Freda, from Dumfries and Galloway in Scotland, was one of the UK-Med members who helped treat patients following a Diphtheria outbreak in Cox’s Bazar refugee camp in Bangladesh in 2017.
On top of her experience of working on the UK-Med Register, she has a wealth of humanitarian experience, including working with MSF on the North Jordan border and treating patients in Gaza with Médecins du Monde. She shares how her experience deploying overseas has built her confidence and passion for the NHS.
It builds your resilience, your capabilities, and ability to feel calm. I think it’s very good to have worked in low resource hospitals so that you’re able to appreciate what you’ve got and what’s available at home.
Having seen the atrocities that I’ve seen overseas, nothing much fazes me in the UK anymore! People remark that I’m always very calm in a crisis, probably because of the things that I’ve seen and experienced. I do try and reassure patients here that we have great facilities available, that we are well-resourced in the UK, and that there will be something that we can help them with.
Here in Scotland, we’re not by any means too remote – but I’ve still been able to share that experience with the local team for when everything is not always available at our fingertips.
I do a lot of teaching with students and junior doctors. Some of my role is in simulation where I can talk to them about: ‘Well, what if you didn’t have that available? What if you didn’t have that drug? What would you do? How can you think about other ways of providing that care if you didn’t have it to your fingertips?’
When you return home, on reflection you think, ‘well, actually we’re so lucky.’
The appreciation that you bring back of what we’ve got and what we can offer is immeasurable. You come back so enthusiastic, and you’re full of stories and things to tell everyone. I think that excitement rubs off on your colleagues too because they’re interested to know what you have been doing.
You have to take some time out and recognise that you have to get away from it – which is more challenging when you’re overseas as you can’t necessarily do that. In Jordan and Gaza, due to security, we were not able to even walk outside our house and hospital.
In the emergency department in UK, I think we’re very bad at taking breaks especially when there’s a queue of patients out the door. You do have to have some kind of escape valve.
We have had some pretty tragic events happen locally, it is difficult for staff to switch off. So I helped to try and organise departmental walking groups so we can get out into the hills.
That’s absolutely something I missed when I was away – not being able to do that with my colleagues. So recognising that when you come back how we’re lucky enough to be able to do it.
I did a Leadership Management course in NHS Scotland where I used some of the tools that we developed in Bangladesh to talk about on that course.
In Bangladesh, we had to write our SOPs (Standard Operating Procedures), develop charts for monitoring blood pressures and temperatures, and develop our own drug regimens for the diphtheria antitoxins because there were none. You’d work in the evening to try and think with a small team of other UK Med clinicians: This is the problem. How can we get around this? How are we going to delegate these tasks to others to help us?
In Bangladesh, we had a pharmacist with us, and we were giving away antibiotics and paracetamol to our patients when they were being discharged. Because many of the Rohingya population couldn’t read, and we certainly couldn’t write anything in Burmese, we devised various pictures of suns and moons to symbolise days and nights and the numbers of tablets that they needed to take which we made into stickers and stuck them on the medication.
That was all through team working and recognising the problems and how we could come up with solutions. And you can take all those skills back into the NHS.
“That was all through team working and recognising the problems and how we could come up with solutions. And you can take all those skills back into the NHS.”