An operating theatre comprising four posts and a tarpaulin, and a surgery schedule of 30 to 45 patients a day (as opposed to her Australian average of around five) was all in a day’s work for Rachel Marsden during her recent stint in Haiti with Médecins sans Frontières (MSF).

Rachel, a registered nurse with a post-graduate certificate in theatre, had received a call from the NGO on a Friday, to find herself in the thick of the Haiti earthquake aftermath the following Monday.

“The situation was terrible. Conditions were pretty awful in Haiti before the earthquake, but after it, it was indescribable. We were in Leogane, at the epicentre, three weeks after the earthquake, so the initial rush was over, and it was our job to set up the hospital and operating theatre. Beyond that, our tasks were earthquake related things like amputations, burns treatment and so on.”

Adrenalin was vital to getting through each day, Rachel adds, and with language barriers also an issue, improvising was key.

“Haiti is French speaking, but I don’t speak French, so there was a lot of speaking with hands. I’d watch what others were doing and listen to what they were calling the different surgical instruments, and gradually I picked up enough to get by.”

Haiti wasn’t Rachel’s first time with MSF. In 2008/9 she’d done a stint with the NGO in Nigeria where she managed an operating theatre for emergency maternity surgery and a vaginal fistula repair program.

“Everything was challenging about that situation really. For one thing it was a culture shock. You walk into a different world, with a different language and customs. We were in a very remote part of the country and it was the first time most of the locals had seen white people. The response we got was mixed; some were scared and some were excited. Nigeria has around 140 languages and the local language was Hausa, with English as the second language. There were no interpreters.”

Rachel spent three months in Nigeria, standard for an operating theatre nurses, who risk burning out if they stay longer.

“I got so much out of it. I met some truly amazing people. They were so resilient and intelligent. It sounds like a cliché but it really teaches you a lot. They don’t tend to dwell on what they don’t have and family is very important. In many ways they are much happier than people in developed countries.”

The experience also provided a steep professional learning curve.

“I took on a management role which I’d never done in Australia. It really took me out of my comfort zone but because of that it really stretched me. If someone had told me before I’d left what I would be doing when I got there, I probably wouldn’t have done it, but I’m so glad I did. In situations like that you really learn your limits, but you also realise how much you really do know.”

Rachel recalls her first inkling of wanting to work with MSF as something of an epiphany.

“I was on holiday in Papua New Guinea when I saw this bombed out ambulance on the side of a road. There were also signs for aid workers. It was a real ‘light bulb moment’. After that I asked around and spoke to a lot of people and Médecins Sans Frontières was the name that kept coming up. ”

For Lisa Mazlin, recently returned from Malawi where she worked on a mass measles vaccination program, working with MSF was always an ambition.

“I did some research on the different NGOs and I really liked Médecins Sans Frontières’ philosophy of speaking out, and ensuring that all the money donated goes directly into the field.”

The stint in Malawi, Lisa’s first, was in many ways “idyllic”; a stable country with English as a common language, plenty of Australians in the field and a great sense of camaraderie. It was also personally and professionally challenging, with Lisa managing 10 national teams that worked in urban, rural and remote communities across the country.

“Initially one of the most challenging things was establishing my role and that of others in the field, so there was a bit of adjusting around that. Beyond that I was working with a mass vaccination program, visiting improvised sites where between 1200 and 1500 vaccinations took place, per team, per day. All in all we achieved around two million vaccinations in as many months.”

With so many people, some of whom had journeyed from other countries such as Zambia, willingly participating in the program, crowd control was a daily task.

“There was never violence or anything like that, but with so many people to deal with, sometimes you had to step in.”

Lisa emerged from her time in Malawi professionally more confident. “Taking on a management role, working with people whose first language isn’t always English and dealing with a project of that scale all stretched me. You’ve got to be flexible and able to think on your feet. And you have to know when to take charge. As a manager, the buck stops with you.”

“I’d say working with MSF is one of the most challenging but rewarding things you’ll ever do. For nurses wanting to do it, I’d say always be open with your Australian employer. I work in emergency at Brisbane’s Prince Charles Hospital; I’ve been there for a couple of years and they’ve been amazingly supportive. Another piece of advice is to make sure you take time off to readjust when you get back from a trip.”

With MSF paying a basic monthly stipend, Lisa is banking up some money to pay the mortgage before her next trip.

“You go where they send you; basically wherever the need is greatest.”

As for Rachel Marsden, she now works short contracts around Australia to allow her the flexibility to work with MSF wherever possible.

“I would recommend working with MSF to other nurses like a shot. You get such an adrenalin rush from working in these situations where the need is so great. In Australia there’s a tendency to downscale the role of nurses, but it doesn’t matter who you are when you’re working with MSF, because it’s about everyone pulling together.”

Founded in 1971 with an ethos that all people should have access to emergency medical relief, Médecins Sans Frontières is an international independent movement with offices in 19 countries. Every year, around 100 Australians and New Zealanders are sent to and supported in the field by Médecins Sans Frontières.

www.msf.org.au