Looking back after 15 years working as a nurse in different types of health institutions I’m still unable to pinpoint the exact moment when helping another person stopped being a choice for me. Somewhere along the way, “going the extra mile” was no longer an “extra mile”, it was just a good old regular “mile”, something that grows on you as a second nature.
Being the source of comfort and smile for in others has always brought me the most warmth, it made the job worthwhile. Although the effort is not often recognised as it should be, this way of life shaped my general notion of nursing, what it means to show support, help in an impossible/painful task, reduce suffering or simply to lend our time and ears without having double thoughts.
Being on the inside gives me the possibility of living “on my skin” the actual challenges and shortcomings of the profession but also the advantage of looking at gratitude, trust and health progression in the widest variety of people.
Like in every other professional career, patients have an outsider view, feel and expectation of nursing professionals. Some expect “24-Hour service“ to fulfill their every need, others suffer in silence as to not bother the seemingly busy nurse or doctor. Others vent their anger and frustration originated by the disease, making their pessimistic views of their progression very clear to everyone, while some are highly motivated and full of energy, facing challenges head on.
There are a lot of variables that affect Human behaviour when suffering from a disease or other health concern. Positive or negative emotional responses and behaviours are not only swayed by the patients current environment but also their past experience, social status, knowledge, society, degree of pain and pain tolerance etc.
As members of “developed” and peaceful democracies we grow accustomed to being able to express our gratitude or discontent at a service, even allow ourselves to be somewhat ungrateful when placing our expectations too high and evaluating our benefits as too low. Why “ungrateful” you ask? We contributed to society, so we deserve to be well treated, well fed, to have no pain and to always be cared for. It is often forgotten that not everyone has those rights.
You can go freely to your doctor or hospital without much hassle, choose which medicine you take or which therapy you think is best for you and, with more or less enthusiasm, show your unhappiness when the results are not perfect. Now imagine what that would be like in a war situation. How easy do you think it would be to safely get medical assistance, medical supplies or even clean food and water when the streets where you used to go to work are continuously under fire. Would the conflicting armies recognize you as a civilian and let you search for assistance? or even allow you to get medicine? Would the hospital be a safe place to go? or would doctors even be available? What about after the chaos? What’s left under the rubble?
Wandering around in the confusion of our jobs, houses, family, friends, debt, education… Who among us has ever had to worry about losing a leg to a hidden mine, the constant roaring of sirens, the sight of big metal birds in the sky, dropping miniatures of the burning sun in what seems like random places of your city. Surely they wouldn’t do it if they knew we
are down here. Who among us has had to worry about finding available shelter for your family before fire rains from the sky. Surely the combatants would not hurt unarmed civilians, they are just here to fight their enemy, not us. Plundering, violence, unlawlessness, sexual abuse, child recruitment… all of those things wouldn’t ever be on their minds, they shouldn’t be…
Who among us has had all their belongings, their family, their dignity, their life… taken by force.
Too many can’t even find the strength to search for humanitarian aid, let alone to have meager thoughts of ungratefulness or dissatisfaction. The numbers of civilians affected by war, violence and tyranny are high and help offered is more than often scarce. This is the violence of terror and the terror of violence.
Being a nurse or a doctor is being intrinsically connected with Humanitarianism, which basically says that people’s duty is to promote human welfare1, a word we do not hear often enough. It is one of the core principles of the healthcare profession and there are a number of associations which try to nurture this principle in local individuals and institutions living in safer life conditions worldwide, in order to extend the umbrella of help available to people in need. There is an association between nursing and an organization that almost every person can instantly recognize due to their shared history, meaning and most notably, it’s symbol.
If I ask any child to draw a nurse, they will first draw a person obviously, but how do they differentiate this person from any other job? They will very likely always draw the same symbol to identify them as a nurse, the internationally recognized red cross on a white background. Although confusions with the flag of switzerland are common2, which also has a reason of its own, the red cross is globally known as the symbol for the International Committee of the Red Cross organization3, and also nursing!
International Committee of the Red Cross
Established in 1863 in Geneva, Switzerland(hence the connection to the swiss flag), the ICRC4 is the largest international humanitarian non-governmental-organisation aiding and protecting victims of conflict and armed violence, like war wounded, prisoners, refugees, civilians and other non-combatants. It is a part of the International Red Cross and Red Crescent Movement5, a network of approximately 80 Million volunteers worldwide that expands the goals of the ICRC to protect human life in disaster, health/social issues and other emergencies(epidemics, floods, earthquakes, etc.) across different societies. Along with the ICRC the movement also consists of the International Federation of Red Cross and Red Crescent Societies, which in turn coordinates the 191 National Red Cross and Red Crescent Societies distributed around the world assessing and serving the local needs.
