Case Study – Debbie

Debbie is a clinical nurse specialist in infectious diseases working in Birmingham. She was one of the first volunteers to go to Gulu, Uganda in 2005 a few years after she qualified, as part of a link between the hospital she worked at then, and the hospital in Gulu for 8 months.

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I’d always wanted to travel more and go and work somewhere that was more resource poor and just have that experience. Obviously, I’d worked for a few years, but I wasn’t really experienced, and I think going out there I just learned so much on so many levels and it was a really good start to my career in infectious diseases

As some of the first volunteers to go on this link, Debbie was briefed about safety, but the links with the medical ward were very new.

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So that was really exciting as well because it gave us the chance to try and really build the relationship between Wythenshawe and Gulu, which is amazing, really. It felt like I was being a bit of an ambassador for the hospital as well as doing something that I’d always really wanted to do

Debbie and her colleague had some crossover time with other staff, which helped them to adapt to the Ugandan culture over time. She feels it was important not to be blasé or there is a danger of offending local people. Gradually she made links with staff in the hospital as well as the NGO community in the area. She remembers that one ward manager was ‘quite scary and intimidating’, possibly because she did not understand fully why Debbie and colleagues were there. However, because they worked hard every day, and worked alongside her, they built a real rapport.

Debbie had volunteered for a medical ward as this was her background, deciding it was important work in a clinical setting she was familiar with because working in another country would be enough out of her comfort zone.

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I don’t think anything can totally prepare yourself for going and working somewhere where there are no drugs and there are no tests and there are no scans to guide anything. So we did feel like we were having to use our clinical assessment skills much more and needed to work closely with the local doctors and nurses there to make decisions about patient care, but there weren’t enough staff for the vast amount of patients needing treatment

Debbie was also very aware of her NHS attitude…

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“We’re going to go in and do everything and save everyone”, which she realised was very different to the approach in Gulu, which she initially struggled with. “As the months went on, we started to understand why. The nurses on the ward would see someone come in that was so sick they knew they weren’t going to survive. Yet we’re very much like, Oh well, we need to do everything. But they’d be like, ‘No, I don’t want to give them the four antibiotic vials that we’ve got left, because actually there’s a boy here who’s much more likely to survive. So let’s use them for him’. And that’s a really strange attitude to get your head around when we’re just flush [in the UK] with all the treatments we need. It took a while to grasp that, I think because we didn’t realise how hard it was to get hold of medication and how much families had to chip in if the government hospital couldn’t get hold of things”

Debbie also worked on the documentation on the ward, introducing a formal drug chart and teaching on drug administration. Debbie recognises there was mutual learning beyond the clinical area – about life in the UK and Uganda…

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“…we made friends and we went to some of the villages and saw how they were living. And they were just so kind and really looked after us.”

In addition to developing her clinical assessment skills and cultural awareness, Debbie recognised she developed resilience, confidence and problem solving skills…

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“…when everything in your day is quite a struggle, you just have to learn to just roll with it!”

Before volunteering Debbie had the start of an interest in infectious diseases…

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“…but then going out there really sparked off a massive interest in infectious diseases because we saw so many things that we just wouldn’t see in the UK. I think the experience of volunteering probably sparked off my interest”

Since returning from Gulu, Debbie has completed a Tropical Nursing Diploma and a Masters in humanitarianism and conflict response. She worked as a TB nurse and went to work in Sierra Leone during the Ebola outbreak. Debbie continues to work in infectious diseases.

Would Debbie recommend a global experience to others?

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“I would just say just take the opportunity and grab it with both hands because it is amazing to experience working somewhere that is totally different from your norm and, the people you meet and the experiences you have will be valuable for the rest of your life.