1. O'Shaughnessy, Patrice


'What does a nurse with a degree in conflict resolution do?'


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Nurse Michelle Mays has served with Doctors Without Borders/Medecins Sans Frontieres (MSF) in war zones and in the midst of epidemics, but her three months as a project coordinator in the Central African Republic proved to be one of her most challenging assignments. Arriving in August 2013, Mays came to coordinate a large, 115-bed hospital at a time when the landlocked nation was gripped by what the aid group calls "a crisis on top of a crisis."

Figure. Michelle May... - Click to enlarge in new windowFigure. Michelle Mays speaks at a ceremony marking the opening of an operating room in Baraka, Democratic Republic of Congo. Photo courtesy of Michelle Mays.

On March 24, 2013, a coalition of rebel groups took over the country's capital, Bangui, ousting the president and embarking on a violent rampage. Many people were driven from their homes; others suffered summary executions and rape. Of the 13,000 patients Mays's hospital saw per month during her assignment, some 10,000 had malaria. "Prior to the coup, there was already malaria in astronomical numbers," said Mays. "Now people have fled their homes and are living in the bush, where they're even more exposed to mosquitos."


MSF, which has more than 100 international and 1,100 local staff working throughout the region, is providing free medical care to about 400,000 people in the country in seven hospitals, two health centers, and 40 health posts. When bloodshed escalated in December-MSF treated 190 people in two days for bullet, machete, and knife wounds-the catastrophe was compared by the international community to the genocide in Rwanda.


"There have been attacks on humanitarian aid workers, and many groups had to withdraw, so there is less access to medical care," said Mays. And while MSF has always been viewed as a neutral organization, dedicated to saving lives, the group is wrestling with tough questions. "Can we stay? Should we leave? It's hard to leave patients," she said. A spokesman for MSF said it was unlikely that the group would withdraw, although it plans to reduce operations. Mays returned to the United States last October.



Mays, now 30, started working with MSF when she was 25 years old. She grew up in Maryland, just outside Washington, DC, where she received her nursing degree from the University of Maryland and worked as a pediatric nurse at Johns Hopkins Hospital in Baltimore.


"I always had a lot of interests[horizontal ellipsis] I really always admired nurses," said Mays. "The work is special and unique. But I was fairly sure my goal was not [to be] a traditional nurse." Mays searched for a graduate program that would combine her interests in philosophy, global affairs, and ethical issues, and decided to focus on international relations. She earned a degree in ethics, peace, and global affairs from American University. While in the program, she traveled to Bosnia with a human rights delegation, as well as to Israel, Palestine, and India.


Mays said she eventually asked herself, "What does a nurse with a degree in conflict resolution do?" The answer came in 2008, when she decided to join MSF. Her first assignment was in Manipur, India, working with local staff on issues such as HIV, tuberculosis, and maternal and child health. "I was overseeing three or four clinics, a reproductive health program, HIV, TB," she said. "Suddenly I was managing a very large team. It was a baptism by fire."


Two weeks after she returned from India, she flew to Haiti following the January 2010 earthquake and remained there for three weeks. "The trauma hospital was collapsed. We treated patients-most of them needing trauma surgeries-in the pharmacy building, the courtyard, in shipping containers, under tarps," she recalled.


She was deployed to Haiti again later that year for what she saw as an even bigger crisis-the cholera epidemic. "Things were chaotic; the Haitians never saw an epidemic like that. I had to keep telling them, 'The iv bag cannot run out.' The first couple of days I was checking pulses, making sure people were alive."


Her next assignment, for seven months in 2011, was the war-torn Democratic Republic of Congo, where she was an outreach nurse, crossing front lines in mobile clinics to help people cut off from medical care. There she treated malaria patients and victims of sexual violence. In 2012 she returned to that nation for 11 months as a project coordinator at a large hospital.


In February 2013, she went to South Sudan, which had been struggling since gaining its independence from Sudan in 2011. Unlike the Congo, where "you could find trained nurses in the middle of a war zone," Mays said, there was a lack of educated health workers in South Sudan, and so Mays and her team trained people to be nursing assistants.



At the time of this writing, Mays was set to embark on her new assignment-coordinating the MSF's emergency surgical program at Ramtha Government Hospital in Ramtha, Jordan, a town bordering on southern Syria that has seen some of the heaviest fighting in Syria's civil war. The surgical program began in September 2013, and within three months MSF had conducted 309 life-saving surgeries, including operating on people needing multiple amputations and those with severe abdominal and chest injuries.


Mays knows that conditions in Syria will be difficult, but she feels that at least the world is aware of the Syrians' plight. The situation in the Central African Republic, on the other hand, is new to the headlines. She hopes to bring attention to the crises in that country, but she also wants people to know of the bravery and compassion of its citizens. One day, for example, her team traveled to an MSF health post in a village outside Boguila that had been attacked by gunmen and whose residents had fled into the bush. Before MSF had even arrived, "they were getting medical care from one of the local staffers," Mays recalled. "He said that before he left the village, he took medication with him. This was someone who had a family to worry about, and here he was treating people."


To watch the MSF webinar "A Disaster Ignored in CAR," which features Mays and other humanitarian workers talking about the situation in the Central African Republic, go to O'Shaughnessyz