Golding, Berenice

Hargreaves, Janet

English

University of Huddersfield Repository

University of Huddersfield RepositoryHargreaves, Janet and Golding, BereniceHumanitarian nursing with Médecins Sans Frontières: an oral history projectOriginal CitationHargreaves, Janet and Golding, Berenice (2015) Humanitarian nursing with Médecins Sans Frontières: an oral history project. In: 32nd Annual AAHN Nursing & Healthcare History Conference, 17-20th September 2015, O'Callaghan Alexander Hotel, Dublin, Ireland. (Unpublished) This version is available at http://eprints.hud.ac.uk/27103/The University Repository is a digital collection of the research output of theUniversity, available on Open Access. Copyright and Moral Rights for the itemson this site are retained by the individual author and/or other copyright owners.Users may access full items free of charge; copies of full text items generallycan be reproduced, displayed or performed and given to third parties in anyformat or medium for personal research or study, educational or not-for-profitpurposes without prior permission or charge, provided:• The authors, title and full bibliographic details is credited in any copy;• A hyperlink and/or URL is included for the original metadata page; and• The content is not changed in any way.For more information, including our policy and submission procedure, pleasecontact the Repository Team at: E.mailbox@hud.ac.uk.http://eprints.hud.ac.uk/Humanitarian nursing with                           Médecins Sans Frontières: The dream job Professor Janet  Hargreaves & Dr Berenice Golding,  Universit y of  Huddersf ield,  Huddersf ield,  England “ It  was like the dream job and I’d just  walk to the helipad in the morning and get  on my helicopter and off we’d go into the mountains,  … beaut iful scenery,  lovely …” (Lesley,  Pakistan,  1995)  Purpose of the study  This original  oral  hist ory research explores humanit arian nursing,  locat ing t his in t he l i f e st ory of  t he nurses int erviewed.  It  demonst rat es nursing’ s cont inued posit ion on a world st age of fering a unique record of  remarkable nursing cont ribut ions in t he lat e 20t h and early 21st  cent ury.  Rationale and significance  Nursing work in t imes of  conf l ict  or nat ural  disast er bot h before and since Florence Night ingale's high prof i le mission in t he Crimean war is signif icant  in t he format ion of  nursing ident it y (St arns 2000).    This research adds t o our underst anding of  t he cont inuing at t ract ion of  such work and it s place in nursing hist ory and pract ice.    Methodology  Oral hist ories were recorded wit h 7 [ female]  nurses,  who worked for  Médecins Sans Front ières (MSF) during t he 1990s and early 2000s.  MSF was chosen as it  espouses a st rongly secular and int ernat ional  philosophy.   Analysis used t he List ening Guide,  a feminist  approach employing four relat ed readings of  t he dat a (Gil l igan et  al  2003).   Findings  Becoming an MSF nurse has element s of  a ‘ love affair ’ .  An overarching t heme of  ‘ dreams’  includes romance,  nightmares and impossible dreams (Fox 2014).    Romance   “ I sor t  of  had t his idea,  …f or  my l i f e t o be wort hwhi le…  t hen going and helping . . .  would be a good t hing t o do… [and]  nursing would be a good way t o do i t ”  [Chris]    “ …and I remember years and years bef ore t hat  I’ d seen a document ary on MSF and t hought  what  a f ant ast ic t hing t o do”  [Jo]    “ …I was sor t  of  almost  in awe of  j ust  seeing t he logo on one of  t hese vehicles…and he said wel l  would you l ike t o come wi t h us f or  t he day,  t omorrow,  t o see what  we’ re doing here in t his,  in t his area.  And I could barely speak”  [Sam, Tanzania,  1990s]  References  Fox,  R C.  (2014).  Doct ors wi t hout  borders:  Humanit ar ian quest s,  impossibl e dreams of  Médecins Sans Front ières,  Johns Hopkins Universit y Press,  Bal t imore Gil l igan,  C. ,  et  al . ,  (2003) On t he List ening Guide:  A Voice-Cent ered Relat ional  Met hod.  In:  Camic,  P. ,  et  al . ,  eds.  Qual i t at ive Research in Psychology:  Expanding Perspect ives in Met hodol ogy and Design.  Washingt on:  American Psychological  Associat ion pp.157-172 St arns,  P.  (2000).  The March of  t he Mat rons.  DSM, Pet erborough Conclusion  At  a t ime of  debat e and  chal lenge regarding t he role of  nursing wit hin societ y,  t his research examines nursing in one of  i t s most  iconic manifest at ions.   Acknowledgements: This research was made possible t hrough t he support  of  MSF UK and a Higher Educat ion Academy  Nat ional  Teaching Fel lowship award.   