The International Year of the Nurse and the Midwife, 2020 and the inception of a battle against the CoVID-19 pandemic has put in evidence the extent to which nurses and midwives lead the way to quality care, at the right times.
Celebrated this year but needed every day, every year, nurses and midwives play a vital role in providing essential health services and responding to humanitarian crises. As the backbone of every health care system, they devote their lives to caring for mothers and children; giving lifesaving immunizations and health advice; looking after older people in addition to meeting essential health needs.
Nurses and midwives are often the first, and only, point of care in their communities, and have been demonstrating their relentless commitment at the frontlines of the coronavirus response, from community clinics to intensive care units in hospitals, at the cost of significant personal sacrifices.
In Cox’s Bazar, they dedicate their lives to relieve the suffering of nearly one million Rohingya refugees and host communities in a complex and challenging setting. These are the stories of nurses and midwives who are leading and inspiring the next generations to save lives whilst upholding patient’s safety and dignity.
Moriam Begun, aged 21, had her second child at the Cox’s Bazar refugee camp with the help of a skilled midwife. WHO Bangladesh/Tatiana Almeida
A midwife in the world’s largest refugee camp, Mustarina Kathun is considered among her peers one of the most committed professionals working at Relief International.
“I was 17 when my neighbor died during labour after a healthy pregnancy. I remember thinking that a skilled midwife could have saved her and the baby, it seemed so easy to prevent maternal deaths. On that day, I decided to study midwifery so I could provide a safe and positive childbirth experience to as many women as I could get hold of in my lifetime. This is my promise to every woman and every child”, tells Mustarina Kathun.
A skilled and highly committed midwife, Mustarina completed her education in 2018 and has since been working at the Rohingya refugee camp in Cox’s Bazar where she provided quality care to over 1000 Rohingya women having attended to 500 labours to date.
“My mission is to provide quality care and dignity to Rohingya women before, during and after pregnancy. Sometimes I need to take the lead in critical situations, in the 500 labours I attended to around 150 were very challenging but I can say that I haven’t lost any of my patients”, she says proudly.
Midwife Mustarina holding a one-day old Rohingya baby next to the child’s proud grandmother. WHO Bangladesh/Tatiana Almeida
To achieve universal health coverage by 2030, the world needs 9 million more nurses and midwives. In Bangladesh, where doctors are a large majority among the health care workforce, there are 61 378 nurses and 4396 midwives.
In Cox’s Bazar, as of April 2020, three thousand five hundred health care workers including 360 doctors, 357 nurses, 341 midwives, 219 paramedics, 1400 community health workers, among others, are at the frontlines of the CoVID-19 response.
In November 2020, the facility-based delivery rate in the refugee camps has reached 60%. According to the District Health Information Software 2 (DHIS2) system, as of September a total of 96 461 women of reproductive age (WRA) in the camps and nearby host communities have been first-time users of contraceptive methods. This includes access to long-acting reversible contraceptives (LARC), and family planning methods such as subcutaneous injectable contraception (DMPA). The majority of such services are ensured by dedicated midwives and nurses.
A senior staff nurse at a government hospital, Sufala Kahtun (on the right) is providing care to critically ill CoVID-19 patients in Cox’s Bazar. WHO Bangladesh/Tatiana Almeida
Originally from Dhaka, senior staff nurse Sufala Kahtun wanted to join the frontlines of the CoVID-19 response in Cox’s Bazar and help her country recover from the pandemic. She is currently working at the high-dependency and intensive care units (HDU/ICU) at the 250 Bed District Sadar Hospital.
“I joined this noble profession to promote health, prevent illness, and care for ill, disabled and dying people and, eventually, make my family proud of the person I have become. But this year has been particularly challenging: I have been working 24h shifts, spending many hours in a PPE (personal protective equipment) because there aren’t enough human resources for the number of inpatients we have. This has been the most stressful year of my career”, shares Sufala Kahtun.
According to the Directorate General of Nursing and Midwifery (DGNM) in Bangladesh, as of October 2020 more than 2200 nurses and 70 midwives have been infected with CoVID-19.
WHO’s Case Management team has been supporting Sadar Hospital’s Intensive Care Unit (ICU) by bringing together clinicians, doctors and nurses to link with remotely based ICU consultants and specialist nurses from around the globe to discuss current inpatient cases that the team is treating in their unit. WHO Case Management Consultant and a nurse at heart, Ina Bluemel is making sure that nurses have a say in a male and senior clinician dominated environment.
“Over time and with the probing of the international nurses in the online meetings, the nursing staff is coming forward more often demonstrating detailed knowledge of the patients’ condition and needs and adding critical information for a holistic understanding of the cases”, says Ina Bluemel. “What I enjoy most is that after innumerous online meetings the clinicians themselves are now probing the nurses for their input and frequently express their pride of the quality of services the entire team is able to provide”, she adds.
WHO Case Management Consultant, Ina Bluemel is a nurse who has been working at the frontlines of emergencies across the globe, from floods to earthquakes, storms and international conflicts. WHO Bangladesh
It is largely recognized that having more women humanitarian leaders will help transform the humanitarian system and foster the recognition, safety and well-being for health care workers from different cadres, including nurses and midwives.
At the 73rd World Health Assembly, held in May this year, 2021 has been designated as the International Year of Health and Care Workers in recognition of the dedication and sacrifice of millions of health care workers at the forefront of the CoVID-19 pandemic.
Committed to establish synergies between health worker safety and patient safety policies and strategies, the World Health Organization has drafted the Health Care Worker Safety Charter and is calling governments and key stakeholders to sign it up in global solidarity for health workers and patients.