- 11 December 2020
- 7 min read
Doctors Without Borders: What I Learned From My Time Nursing In Ethiopia

Critical Care Nurse, Carmine Civilli, relives his experience working with Doctors Without Borders in Ethiopia, and outlines the key takeaways and lessons learnt from his time away.
Topics covered in this article
The Crucial Importance Of Nursing Advocacy
Nursing To Empower People & Protect Health
The Science & Art Of Caring About Others
Introduction
"Just when you think you know something; you have to look at in another way.”
This wonderful quote of the magnificent John Keating (Robin Williams) in the film Dead Poets Society reflects perfectly my nursing experience in Ethiopia.
I spent six months working on a humanitarian mission with the organization Doctors Without Borders between 2018 and 2019.
As any nursing provider among western countries, I used to take for granted that resources for healthcare are available for any patient.
Just think, if we may need urgent health needs, every one of us can just take out their phone and call for an ambulance.
Now imagine for a moment that if you need healthcare assistance, you must walk for three days to get into a healthcare centre.
This has been my nursing experience in a developing African country, in a poor region flagellated from war and tribes’ clashes, trying to solve healthcare related problems, deciding upon patient possibility to improve their health status, with my intervention, on who to spend the few resources available.
The Essence Of Nursing
Working for six months in Ethiopia taught me the “Essence” of Nursing, something that is difficult to experience in our western environments.
A kind of purity in taking care of people, nullifying all of the strict issues and hand-tying protocols and regulations, that often obstruct even the most experienced practitioners.
Obviously, these are crucial, in order to create the right context of safe care delivering and, also, huge part of my mission was to create and implement such guidance.
Where it is usual that people lose their life, society got used to it and acceptance of death or lack of health is more part of a common feelings of morality.
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This is reflected on nursing as it is the highest essence of health management: holistic care, every single part of the person intimately interconnected, and good care can happen only thinking at the person referring to their whole individuality.
Part of person’s individuality are culture, beliefs, physical status, expectations, willing.
In Africa it is common to lose life “easily” (I am sorry for the raw concept, but these are the facts), this is reflected in nursing as being alive is already enough and people would not complain if a poor quality assistance is given; this while in western country we are aware of our rights and we are taught to stand for these.
The Crucial Importance Of Nursing Advocacy
The fact that no control and regulation are put in place in an environment where life worth isn’t as much as in our country, puts people’s lives in serious danger.
The professionalism and effort that people put into their work is extremely less than their western colleagues.

On top of that, a very low salary and life quality makes the work much more difficult for healthcare professionals.
If you are not sure to have a good life, how can you pay efforts to improve and advocate for others when the law is not clear and doesn’t protect you?
Nursing advocacy arises from the concept of acting to make people aware of what they deserve and speak up to seek what is their health right as human being.
Nursing To Empower People & Protect Health
When you work without what you take for granted, you begin to understand how important the efforts that someone made in order to give you rights when they were not granted at all.
Each one of us need to assess and work constantly to recognise and grant right when these are not so.
This is one of the biggest teaching I have brought back from my African experience: to work for others and the community for a better future, mainly for others as you will not see the effect on yourself but you know you are changing in better for future generation.
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What do YOU think?
Let me know your thoughts in the Comments & click Like!
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They will have better environment and possibilities than yourself, but despite that, you put your efforts anyway.
This concept is underpinning Nursing: spend our “Vital energy” not for ourselves but to help others, that we may not encounter again in our life, but making them able to continue their life in better condition, for themselves, their family and their community.
Discover the base of caring about health care needs means be willing to spend own resources such as time, energy and effort, for someone who you never seen before and most probably, you never see again in your life.
This is the essence of nursing.
I don’t know who you are and where you are going, I only know that you need help and I am ready to use my vital energy to improve your own.
I went to Africa hoping to learn how to be a better nursing provider, and this huge experience prized me in revealing the meaning of Nursing.
This would not happen without breaking my comfort zone and putting myself in a complete different prospective, not only professional, but socio-cultural based.
The Science & Art Of Caring About Others
I went there to bring help; I came back having received way more than what I were able to give.
I discovered what Nursing science and art is, or to be precise, I understood how really the need of nursing is at the base of a healthy community.
This experience made me way more aware how our actions can change others lives and improve the whole of humanity.
Every single difficult moment, risk or danger not only made me a better healthcare provider, but also more aware about how important our actions towards the other lives are.
Now I understand how our science is bonded with the nursing art, because only when the “cold” science merge with the “warm” art of care for someone else Nursing protect and improves people lives.
“Nursing is an art: and if it is to be made an art, it requires an exclusive devotion as hard a preparation as any painter's or sculptor's work; for what is the having to do with dead canvas or dead marble, compared with having to do with the living body, the temple of God's spirit? It is one of the Fine Arts: I had almost said, the finest of Fine Arts."
– Florence Nightingale, mother of Modern Nursing.
Let me know in the comments your thoughts on my time in Ethiopia and what I've said about Nursing - let's chat there!
Oh, and please Like this article to let me know you enjoyed it - thank you!
Surgical Team Leader
About the author
Surgical Team Leader
Carmine Civilli has experience in many different roles, including: Surgical Team Leader, Surgical First Assistant, Advanced Scrub Practitioner and Anesthetist Practitioner on operating theatre department. Carmine also spent time working with Doctors without Borders in Ethiopia.
Want to get involved in the discussion
Sign In JoinJulia Orege
Julia Orege
one month agoCarmine, I found your article very intuitive into working in a 3rd world country. Your insight into some of the ... read more
Carmine, I found your article very intuitive into working in a 3rd world country. Your insight into some of the most basic human needs, such as being kind and caring with limited facilities ,really came across. Your articulate use of language and pertinent quotes really embellished your article.
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Julia thank you so much for your kind comment. The experience in such environment and all the feelings and learning I have brought back are so precious to me. I am really happy if all I have learnt ca... read more
Julia thank you so much for your kind comment. The experience in such environment and all the feelings and learning I have brought back are so precious to me. I am really happy if all I have learnt can help you and other people to deliver better care to whom needs health assistance. Thank you again. The kindest regards.
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