Real Heroes Don’t Wear Capes – the Role of Health Workers in Emergencies

By Moy Bracken, Key Correspondent for the Irish Forum for Global Health

We feel a responsibility towards the people of Southern Sudan, but we need support

-A Sudanese health worker at the 4^th Global Forum of Human Resources for Health

Three scenarios from different contexts, but the similarities are striking. The role of the health worker in emergency relief is vital. Infectious outbreaks, natural disasters and conflict all result in increased demands on health workers. Situations are further complicated when the health system is already in chaos. Speakers from Liberia, Nepal and Sudan documented the bravery of health workers in their countries at the 4th Global forum for Human Resources for Health. Their stories brought home the crux of the matter: health workers are people too. In times of emergencies they also suffer, but continue to help when they are needed most.

The ongoing conflict in Darfur, Sudan has placed a burden on the health system.

Violence is a cause and consequence of massive planetary changes. Health workers are active participants in such violent social processes. Sometimes they are targeted.

said Dr. Enrico Pavignani, an expert on health emergencies. During times of insecurity and instability, much of the health work is done informally. This means the full contributions by health workers are often not recognised or remunerated.

In 2015, the earthquake in Nepal affected health workers and their families. ‘They still had to provide services, despite psychological stress and a challenging workload’ said Dr Ramkrishna Lamiachane (Nepal Ministry of Health). Structural damage to health centres meant sometimes their place of work was not safe. People were forced take on tasks that exceeded their professional skills.

During the 2014 Ebola crisis in Liberia, health workers remained working at the frontline, despite the high risk of contracting the virus. They paid a high price. 378 were infected with the virus, 192 died. ‘The system was not prepared enough to protect them’ admitted Dr Catherine Cooper (Assistant Minister for curative services Liberia). Without the selflessness of health workers, the casualties in these emergencies would be far greater.

The importance of preparedness was a recurrent theme in today’s talk. Planning is key. Fail to prepare, prepare to fail was a mantra echoed by of all the speakers. However, these plans must be made with the country’s resources in mind. Management and ownership of these plans are also important. The human resources shortage is more complex than an imbalance in supply and demand. It is about effective management and better utilization of existing health workers. But have we learned lessons from past experiences? We heard examples of how Liberia has set up a Public Health Institute to monitor and manage potential outbreaks post Ebola. Nepal has formulated a new rapid response plan to deal with future emergencies. In Sudan, there is a drive to incorporate responses to emergencies into health worker training.

It is inspiring to hear about how resilient health workers are in times of crisis. However, they need more than just our gratitude and admiration. Learning from previous mistakes is an encouraging step in the right direction. It is unfortunate that it often takes a disaster for our health worker issues to be noticed.

November 16^th, 2017

Moy Bracken recently graduated from the Masters in Global Health Programme at Trinity College Dublin. Moy’s interests cover the areas of epidemiology, access to medicines, and achieving health equity. She is currently working as a locum pharmacist in Dublin.