Post er designed by Berenice Golding.   Background image credit :  MSF f ront  door in Chad,  Mark Knobil ,  (ht t ps: / / commons.wikimedia.org/  wiki/ File:  MSF_ f ront _ door in_Chad. j pg#/ ) Licensed under CC BY 2.0 (ht t ps: / / creat ivecommons.org/ l icenses/ by/ 2.0/ deed.en)    Impossible dreams   “ …So t hese poor people… desperat ely coming over  and j ust  sor t  of  st opping hal f way out  of  Goma up t o Kigal i… f or t y minut es,  an hour ’ s walk… people who walked out  wi t h not hing,… no f ood,  no clean wat er ,  no not hing.  And by now cholera was set t ing in.  So i t  was j ust  an area of  volcanic rock. . .  you couldn’ t  dig lat r ines,  you couldn’ t  put  proper t ent s up,  i t ’ s j ust  rough and t his is where everyone j ust  st opped.  And we,  we had t o deal  wi t h t hem t here”  [Jo,  Rwanda,  1994]   “ Remember having huge quest ions about  what  was I doing in humani t ar ianism and was i t  real l y humani t ar ian and what  di f f erences are you act ual l y making and a lot  t o t hink about  af t er  i t ”  [Alex,  Sierra Leone,  c1999]  Nightmares  “ …I t urned up on a Hercules… t hey didn’ t  swi t ch t he engines of f  because i t  wasn’ t  saf e t o do so… I was on my own… I sor t  of  got  of f  t he plane and was on t he sand,  no t armac,  and t his guy met  me and he said ‘ Welcome t o Hel l ’ ”  [Bo,  Somal ia,  1992]   Picture credit: Niger ,  July 2012,  Sean Smith,  Flickr  (ht tp: / / bit . ly/ 1Jkv4lK) is l icensed under  CC BY 2.0 (ht tps: / / creat ivecommons.org/ l icenses/ by-sa/ 2.0/ ) “ …t here was an incident  one t ime… we were,  I say semi -kidnapped,  we were sor t  of  kidnapped real l y by,  at  t he end of  a r i f l e,          Int erahamwe and,  t aken of f  and marched of f  f or          about  t wo hours int o t hese mount ains”  [Jo,  Zaire,        1995]               “ I had been . . .  t wo-and-a-hal f  mont hs wi t hout             break,  j ust  in t he l i t t l e pr ison . . .  [ i .e.  l ocked in an       enclosed MSF ‘ bunkered' area f or  saf et y]  . . . . .  on       bunkered missions people go crazy”  [Sophia,          Somal ia,  2000]  Picture credit :  People queuing to access the t ransit  camp in Dolo Ado.  Cate Tur ton,  Depar tment  f or  Internat ional Development .  Fl ickr  (ht tp: / / bit . ly/ 1Jkv4lK) is l icensed under  CC BY 2.0  (ht tps: / / creat ivecommons. org/ l icenses/ by/ 2. 0/ ) Humanitarian nursing with                           Médecins Sans Frontières: an oral history project  Professor Janet  Hargreaves & Dr Berenice Golding,  Universit y of  Huddersf ield,  Huddersf ield,  England  Background image credit :  MSF f ront  door in Chad,  Mark Knobil ,  (ht t ps: / / commons.wikimedia.org/  wiki/ Fi le:  MSF_ f ront _ door in_Chad. j pg#/ ) Licensed under CC BY 2.0 (ht t ps: / / creat ivecommons.org/ l icenses/ by/ 2.0/ deed.en)    In 2012 I was fortunate to be awarded a National Teaching Fellowship by the Higher Education Academy in the UK. My route to becoming a university lecturer had been through nursing and I had developed an interested in nursing history. I also had great respect for the work of Médecins Sans Frontières (MSF). I therefore decided to use my fellowship grant to undertake a project researching MSF nurses if MSF would allow this: They did. MSF [also known as ‘Doctors without Borders’] is a large, multinational organisation offering medical aid in areas of conflict and natural disaster. Formed in 1971 in France it was created on the “belief that all people have the right to medical care regardless of gender, race, religion, creed or political affiliation, and that the needs of these people outweigh respect for national boundaries” (msf.org.uk). There are now regional offices all over the world, operating in a coordinated but diffuse system. MSF UK was opened in the early 1990s, which gave starting date to the period of time explored in this project. The nurses offer a window into the life of a nurse working for MSF at that time and thus some insight into the organisation itself, although no attempt has been made to explore MSF in detail. In addition, the histories include eye witness reports of involvement in humanitarian missions all over the world in the late 20th and early 21st century.   