. 

SLIDE 2:  Groote Eylandt

Home for me was Groote Eylandt.  A remote island in the Gulf of Carpentaria in the Northern Territory of Australia.  

Both my parents are Greek, they migrated to Australia in the 1970’s.  My Dad worked on the manganese mine while my mum supported us at home when I was born.  We lived on the island until I was 14.

Groote Eylandt is a close-knit community.  It is a place where multiculturalism and diversity are the norm and where it doesn’t matter what your background is, people rely on each other to survive in such a remote location. 

As a child I joined volunteer organisations in the community where we helped those in need. I learnt how to be creative when problems came up and we had limited resources.   If someone had an accident and needed a wheelchair, we went out and fundraised to buy them the wheelchair.  It was that simple.
 

SLIDE 3:  Picture of helping people
As a child one thing my parents taught me from my Greek heritage was ‘Filotimo’.  
Filotimo is a word that has no English translation, but It is defined as being hospitable and giving to others, without discrimination, and without expecting anything in return.
I learnt from growing up in a small community and from my parents that we can show Filotimo in everyday life.
I realised very early on that my passion in life was to help people. 

But to do this as a career and to achieve my purpose I would have to further my studies to
get the skills to be able to pursue my passion.

So, When I finished high school I applied to university.
(PAUSE)
I didn’t get in.
In fact, I didn’t get accepted into anything that I had applied for.

It was up to ME to change this.
So, I wrote a letter to the university with the help of my teacher asking them to review the
application.
Essentially, I was begging them to give me a chance. 

While I waited with hope, I started a TAFE course through the volunteer ambulance service
to become a Paramedic.
3 months later a letter came from the university saying that a position had come up in the
nursing program and they would trial me for the first semester.
This was my chance


SLIDE 4: picture of red writing on essay

I was so excited to be accepted into Nursing because I would be gaining the skills needed to
help people. 
This was my passion, and this was my purpose.
My excitement soon faded, when my essays started coming back to me covered in red pen. 
I was just barely scraping through on a pass mark.  One day my lecturer called me into her
office and she said:
(PAUSE)
“You will never make it as a Nurse, or a paramedic, you should quit and pick a
different Course, Nursing is just not for you.”
(PAUSE)
Why? Because I couldn’t write academic essays.
I was devastated.  That was my dream.
I was being told that I couldn’t do it, that I couldn’t pursue my passion or fulfil my dream.
In that moment I knew that it was up to me to change this, I knew as I walked out of her office that day that I was not going to give up.  It was up to me to create the change to prove to myself that I could do it.
I was NOT going to QUIT.
I persevered, and I kept handing in those essays.  They kept coming back to me covered in
red pen but I managed to pass them, and before I knew it, I had completed all my subjects
at University. 
My perseverance and persistence and ability to tackle problems head on had paid off.
I was able to graduate with a Batchelor of Nursing and a Diploma of Paramedic studies. 


 

SLIDE 5: NURSE
Everyone has a moment.
A moment where they realise they are on the right path.
My moment came on a Friday night, one year after I graduated from Nursing.
I was driving into town and I saw an accident up ahead.  It was a chaotic scene. 
There were people panicking, bystanders not knowing what to do and there was a lack of
equipment.
There was a fire truck there but no ambulance yet. 
A woman had attempted to cross a busy road and had been hit by 2 cars. 
You can imagine how horrific her injuries were.
I stopped at the scene and that is when my training kicked in, helping the fire crew,
doing all that we could to save this woman’s life.
I treated the patient with all my skills that I had learnt both as a nurse and a paramedic.  I
remember one of the fire men thanking me repeatedly for stopping to help them.  I was
holding a bag of fluids in my hands and I reached out to a bystander to pass it to them, so
they could hold it for me. 
As I reached out I looked up.
(PAUSE)
It was her
(PAUSE)
It was that lecturer that had told me to quit and that I would never make it.
(PAUSE)
She had been driving one of the cars that hit the woman crossing the road. 
Sometimes the very people that tell us that we can’t do something end up needing our
help, and they end up showing you that you are on the right path.
That was my moment.
(PAUSE)
 

SLIDE 6: mahatma ghandi quote
Creative change is more than embracing new ideas.  It’s revisiting old ideas. 

