New Zealand nurse Janine Issa, 59, found her calling as a Médecins Sans Frontières midwife.

Trained as a nurse (1969-1972) at New Zealand’s Auckland Public Hospital, Janine worked in her home town before travelling and working in England and India. She returned to NZ in 1977 and the following year came to Australia where she trained as a midwife at the former Crown Street Hospital, the site of Sydney’s first natural birth centre.

“I worked for a few years as a midwife and then in an Aboriginal community at Mornington Island in the Gulf of Carpenteria, before returning to Sydney and becoming involved in homebirthing over the following four years,” she said.

But Janine nurtured a secret wish.

“Since I first started to hear about Médecins Sans Frontières in the 1980s I always wanted to work with them,” she said. “I even loved the name. It encapsulated what I believe about healthcare - that it should be available to everyone regardless of politics, religion, race or ethnicity.”

So Janine supported Médecins Sans Frontières as a donor but had to wait until her children were grown before she could join them.

“I lived in Canada from 1987 to 1994 and Médecins Sans Frontières has a high profile there with a big office in Toronto,” she said. “I’d known about them for so long and it always interested me.”

When her father died in New Zealand, Janine brought her mum to Australia but her mother’s death in 2008 became the catalyst for her to act.

“By then my children had left home. I had a great job working with marginalised people as the nursing unit manager at the Kirkton Road Centre in Kings Cross, but always dreamed of working in the developing world,” she said.

“When mum died I decided to take some long service leave to see what I would do next. It had been a hard few years.”

Janine submitted her application to Médecins Sans Frontières worrying she may be “too old” but was delighted to find she was accepted.

“Part of my reason for working at Kirkton Road was to learn more about sexual health because I thought I would be more suitable for Médecins Sans Frontières working in this capacity and its HIV/AIDS programs,” she said.

“But when I went to my interview they told me they were desperate for midwives and my midwifery training was what they needed.”

Janine went to South Sudan and Kenya with Médecins Sans Frontières. She found working as a midwife in the developing world very different to working in the developed world “where it’s very high-tech and regulated”.

“Women here have fewer babies; they’re generally older, are often looked after privately and have very high expectations of the care they will receive and of the outcomes. And they can have those expectations because the facilities exist,” she said.

By contrast, in Kenya and Sudan she found low expectations and scant resources.

“The vast majority of women I looked after would normally have birthed at home with unskilled help. You see many complications over there that you’d never see in the developed world.

“If they have a complication they wait too long or have to travel too far before they get to hospital and this can result in the death of their baby and severe complications like fistula for the mother.”

Nonetheless Janine loved working in that environment.

“At first I was worried that I would not be able to deliver the goods but I found that my knowledge and skills were very useful. The people were wonderful to work with and so very grateful,” she said.

“I learned an enormous amount. There were national staff I worked with whose clinical skills were amazing even if their theoretical knowledge was limited. They taught me how to deliver breach births and to deal with emergencies I’d never come across in my midwifery experience.

“In both Sudan and Kenya we always had an obstetrician surgeon available, as we needed to be able to provide caesarean section when necessary. We worked wonderfully together as a team and I learned much from them.”

And working with Médecins Sans Frontières was “fantastic”.

“I always felt really well supported. I had thought security might be an issue but I never had any problems and never felt unsafe. I also loved working with an international team – people from different countries, cultures and experiences. I really enjoyed the camaraderie.”

Janine is now back in Sydney, working once again at the Kirketon Road Centre and in the Schools Immunisation Program with the Public Health Unit at the Prince of Wales Hospital.

She has promised her family she’ll stay put this year but next year hopes to take another placement with Médecins Sans Frontières.

“There is something about working where you can see a real need and where the knowledge you bring is really useful,” she said.

“It’s challenging because you have to find ways of dealing with problems in a lateral way. You’re pushed into new roles and skills you haven’t performed before and constantly extending your knowledge. And the people – they’re just wonderful.”

Médecins Sans Frontières is always looking for competent nurses and midwives who are willing to live and work within an international team, share their skills and dedicate their time to support the organisation’s medical humanitarian work around the world.

All field workers are insured for health, medical repatriation, death and disability for the period of their project. All costs associated with the work are covered, including your travel from home to the project, and living expenses while you're away.

The basic monthly stipend for people without previous relevant field experience for the first 12 months is $1400. To find out more about working with Médecins Sans Frontières, visit www.msf.org.au/join-our-team