“The International Committee of the Red Cross (ICRC) is an impartial, neutral and independent organization whose exclusively humanitarian mission is to protect the lives and dignity of victims of armed conflict and other situations of violence and to provide them with assistance.
The ICRC also endeavours to prevent suffering by promoting and strengthening humanitarian law and universal humanitarian principles.
Established in 1863, the ICRC is at the origin of the Geneva Conventions and the International Red Cross and Red Crescent Movement. It directs and coordinates the international activities conducted by the Movement in armed conflicts and other situations of violence.”6
The ICRC’s Mission Statement
United by its seven fundamental principles of humanity, impartiality, neutrality, independence, voluntary service, unity and universality they play an important role alleviating the suffering of vulnerable people in countries like Syria, Lebanon, Yemen, Afghanistan, Iraq, Myanmar, etc.
In June 1859, a swiss businessman named Henry Dunant traveled to Italy for a meeting with the emperor Napoléon III to discuss business matters in french occupied territories. Arriving in Italy he witnessed the terrorific result of an engagement for a war of independence in Italy. Forty thousand soldiers either dead or wounded lay on the battlefield with no assistance. Shocked by their suffering and lack of basic medical care, he put aside his main objective and devoted himself to the treatment of those wounded soldiers, organizing an immense amount of support by motivating the local population to help without discrimination. Three years later in 1962 he published a book called “A memory of Solferino”7, which he sent to european leaders, vividly describing the suffering he saw in the post-war battlefield and advocating the creation of national relief organizations to nurse wounded soldiers and also international treaties to guarantee the neutrality and protection of medics, nurses, field hospitals as well as those wounded in battle.
One year later, in 1863, he founded the International Committee for Relief of the Wounded together with other important and experienced figures of the swiss army and health departments to discuss if his ideas were feasible and to organize an international conference to discuss their implementation.
On 22 August 1864, an official diplomatic International conference attended by representatives of states and kingdoms from all of the world invited by the swiss Government was held in Geneva. In this occasion the famous Geneva convention “for the Amelioration of the Condition of the Wounded in Armies in the Field” was signed by the 12 participants9, establishing for the first time legally binding rules guaranteeing neutrality and protection for those wounded or helping in armed conflict, also declaring the rules necessary for the recognition of newly founded national relief societies by the international committee. In this same conference the red cross was introduced as the official symbol.
The name International Committee of the Red Cross was adopted in 1876 and maintained until today. The organization was awarded its first Nobel Peace Prize in 1917 by the Norwegian Nobel Committee “for the efforts to take care of wounded soldiers and prisoners of war and their families.” achieving even more international recognition, and two more times in 1944 and 1963, being the institution with the most Nobel Peace Prizes10.
The first world War
In the first world war, the ICRC worked to restore links between captured soldiers and their families, intervened over the use of arms that caused extreme suffering, like mustard gas, and had volunteers running ambulance services and caring for the wounded on the battlefield11. After the war, it was very active in civil wars and persuaded governments to adopt new conventions, although not in time to protect civilians and prevent some of the atrocities of the second world war.
The second world war
During the events of the second world war, the Red Cross was active in the shipment of supplies across the globe and tried to assist victims on all sides. Although, due to its ties with the swiss establishment and lack of a specific legal basis(not enough legal coverage), it was unable to tak decisive action or speak out for the victims of the holocaust and other persecuted groups.
After the second world war the organization continued to expand, playing important roles in many zones of conflict and promoting revisions and adoptions of protocols for further geneva conventions, increasing the legal coverage of its action in armed conflict.
Red Cross and nursing
Being a nurse in the modern sense was nowhere close to where it is now in the 17th century. The structure of the career started to take shape thanks to the founder and pioneer of modern nursing Florence Nightingale. Internationally renowned for her management and training of nurses and care for the wounded soldiers during the Crimean War in 1953, she gave nursing a very positive reputation by being know as “the lady with the lamp”12 because of her midnight rounds to check on wounded soldiers. She later founded what would be known as the first secular nursing school in the world in London, laying the foundations of professional nursing for the future. Nightingale is also credited for innumerous sanitary reforms promoting hospital hygiene and sanitation, improving statistical data visualization and expanding the acceptable forms of female participation in the workforce.
