Behind the scenes of working on the frontline

Having worked everywhere from Afghanistan to Haiti to Pakistan, Paula Sansom has been with Merlin for over ten years and tells about some of her most memorable moments.

Although I’ve been on the frontline for many disasters and you would think I might have been desensitized by now, it breaks my heart every time I hear the testimonies from the locals themselves. During the Cyclone Sidr in Bangladesh, the flood water had reached the top of a two storeys high clinic and they were standing on the roof, pulling their fellow neighbours from the water as they were swept past. That was their one chance; otherwise, many villagers had to climb and cling onto trees to survive.

Even more catastrophic than Cyclone Sidr was of course the Asian tsunami. Our teams distributed relief items to thousands of displaced people and helped rebuild clinics and hospitals. Six months afterwards, I travelled to Indonesia to fill in the gap as the Country Health Director. I could not believe the devastation. There was still SO much to do even though there was no media attention on it anymore. I stayed in Indonesia for a month, supporting Merlin’s ongoing response and ensuring that Merlin’s procedures and policies were in place. On my last day, I broke my ankle, putting into practice the procedures of medical evacuation that I had just finalised.

In emergency relief, time, money and resource constraints are not our only challenges. We often face cultural constraints which will likely take years of education to overcome. After the massive earthquake that struck the Kashmir region of Pakistan in 2005, I had a call from one of our doctors who was struggling with a difficult delivery. Even in moments of life or death, he wasn’t able to touch or even treat the woman, who herself is a nurse giving her first-ever delivery. Instead, she had to deliver her own baby with him standing outside the tent giving her instructions with a midwife and me on the other end of a phone line. Thankfully, the baby was delivered safely without further complications.

Working in emergency relief means we often have to deal with whatever resources we can lay our hands on. After the Haiti earthquake, I was originally meant to go out for two weeks but I ended up staying for three months. With the already fragile health system destroyed, the community was in dire need of healthcare. Our team set up a tented surgical hospital on the grounds of an abandoned tennis court which quickly became known as “Wimbledon”. Our goal was to salvage limbs and reduce the number of amputations. In the end, our 40-bed facility carried out 348 operations on 158 patients, an average of 47 cases per week.

One of the more rewarding aspects of my work is when I meet patients who have benefited from our healthcare. When I returned to Haiti almost a year after the earthquake, I met Dahanna, a young girl who had surgery on her hand. The first hospital she went to after the earthquake told her that her hand would have to be amputated. Luckily, she came to us and one year on, she had almost a full range of movement in her hand again.

If you asked me what keeps me going ten years on, it is the progress that I know I’ve made during my time with Merlin. We’ve worked in so many countries, responded to so many large scale as well as silent emergencies which never garnered media attention, and still there is so much work to be done. It is a never ending task but I hope that within my lifetime, we will reach a point where the health infrastructure in these developing countries will be strong enough to stand on their own.