Certain populations in the United States are particularly vulnerable to being medically underserved. For example, it is estimated that 60% of women older than 85 years live alone; Hispanic and black elders are more likely to live with family. Black men have a 200% greater rate of stroke than do men of other races. The life expectancy of migrant farm workers in the United States is 49 years. Older adults with Medicaid are more likely to have poor health.

Nurse Nola Henry

The conflict in South Sudan was continuing into its second year when the Australian Red Cross aid worker Nola Henry spent 10 weeks in this African country bordering Kenya, Ethiopia, Uganda and other countries in northeastern Africa.

Imagine yourself in a tent in the middle of a swamp in South Sudan. It's hot, wet, muddy, and the mosquitoes are ready for their supper. However, you're about to perform surgery by torchlight! Nurse Nola experienced these exact conditions as a Red Cross health worker in a field hospital in South Sudan.

The armed conflict in South Sudan left hundreds of thousands of people in desperate need of aid, and when Nola arrived, the International Committee of Red Cross (ICRC) and South Sudan Red Cross were working to provide food, water and sanitation, shelter and healthcare to the most vulnerable people.

Between 2013 and 2015, the ICRC performed nearly 5,500 surgeries, conducted more than 23,000 outpatient consultations and assisted more than 3,000 people with disabilities.

Nola Henry spent time in South Sudan during two missions with the ICRC, where she worked as part of a mobile surgical team to treat weapon-wounded patients. Ward nurse Nola supported a surgeon, an anaesthetist and an operating theatre nurse during her mission, who work alongside local nurses and volunteers.

Nola said: "It may be that we need to set something up in the middle of nowhere so our kit consists of taking everything we need to be self-sufficient: tents to set up an operating room and nurse the patients, tents that we can live in of course, and then you put up a tarpaulin under a tree so the cooks can prepare the food." 

The minimum services are provided, of course. There are no x-rays, scans or blood tests. Also, the teams often treat patients who were injured weeks or months before. Many have survived for at least five days, but others haven´t.

Infections often take hold in a few days after the injury, leaving surgeons with little choice but to focus on saving limbs.

Nola's role comprised everything from helping to determine which patients need to be treated first to communicating with relatives and organizing treatments.

The difficult conditions in South Sudan are far from shocking for Nola. She was awarded the Florence Nightingale Medal in 2015 and she has completed 12 international missions. She was in Indonesia in the wake of the Indian Ocean tsunami. She´s also been to Pakistan, Afghanistan, Libya, Kyrgyzstan and the Philippines.

She said that simple camping experience can help you prepare for humanitarian mission of this sort. "You don't have to replicate South Sudan by camping in a swamp, in a mosquito-infested area, but make sure that you can live outside of an air-conditioned building," said Nola. You also need to be able to live without a flushing toilet, long showers and the sort of food you´re used to.

You're not going to have all the answers, she says, but you can be refreshed by the fact that no-one expects you to have the answers while you're there. They're just grateful that you're there, listening and trying to help.

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