One of my favourite quotes is from Mahatma Ghandi.
“The best way to find yourself is to lose yourself in the service of others”.
I did just that.  I began to use my skills to volunteer.  I volunteered in the ambulance service
And in the local community.  I hoped one day to be able to take my skills overseas and
Volunteer.
BUT
Once again I was told NO.  I was not skilled enough, and I needed more
experience.  The aid organisation said I couldn’t go and volunteer overseas.
(PAUSE)
Again, I was being told that I could not achieve my goal, that I could not fulfil my dream.
(PAUSE)
People also questioned how I, as one person, could make a difference if I went overseas to
Help.
Again, It was up to me to prove to myself that I could do this. It was up to me to create the
change.
I persevered and persisted, I took up post graduate studies and went on to complete my Masters of Emergency Nursing and eventually, I made it overseas to volunteer as a Nurse. 
(PAUSE) 
It was while I was there I learnt some memorable lessons.

SLIDE 7: Pic from Philippines

It was November of 2013 when a large Typhoon struck the Philippines.  This was going to
be my lesson in Empathy.

Tacloban was just devastated, I joined a medical group on a disaster response and headed
over to volunteer and help.  On one of the days we were there, we set up a makeshift clinic
on the side of a basketball court surrounded by debris.

I was standing there taking in the sight of the devastation and the crowd needing
Medical treatment.  The sight was overwhelming.

A local woman came and stood next to me, she looked exhausted and she was wearing clothes that had been donated and were way to big on her.

She sobbed as she told me how she had lost her child in the typhoon.  It was
heartbreaking.  She spoke of the Nightmares she was having and that she was scared that
the Typhoon would return. 

There was nothing I could do for this woman medically at that
time, so, I sat and listened to her and I held her in my arms as she cried.  I showed her
empathy and later she told me that sharing her story and having me listen to her had
helped her and that she would sleep much better now.
 

SLIDE 8: The lesson I learnt

In the Philippines I learnt that if you can listen to someone, console them while they
are grieving and show them empathy, you CAN create change, you CAN make a
difference.
 

SLIDE 9:  Pic from Nepal

An earthquake rocked Nepal in 2015.  Little did I know my lesson here would be
compassion.
I volunteered with a medical team and we were situated up in a remote village in Ghorrka treating patients.  We set up a basic clinic and treated hundreds of people every day.  We heard stories of tragedy and loss and of courage. 
The problems were so great and there were people that could not be saved.
One day an 8-year-old boy approached us at the clinic.  He had hiked 4 hours down the mountain to get to us.  His shoes were old and were falling apart and held together with tape. His face was dirty, and when he smiled he had 2 front teeth missing. 

He was hungry, and he was asking for food and supplies to take back to his family.  We fed the boy, and we were so impressed by how brave he was.  We gave him rice and other supplies to take back to his family.  He didn’t need medical assistance from us he just needed some supplies.   I’ll never forget that big smile he gave me as he headed back up the mountain carrying what we had given him.
 

SLIDE 10:  The lesson I learnt

In Nepal I learnt that If you can feed a hungry boy and give him supplies to help his family, and show him compassion, you CAN create change, you CAN make a difference.
 

SLIDE 11:  picture of refugee crisis Greece/ border

The height of the refugee crisis in 2015 saw thousands of refugees fleeing Syria and
neighbouring countries, crossing the Aegean sea to the Greek islands. 

Being Greek Australian I felt compelled to go and help when there were calls for Nurses to
volunteer.  
It was here that I learnt the lesson of kindness.

When I wasn’t working in the clinic I was on the foreshore helping with boat arrivals.
Thousands of people arrived every day.  It was winter cold, and people were soaking wet
from the boat ride across sea. 

I helped a woman with her 2 children get changed into dry clothes, I
wrapped a blanket around them.  The children were so cold their teeth were chattering as I
hugged them. 
There was a look of shock on their faces as they had witnessed people drown on the
journey.
The woman had been so frightened but now there was a look of relief on her face because
they were safe. 
She squeezed my hands and thanked me for being so kind.
 
Slide 12: The lesson I learnt

In Greece the lesson I learnt is that If you can wrap a blanket around someone
who is cold and show them kindness, you CAN create change, you CAN make a difference.
 

