Guest editorial – January 2008

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I begin by congratulating everyone concerned with the Journal on its new and very appropriate name. May I also thank you for the privilege of writing this editorial?

I particularly appreciate the significance of your specialism as I now spend much of my time in parts of the world where people are suffering from devastating effects of conflict or its aftermath. I therefore value the opportunity to share experiences and challenges with professional colleagues.

My small humanitarian organization, Humanitarian Aid Relief Trust (HART) focuses primarily on forgotten peoples in forgotten lands – often trapped behind closed borders, cut off from major aid organizations. This situation occurs because the large, well-known organizations, like ICRC, UNICEF and UNHCR can only visit places with the permission of a sovereign government. If a ruling regime, like the brutal military junta in Burma, is oppressing its own people and does not give such organizations permission to take aid to them, they cannot do so.

In HART, we do not believe that people in life threatening situations, suffering major violations of human rights should be left to suffer and die without any aid or anyone to speak for them. Therefore we focus on such communities, operating on our ‘4 A’ principles:

As stories speak more eloquently than abstract principles, let me illustrate how HART works.

Sudan has suffered civil war for most years since Independence – a war which escalated into such violent conflict in 1989 that it caused the death of 2 million people and the displacement of 4 million – before the tragedy of Darfur.

That war also left a devastated infrastructure with hospitals, clinics, schools in ruins and a ‘lost generation’ of children denied education by constant bombardment. With Darfur now acting like a magnet for the media and aid organizations, the rest of war-torn Southern Sudan is left bereft of aid and advocacy. Many people are suffering and dying from preventable or treatable diseases. For example, in January last year, we discovered widespread leprosy in Eastern Upper Nile and around Yei, in Equatoria, many people dying from malaria, measles, meningitis and problems with childbirth.

HART is therefore supporting 2 primary health clinics in rural areas around Yei, where roads are still so damaged by war that access to the hospital in the town is impossible. The nurse practitioners who staff these clinics would welcome professional help with supplies and clinical updating.

In northern Nigeria, Kano State has been ravaged by conflict. There, we support a primary health care clinic serving a population so impoverished that they cannot afford to pay for medication, having to sell a goat or clothes to purchase life-saving medicines, forcing them further down the spiral of poverty and deprivation. The clinic was originally established by a Welsh nurse, who had to flee a few years ago when conflict erupted. HART is now focusing on acquisition of supplies and funding the salary of the nurse.

In Burma the brutal military junta with the Orwellian name, the State Peace and Development Council (SPDC) has been in the headlines for its ruthless suppression of the peaceful demonstrators pleading for democracy and freedom for political prisoners. Some of their voices have been heard. Less often heard are the voices of ethnic national groups like the Karen, Karenni, Shan, Chin and Rohingya peoples, trapped inside Burma and subject to systematic violations of human rights, including murder, rape, forced labour and torture. HART has 2 programmes supporting people suffering inside Burma, in areas where major aid organizations such as ICRC and UNHCR are forbidden by SPDC to visit. One project is based on a partnership with SWAN (Shan Women’s Action Network) to promote health education inside Shan State; we also support 2 clinics for the Chin people, as well as mobile medical teams working in remote areas with the hill tribes who have no provision of health care in their villages.

In East Timor, devastated by a bitter war and afflicted by a resurgence of violence in 2006, we are supporting an outreach programme to rural communities where children are dying from disease and malnutrition; in the Armenian enclave of Nagorno Karabakh, we have been asked to develop a Rehabilitation Centre – an innovative initiative, as the former Soviet Union had no concept of Rehabilitation and people with disabilities were merely ‘warehoused’, dying prematurely from pressure sores, urinary and respiratory infections. Our dedicated and visionary Director, Vardan Tadevosyan, has created a centre of excellence, which is disseminating the concept, principles and practice of holistic therapeutic repertoires throughout neighbouring countries such as Georgia, Chechnya, and Ossetia.

In conclusion, if any readers would like to use experience and expertise in a part of the world where you could really make a difference, we in HART would love to hear from you. Involvement need not take much time. For example, we would appreciate expert advice; a visit to one of our locations might only involve a week. We always return, inspired and often amazed by the way our partners multiply the few resources we give them in ways beyond anything we can imagine. You would also have the deep satisfaction of using your specialist knowledge on behalf of suffering people in some of the darkest and most forgotten parts of the world.

When I qualified as a nurse at the London Hospital, I was struck by the ideal enshrined in the hospital’s motto: Humani nihil a me alienum puto’, which can be translated into: ‘I must be concerned for all humanity’.

Thank you for letting me share with you the way in which it has been my privilege to try to put some aspects of this ideal into practice.

May I wish you all your own professional satisfaction in developing your immensely important specialism of Emergency Nursing, supported and encouraged by this very significant and well-named Journal!