Red Cross nursing: “I just go where they ask me”

1 March 2012

FIONA CASSIE talks to recent Florence Nightingale medal winner Andrew Cameron about the momentous and mundane of being a Red Cross nurse.

Andy Cameron was a 19-year-old welder when a hospital visit to an injured mate set him on the path of that most famous of war-zone nurses.

He started as the only man in a class of 43 women at Hutt Hospital in the days when male nurses had separate registration and blokes – unless they were doctors of course – were not welcome in the maternity award (it was only the 1977 Nurses’ Act amendment, mid-training, that saw him able to graduate with the same registered nurse status as his female colleagues).

The initial expectation to learn obstetrics and gynaecology from a textbook galvanized him. “It didn’t put me off nursing; instead, it made me more determined, so I (eventually) went and trained to be a midwife.”

Midwifery training also fitted in with Cameron’s early nursing ambition to run a backcountry district hospital.

If it was isolation and autonomy he wanted, his ambition has been met; but if he had a hankering for the quiet life, he definitely struck out. List the world’s biggest trouble spots of the last decade and Cameron has worked in many of them.

The readiness of Cameron to apply his considerable skills anywhere he’s asked to saw him last year awarded the highest international nursing award, the Florence Nightingale medal.

His career path, which has taken him nursing near the Khyber Pass and in the Yemen mountains, began with him checking off the skills required as a bush-hospital ‘matron’, including crossing the ditch for his Melbourne-based midwifery training.

Health reforms this side of the Tasman saw cottage hospitals closing left, right, and centre in the 80s and 90s, but in Australia’s more geographically isolated locations, they were still deemed essential services.

Tropical island to desert

In 1992, he headed for the tropics as director of nursing of Mornington Island’s 10-bed hospital – serving an aboriginal community of about 1000 people in the Gulf of Carpentaria.

It was his first taste of isolation – nearly 500km from his line manager at Mt Isa on the mainland – and doctor visits were rare. The island is now dry, but back then, alcohol and domestic violence problems were common, and public health issues included a meningitis outbreak and the occasional case of tuberculosis and leprosy.

The belief that he and his nursing staff were making a difference kept him there for seven years. A study sabbatical in 1995 saw him gaining his masters degree in tropical health at the University of Queensland (including an award-winning research thesis on the epidemiology of malaria in Guadalcanal) and meeting his German medical student wife. Daniela is now a GP living in Germany with their two daughters Emily (13) and Josephine (11).

In 1999, Cameron exchanged the tropics for the desert, becoming the sole health professional for the gold mining ghost town of Cue, in the centre of Western Australia.

A doctor visited the mining and sheep farming community of about 250 people once a week, but otherwise, Cameron was the on-call answer to the community’s health issues and emergencies. He must have done an okay job as he was nominated and subsequently won the Australian Nurse of the Year award in 2004 for his services to remote-area nursing.

Sudan war victims first mission

The search for a new challenge saw him in 2005 being accepted by Red Cross for work overseas. For his first mission, he was sent to Lokichokkio, a north Kenyan town on the border with Sudan, where Red Cross had a 500-bed field hospital, treating the war-wounded from over the Sudanese border.

“That is where I cut my teeth on nursing care of the war-wounded,” Cameron says.

Seeing his first battle casualties was “quite traumatic”. “But you just have to get on and help with getting people to surgery as quickly as possible”.

Victims of war were a new phenomenon to Cameron, but obviously, not to Red Cross, and he learnt how to adapt to the long tried and tested systems of an organisation that has been offering humanitarian aid to victims of armed conflict since its founding in 1863.

At the end of his six month mission, the hospital’s activities were relocated into Sudan itself and Cameron followed, with his next mission being director of nursing at the 25-ward Juba Teaching Hospital where he and six other Red Cross nurses offered training support to the Sudanese nursing school and the 400 nurses working across the hospital.

By then, he was well immersed in the humanitarian aid world, and the missions have kept coming ever since: Afghanistan, Yemen, Iraq, and South Ossetia.