Slide 13: Iraq

It was in Iraq in 2017 that I learnt the lesson of hope.
There was a call for volunteer nurses in camps to assist those that were
escaping the conflict. 
I responded to the call and I went to Iraq.  I was treating patients in the clinic one day when
a mother with her child approached me. 

They had a dullness in their eyes and looked so sad. 
They were malnourished and traumatised.

They begged me for water to drink.  I can’t describe the heartache I felt at that moment as I
rushed to get them some water.

The mother could not stop thanking me as they sat, quenching their thirst. 
Through the interpreter she said that seeing a nurse had given her hope.
 
Slide 14: Lesson learnt

In Iraq the lesson I learnt is that if you can give water to someone who is thirsty and give them hope, you CAN create change, you CAN make a difference.
 

Slide 15: volunteer hugging
You can create change in your own life or in someone elses life.
When people say to me
‘Helen I would love to volunteer like you, but I don’t have your skills’
I think back to the lessons that I learnt and I say:

• If you can listen to someone who is grieving and show empathy, you can volunteer;

• If you can hand out food to someone who is hungry and show compassion, you can volunteer;

• If you can wrap a blanket around someone who is cold and show kindness, you can volunteer;

• If you can give water to someone who is thirsty and provide them with hope, you can volunteer;

Remember that facebook message from that teenage boy that wanted to kill himself?

All I did was show him Filotimo.  I was a stranger that gave him a shiny smile and said some kind words and it saved his life.  If you can give to others without expecting anything in return, you CAN volunteer.
 
Call to action

One person can’t change the world on their own, but together we can make a difference.

I challenge you all to create change.
I challenge you all to go out and volunteer, here at home, in your local community.
I challenge you to make a difference to one person.

People will tell you that you can’t do it, that it is too hard or that you aren’t skilled enough.

But it is up to you! Give it a go. You are the person that can create change.  You are the person that CAN make a difference.


Thankyou

SDG 3.4 NCD , trauma and mental health. Geneva, WHA

What do think of when you hear the words: Universal Health Care?

You might think of 'Utopia'. A place where everything is perfect.

Where quality healthcare is accessible to all, where human beings are all equal, where age,

gender, disability, geography and economic status have no negative impact on your life. A

place where no one is left behind.

SLIDE

I know a place called ‘Utopia’, it's an Indigenous community in the central desert of

Australia. I actually spent several years working in this area.

SLIDE

It's a community where Indigenous Australians are more likely than Non- Indigenous

Australians to have Respiratory disease, Cardiovascular disease, Diabetes, Obesity, Chronic

Kidney disease and Mental Health problems with high incidence of teenage suicide.

A place where non-communicable disease leads to premature death.

This is not the Utopia we imagine when we hear: Universal Health Care, particularly when

this community is in a developed country like Australia.

These pictures were taken 10 years ago. Most of these children will not have finished school,

will be in trouble with the law secondary to alcohol abuse or chroming, will be pregnant as

teenagers, will have attempted suicide or suffer with mental health problems, they will have

experienced domestic violence or sexual abuse and almost all of them will die prematurely

due to Non-communicable diseases.

SLIDE

When we look at Non-communicable diseases ( NCD’s) what do we know?

 We know that in developed countries, such as Australia, there are disparities in health

between indigenous and non-Indigenous people;

In Developing countries such as such as Ghana, Zimbabwe and Gambia, Health

disparities also exist amongst the population and that NCD’s are prevalent in low to

middle-income families, and factors such as economic status, geography and lifestyle

contribute to these health disparities.

SLIDE

 We know that based on the NCD Country Profile report from the World Health

Organisation that the percentages of premature deaths from NCD’s are a global issue

and that NCD’s account for premature deaths accounting for:

 34% in Gambia

 43% in Ghana

SLIDE

 33% Zimbabwe

 89% Australia

We know that NCD are chronic health problems that are preventable and

can be linked to culture and behaviour, where obesity in some cultures is considered

fashionable and beautiful.

In some countries, smoking amongst men is cool, manly, and fashionable, and we need to

consider the diaspora when they return to their home countries, what habits they bring back

with them.

We know communicable diseases such as Ebola take precedence in the Health budget of

developing countries, understandable when you look at the statistics of communicable

disease.