In 1883, Nightingale became the first recipient of the Royal Red Cross, a military decoration awarded in the United Kingdom for exceptional services in military nursing13.
The International Council of Nurses (ICN) has, since 1965, celebrated the International Nurses Day on the 12th of May, the anniversary of Florence Nightingale, to mark the contributions made by her and all nurses to society14.
The ICRC also attributes the Florence Nightingale Medal in honour of the renowned english nurse to award nurses or nursing aides who have distinguished themselves in times of peace or war.15
The famous connection between nurses and the Red Cross was made after the creation of the American Red Cross by a self-taught nurse named Clara Barton, known as the “Florence nightingale of America”16 who is recognized for humanitarian work during the american civil war. She was introduced to the Red Cross and Henry Dunant’s book and later invited to represent the American Branch of the Red Cross. She promoted the acknowledgement of the ICRC in the United States of America and immortalized the Red Cross-Nursing connection internationally.
Statistics and funding
The modern ICRC is present in more than 100 countries with 18,800 staff members working around the world. According to its latest annual report (2019)17 had a total expenditure of 1,792 million Euros of which 1,564 million were spent on the field, a great majority in assistance and protection. All of this funding comes from voluntary contributions from the states who signed the Geneva conventions, such as Switzerland, the United States of America, European states, Australia, Canada, Japan and New Zealand, also Red Cross and Red Crescent Societies, supranational organizations and public and private donors.
12 Swenson, Kristine (2005). Medical Women and Victorian Fiction. University of Missouri Press. p. 15
13 “No. 27677”. The London Gazette. 17 May 1904. p. 3185
16 Barton, William Eleazar (1922). “The Forerunners of the Red Cross”. The Life of Clara Barton:
Founder of the American Red Cross, Volume 2. Houghton Mifflin. p. 115
All of these numbers can back its incredible humanitarian effort and its successful statistics, which include:
● 981 people reunited with their families, of which 773 were minors,
● approximately 1 million detainees visited,
● 4,7 million people received food aid of which approximately 60% were internally
displaced and 40% were children,
● 34 million people benefited from water supply of which more than 77% in the near
and middle east,
● 28,5 thousand prostheses were delivered and 471 thousand physiotherapy sessions
conducted, more than half in Afghanistan.
Numbers that put in perspective the size of global human need, making us only imagine the order of difficulty expected in the organization of such a movement.
Facing the challenges of the present
Nowadays the organization faces multiple complex problems in various countries, with its largest operations being in the Syrian Arab Republic, South Sudan and Iraq. The current COVID-19 pandemic poses an extra burden on the task of supporting victims of conflict. In addition to distributing basic care to frail health systems, it must now organize activities to provide protective measures to displaced people often living in crowded refugee camps and inadequate sanitation, shelter and/or nutrition.
“Since the COVID-19 outbreak, we have developed an emergency plan to ensure continuity in the most critical hospitals we support around the globe. This means increasing stocks of essential medical supplies and putting in place, or reinforcing, contingency plans and infection prevention and control measures in hospitals that are highly dependent on the ICRC support for their functioning.”18
The ICRC also makes sure that detention facilities, sometimes characterised by overcrowding, poor ventilation, deficient hygiene, are respecting the needed measures to avoid contagion through the detainees, visitors and guards.
“In many places of detention around the world, the ICRC works together with relevant authorities to strengthen standard practices such as the medical screening of new arrivals and the setting up of prevention measures – such as hand washing stations – for detainees, visitors, guards and delivery personnel. We also support disinfection measures, such as fumigation campaigns and distribute soap and other hygiene and cleaning materials to detainees.”19
Another struggle originated from the pandemic is the hardship to meet its annual budget. The COVID-19 pandemic has increased the need for humanitarian aid, meanwhile donors have faced financial pressures due to the global economic decline caused by the virus, leading to a cost-cutting plan which included the elimination of some posts at its headquarters in Geneva.
Our place in the global perspective
After reading only a small piece of the work,statistics and activities of such immense organizations we are left in the position to question our place in the world and how we can and should make a difference. We have certain privileges and freedoms that millions have never seen or heard about, privileges we shouldn’t take for granted. In addition to those freedoms, there are a hundred other problems that we can simply skip worrying about, that are cared for under the engines of a structured and functioning society. Using that position of comfort to provide aid to those in need is not only a statement about our increasing consciousness and intelligence but also a step towards global solidarity and empathy. Together with other civilians and health care workers, Nurses are key contributors to Human evolution, deserving the honour bestowed by an Internationally dedicated day.