The aim in recording their histories was to better understand nurses’ motivations for engaging in humanitarian work, in particular where no immediate threat of war or invasion is present and in the absence of overt religious or nationalistic motivations. In so doing the project offers insights into nursing identity and the place of humanitarianism in nursing lives and practice. Secondary aims were to explore nurses’ contribution to MSF and their experience of being in the field following humanitarian crises of the 1990s and early 2000s.  Following ethical approval from the University of Huddersfield and support to access participants from MSF UK seven oral histories were recorded in 2013; each was recorded in a single sitting. They were asked to recount their pathway to becoming a nurse and then subsequently volunteering with MSF; their experience of working for MSF; and their post-MSF life. Beyond these three questions few prompts were offered. The listening guide was used to aid analysis of the text due to its multilayered and feminist approach to understanding and analysis: ‘The Listening Guide method comprises a series of steps, which together are intended to offer a way of tuning into the polyphonic voice of another person.’1 Multiple ‘listenings’ / readings of the text are advocated2: firstly for the plot which parallels to other methods of thematic analysis that are looking broadly for themes, gaps, surprises. Second is to read specifically for the use of ‘I’ ‘which involves listening for the ‘self’ within the context of the story being told3  and by extrapolating phrases where ‘I’ is used; in some instances the ‘I’s are used to create ‘I’ poems. More layers of analysis follow when using the guide, but are not discussed further here. Five thematic groups are identified: ‘becoming’, ‘being’ and ‘leaving’ MSF; dreams [the ‘dream job’, ‘romance’, ‘nightmares’ and ‘impossible dreams’]; nursing identity and humanitarianism.  Humanitarian nursing with                           Médecins Sans Frontières: an oral history project  Professor Janet  Hargreaves & Dr Berenice Golding,  Universit y of  Huddersf ield,  Huddersf ield,  England  Background image credit :  MSF f ront  door in Chad,  Mark Knobil ,  (ht t ps: / / commons.wikimedia.org/  wiki/ Fi le:  MSF_ f ront _ door in_Chad. j pg#/ ) Licensed under CC BY 2.0 (ht t ps: / / creat ivecommons.org/ l icenses/ by/ 2.0/ deed.en)    There is congruence with some of the motivations of humanitarian workers in the 19th century identified by Gill4 as: Honing professional expertise; Evangelism; Adventure and Moral citizenship. In addition there is a strong association with the motivations of MSF workers explored by Fox:   “ ... idealism, altruism, moral indignation, a commitment to social justice, a sense of adventure, the desire to 'escape an uncomfortable situation back home' or to ‘put the past behind' one, a search for self-fulfilment and a 'because we can' spirit of pragmatism “ (Fox, 2014 p 19)5    At the outset I asked my colleague, Dr. Berenice Golding, to collaborate with me on the analysis and development of this project which has added greatly to the thematic development and to my enjoyment. We are both indebted to MSF for their support, to the Higher Education Academy for my Fellowship grant, and most especially to the seven nurses who so freely and eloquently shared their lives.   For more on this research see Hargreaves and Golding (2014)6.   Janet Hargreaves [j.hargreaves@hud.ac.uk] & Berenice Golding [ b.golding@hud.ac.uk ] University of Huddersfield, UK  References 1On the Listening Guide: A voice-centered relational method. Gilligan, Carol; Spencer, Renée; Weinberg, M. Katherine; Bertsch, Tatiana Camic, Paul M. (Ed); Rhodes, Jean E. (Ed); Yardley, Lucy (Ed), (2003). Qualitative research in psychology: Expanding perspectives in methodology and design. , (pp. 157-172). Washington, DC, US: American Psychological Association, xvi, 315 pp  2Carol Gilligan The Listening Guide Method of Psychological Inquiry Qualitative Psychology  2015 Qualitative Psychology, American Psychological Association Vol. 2, No. 1, 69–77  3Brown, L.M., & Gilligan, C 1992. Meeting at the Crossroads: Women’s Psychology and Girl’s Development, Massachusetts: Harvard University Press   4Gill, R., 2013. Calculating compassion. Humanity and relief in war Britain 1870-1914. Manchester: Manchester University Press.   5Fox, R C (2014) Doctors without borders: Humanitarian quests, impossible dreams of Médecins Sans Frontières, John Hopkins University Press, Baltimore.  6Hargreaves, J. and Golding, B. (2014) ‘Not for God Queen or Country’ The Bulletin of the UK Association for the History of Nursing , 3, pp. 33-44. ISSN 2049-9744   

Humanitarian nursing with Médecins Sans Frontières: an oral history project

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