We know one of the largest barriers to providing primary health care in developing countries

is Accessibility.

This may be due to a lack of Infrastructure, if there is no clinic or hospital how can the

healthcare workers deliver health care?

Access could be difficult because of Geography, if you live in a rural or remote area it may

be too far or too expensive to travel to access Primary Health Care.

Conflict or unstable environments may also prevent people from getting to a facility.

As a nurse working on the frontline I have seen firsthand what a lack of primary and acute

care facilities, a lack of diagnostic and lifesaving equipment, a lack of medications and a lack

of technology can lead to. Where deeply rooted exclusions and inequalities costs Human

Life

I have felt the frustration of holding a young woman's hand as she took her last breathes,

knowing that her death was preventable if only we had basic emergency equipment and

access to a medical facility.

I have felt the frustration of telling a family that they must now say goodbye to their

grandmother knowing that having access to the right medication could have prolonged her

life.

I have felt the frustration of telling a woman that she has cervical cancer, that has now

metastasized, knowing that with the right equipment and diagnostic tests, the cancer could

have been detected earlier, and given her more time with her children.

I have felt the frustration when a hospital was sending a child home to die with severe burns

because her family had no money and the hospital could not afford to care for her severe

injuries, knowing that in another country this service would be free.

I have felt the frustration of cutting a teenage boy down from a tree where he hanged himself

knowing that if he lived in the city he would have had access to mental health services and

support.

There are so many barriers to accessing Primary Health Care,

And, yet, according to the United Nations Convention, access to health care is everyone’s

human right.

So what do we need to do?

SLIDE

 Governments, globally, need to focus on prevention of NCD’s and need to allocate at

least 5% of the health budget towards this. Non-Government Organisations and

Donors should also consider this when allocating money to projects. 5% is the

example of the goal that Australia to needs to reach.

Developed countries such as New Zealand already allocates 6.4% of the health budget

to prevention of NCD’s, Canada 6.2%, The UK 5.4%, USA allocates only 2.8% of its

budget to prevention of NCD’s and Australia is less than 2% which is reflected in the

figures of premature deaths cause by NCD’s standing at 89%.

Developing countries struggle now with their health budgets and need our help.

Money invested now in ‘prevention’ will create a savings in future costs to primary

health care delivery for NCD’s.

 The emerging health problems in Africa require a commitment to prevention as well

as a focus on coordinated acute care and primary health care services. The long term

projected plans should also include capacity building to facilitate preparations for

disasters/emergencies or conflicts.

 We need to build Infrastructure that is accessible and inclusive of people living in

rural areas, and being sensitive to the communities needs, to be able to deliver

effective primary healthcare. If there is no infrastructure, or health care facilities for

people to access Primary health care, then early detection, treatment and ongoing

monitoring of NCD’s is not achievable. These facilities need to include quality

diagnostics, use current technologies, vaccinations and medications.

 Countries such as Ghana, Zimbabwe and Gambia have existing trained healthcare

workers willing to work and deliver primary health care but there is no facility or

equipment for them to be able to do this, or, there is no funding to hire them to work

so there are existing staff shortages and poor nurse to patient ratios. A colleague from

Ghana told me this week that in a ICU and acute care facility the nurse to patient ratio

was 1:28

 There are opportunities as part of future planning around the delivery of primary

healthcare and achieving Universal Health Care, to grow and develop expertise in the

health sector, amongst the community, through education programs linked with the

health care facilities

 Africa has an opportunity to develop long term plans to work towards achieving

universal health care. These long-term plans are key to sustaining population health

improvements, over time.

 We need to create healthy environments with the community’s best interest in mind

and include women and girls in the development of this. Reducing tobacco and sugar,

and modelling good behaviours will also assist in achieving this.

Achieving Universal health care is everybody’s business, there needs to be a focus on

‘accessibility’ and ‘fairness’ and not equity. We need to access those hardest to reach in

order to leave no one behind, but we can’t do this alone, we must all work together to provide

coordinated care involving long term plans.

Well, all week here at the World Health Assembly, we have been talking. We have discussed

the issues, we have analysed them and we have talked about them some more.

How much more do we need to talk?

SLIDE

Now, it is time to take Action