At the moment, the lifestyle suits Cameron down to the ground. Brief respites include farming his bit of land in Porangahau, Hawke’s Bay, between stints working with the war-wounded and displaced.

The remuneration on mission is not an attraction. He says it is quite similar to what he would earn here, although basic expenses are covered. The work is also disruptive to Cameron’s social and family life, forces him to live out of a suitcase, and he risks finding himself in the wrong place at the wrong time in one of the world’s hot spots.

But Cameron thinks it‘s a great job.

Red Cross allows him to use his initiative and skills to make a difference to the civilians and nurses of the countries he’s in – be it streamlining triage to avoid ER bottlenecks or improving the plight of prisoners of war. He may one day seek a job back in Hawke’s Bay but is unsure how his niche skills would translate into a ‘civilian’ nursing job (though often between missions, he ducks back across the Tasman for a short-term relieving contract to keep up-to-date professionally and retain his Australian practicing certificate).

Hawke's Bay to Kandahar

Currently, he is in Afghanistan for his third mission since 2008. This time to Kandahar, but the first time was managing the surgical division of the Jalalabad Public Hospital Number One, near the Khyber Pass, whose patients included victims of the ongoing conflict.

Cameron says when on a mission you work, live, and socialise with your team. “You stick together for months, sometimes living in the same house… we all get along famously, as a rule.”

You also often work with a mini ‘United Nations’ of colleagues. The team for his male-only mission to Yemen was made up of a Spanish water engineer, a Pakistani food security officer, a Chechen administrator, a Lebanese co-operation delegate, and Cameron the kiwi nurse.

Cameron’s role there was to ensure clinics for displaced people in the highlands ran smoothly, but travel could be “extremely difficult” with reports of ‘insecurities’ forcing last minute detours. And yes he’s been around gunfire. “But we didn’t stay there for too long,” he adds laconically.

Cameron muses that he’s never turned a mission down, but he did choose Iraq over Lebanon and went to Najaf, a large city on the Euphrates, to manage a series of ER training programmes being offered to groups of Iraq nurses, where most nurses are male.

After the highlands of Yemen and the war-torn situation of Jalalabad, the relative wealth of Najaf stood out. “You notice a big difference”.

“On some missions, you feel like you are the one in prison – you can be quite confined due to the constraints required for security,” says Cameron. And tight security has its frustrations. He is a keen jogger but there are limited options when you are stuck each night in a guarded compound because of the risk of ‘untoward events’.

“In Yemen, I used to run around the house – twenty-five times one way and twenty-five times the other way. I wore a big track in the grass around the house and the other fellows used to laugh at me.”

Entertainment in the usually alcohol-free zones also has to be homegrown – reading a book, playing ping-pong, hosting wine-less dinner parties, and the like.

“You just make your own fun … it’s not forever.”

When he’s back in New Zealand, he can catch up with movies, mates and family… not to forget tucking into some paua fritters.

However, the relative freedom of his last mission was quite appealing. That was in South Ossetia – a small territory tucked between Georgia and Russia, which in 2008 became caught up in a territorial turf war that left many people’s lives in disarray.

Cameron’s job was to act a bit like a roving district nurse, supporting about 40 slightly neglected little health clinics in communities on the northern side of the boundary. It was in the South Ossetian town of Tskhinvali that he heard about winning the Nightingale medal.

The town was not big on bars or pubs, but locals make homemade wine and vodka, so he was able to have a drink to celebrate the honour.

His latest break back home included a visit to Government House to receive his medal from Governor-General Sir Jerry Mateparae. There to share the moment was his family and the former Hutt Valley director of nursing Vera Ellen, who courageously took on the motorbike-riding welder back in 1976.

Cameron says he didn’t envisage back then that nursing would take him “to these interesting places”. Nevertheless, wherever he ends up in the field of humanitarian aid is incidental to Cameron, who stresses that it’s the immensely rewarding nature of the work that is key to him.

“I just go where they ask me.”