It’s common knowledge that there are Filipino health workers in most countries, but it’s little known that there are more than a hundred of them working with Médecins Sans Frontières (MSF) or Doctors Without Borders.
MSF is an international humanitarian organization that was awarded the 1999 Nobel Peace Prize. It deploys medical and non-medical workers to field hospitals in some of the most difficult parts of the world.
Three of the Filipino workers – Dr Shirly Pador, Dr Karina Marie Aguilar, and nurse Jerwin Capuras – shared with Rappler their stories of serving on the frontlines of healthcare emergencies in Africa.
Medical doctor, 35, assigned in Lankien, Jonglei State, South Sudan
Basically, I am the all-around MD (medical doctor). This task fits my personality well.
During medical school, one of our professors asked us to take several personality tests. In one of them, I emerged as “the troubleshooter,” and the description couldn’t be more apt.
I start ward rounds at 8:30 am and go to whichever ward I am needed – to the trauma ward to do sedation, to the maternity ward to assist in a difficult case or to assess a sick baby, to the adult medical ward for decisions on cases, to the emergency room for referrals, to the COVID triage for assessment of a suspect case, to the ER (emergency room) every day at 4 pm to examine sick national staff, to the MSF Academy for scheduled trainings (these days, they’re mostly related to COVID or Infection Prevention and Control).
For the non-COVID wards, we use medical masks in our day-to-day operations, and we wear full personal protective equipment in the COVID areas. Still, there is a risk of getting infected any time, on top of all the other contagious diseases that we encounter, such as tuberculosis.
There is also the risk of running yourself to the ground, as there are just so many things to do due to staffing issues worldwide, not only in MSF projects but in a lot of healthcare facilities.
Working in South Sudan is not easy. I often wonder, especially when I am exhausted, if this is the day I throw my hands up and give up. Before I agreed to the assignment I knew this was a hard mission, but I thought to myself: if many people have come before me and have survived, I can too.
The patients, and even the staff, are a vulnerable population, not only because of the illnesses and lack of medical care, but also because they don’t have access to clean water in their homes. Their water comes from bore holes that NGOs dug. The women and children carry buckets of water on their heads and walk for miles. They don’t have access to adequate food, and most of the population rely on food supply from the World Food Program. They don’t have electricity or telecommunications or proper hygienic latrines. For these reasons, I became hyper-aware to contextualize our health education messages.
Sometimes when I do rounds on children, they reach out to stroke my skin, seeing it is different from theirs. Their curious eyes will melt your heart.
Every patient sent home better than when they came in is the reward of this job. I get to know them by their first name. Especially when I see the severe ones get better – children with tetanus, or tuberculosis which has spread to the brain – I live for moments like these.
Karina Marie Aguilar
Project medical referent/Medical activity manager, 39, recently finished mission in Bamenda, Cameroon
As a manager, I ensure smooth operations of the hospital. I ensure good collaboration between MSF and the local actors that we work with to deliver proper quality medical care to our patients.
With an insecure context as in North West Cameroon, we face a lot of risks in our daily work. We face getting caught in a crossfire every day. There was a time there was an exchange of fire near the hospital. That moment made me realize that the risk was very real in my work. My first concern was my team and making sure all were safe. Once I knew everybody was safe, I felt better.
The reward is seeing our patients walk out of the hospital alive, forever grateful for our service.
Once, as I was walking in one of the hospitals we support there, all the mothers of our pediatric patients pulled me aside and surrounded me. Suddenly, all of them started singing and dancing, thanking me for saving their kids from starvation. I felt good, and humbled, and appreciated. Being the crybaby that I was, I moved away and turned around just in time for them not to see me crying.
Pakistan was my first mission. For my parents, my decision to join MSF was hard to accept. With my specialty, they knew I was going to be in difficult situations, handling trauma patients. And, yes, I received that lecture: that I would be earning a fraction of what I am supposed to be earning. They even organized an intervention, where they called all my cousins who were doctors to try to talk me out of it. But, at that point, my mind was made up.
My parents were so worried about me going to a very dangerous place. But, as I was doing my mission, nothing could be further from the truth. Pakistan is such a beautiful country, full of lovely and kind people. I loved the country so much that, after my first mission there, I went back three more times.
Wherever my mission takes me, I find that when you are able to save a patient on the brink of dying, then that patient looks at you and says, “Thank you so much for saving me.” There is a feeling of fulfillment that no other profession can understand.
ICU nurse team supervisor, 28, assigned in Kenema, Sierra Leone
I am currently the nurse team supervisor in the intensive care unit (ICU) of the MSF Hangha in Kenema District, Sierra Leone. My day-to-day role involves daily supervision and management of the ICU, where we currently have 10 beds.
All patients in severe condition are admitted to our unit once they are stabilized in the ER. Never has there been a day since I arrived here when the ICU is not busy. There is always a lot to do, but all the hard work is compensated whenever we save babies in Kenema and we see how grateful the caretakers are.
It cannot be denied that, despite all the best efforts we pour into the job, we cannot save every patient. I have witnessed so many babies dying since I started working here. Before coming here, I already knew that Sierra Leone had one of the highest child mortality rates in the world, but it is different when you see what is going on in the field compared to reading statistical reports or mortality rates on paper. It is very difficult to see it and experience it firsthand. I try to comfort myself with the fact that the community sees our impact here and trusts our presence.
Humanitarian work, such as mine with MSF, is often filled with various hazards while in the field. There are risks that naturally come with the job, some are inevitable and may even be necessary to get the job done.
In Sierra Leone, risks may come from contracting different diseases, such as malaria, blood-borne diseases, or Lassa fever, a viral haemorrhagic disease that humans can contract through exposure to food or to household items contaminated with rodent urine or feces. Lassa fever is endemic in Kenema, so contracting it is higher here than in other places in the world.
In ICU, we see many patients who are suspected Lassa fever cases, but with the strong and clinical assessment that we follow, these patients are taken care of without compromising the safety of staff and patients. Then, of course, there is COVID-19.
I came to a gradual realization that becoming a nurse would be a great life path for me. After nursing school and working in one of the biggest state hospitals in southern Philippines, I signed up for a 6-month volunteering trip in Benin, a tiny country off the coast of West Africa in 2016.
I made a decision that is uncommon among the majority of young Filipinos, especially for a Filipino health worker. The Philippines is the biggest exporter of nurses to countries in the global north, but seldom do you see a Filipino who chooses medical humanitarian work, going to places where people opt not to go. I discovered so much about myself and passion during my short time in Benin.
Later on, I worked in Bangladesh at the start of the Rohingya refugee exodus. I stayed there until the end of 2018. It was in Bangladesh where I got a glimpse of MSF and the work they do. They were running a very big project in the refugee camp and I would always see the staff and the MSF vehicles every day. Everyone at the camp knows MSF and I met several MSF people who became my friends.
My work allows me to be part of something bigger than myself. I can’t see myself being in a field not related to this type of work.