Would you risk your life to help your patients?

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    http://www.revolutionmag.com/newrev11/uganda.html
    A Canadian filmmaker goes to Uganda to document wartime atrocities. He ends up
    creating a film about nurses engaged in
    the horror of their lifetimes.

    One hundred seventy-three people died in the
    outbreak, including a doctor and 12 nurses.
    Belluz said more people were saved from
    infection or death because of the extraordinary
    job of containing the disease and educating
    people about what they should and shouldn't do.

    You're a nurse. A deadly epidemic breaks out. Would you risk your life to help your patients? In the fall of 2000, 12 nurses in Uganda died doing just that.

    To David Belluz, cinematographer, it was the story of a lifetime.

    Belluz didn't start out as a cinematographer. After travelling around many parts of Africa, he graduated from the University of Regina with a bachelor's degree, with high honors, in religious studies.

    "I realized there were some great stories that needed to be told that never made it into the mainstream media, especially in Africa, which I knew would have great visual images," he said. "So I went to Uganda because I wanted to document the child soldiers there."
    Belluz said he was drawn to the tragic story because "10-year-old children --sometimes even younger -- were abducted from their homes by rebel soldiers and dragged off into the bush. They were often forced to kill family members so there would be no incentive to leave the rebels and go back home."

    The Regina, Canada-based cinematographer was "fascinated by these little adults that had escaped and found the courage to start their lives all over again."

    While Belluz was in Uganda documenting the child soldiers, he heard about the deadly Ebola outbreak in Gulu, a community of about 300,000 consisting of mostly poor farmers. Even though he realized his life would be in danger, Belluz knew he needed to make a film about the nurses who risked their lives to save their patients.

    There were two main reasons why this first-time filmmaker decided to put his life at risk.

    "First, the Ebola outbreak was striking an area that was already reeling from 16 years of civil conflict," said Belluz. "I wanted to document the nurses who volunteered to work in the Ebola wards to help their own people, with no thought of financial reward. To watch these nurses dedicate themselves to healing patients infected with this deadly and highly infectious disease blew me away. It was a story I had to tell."

    Belluz said the second reason was because he saw ordinary people doing extraordinary things.

    "The first thing that went off in my mind was this is a story people in the West - Canada, America, Europe - have to see," he said. "They have to see that Africa isn't just about child soldiers, or guns, or diamonds, or civil war - it's about real people. Here are some real nurses who are doing some absolutely amazing things. I wanted people to see this heroic face of Africa."

    Belluz said his first film, "Ebola War: The Nurses of Gulu" was his "opportunity to let people in the West see what else is going on in Africa."

    Recalling what he saw in Gulu's isolation wards, Belluz described the human misery.

    "Men, women and children of all ages infected by the virus were in various stages of the disease," he said. "Some were sweating with high fevers. Some were vomiting. Many had diarrhea."

    But he said the worst part was the bleeding. "Their internal organs melt. They can be bleeding from everywhere - from the nose, the gums, the eyes. Blood becomes a time-bomb because the virus stays alive in the blood secretions of the dead for up to three days."

    He added that the noise in the hospital was horrific as the children and adults writhed in pain.

    Yet, in the midst of this nightmare, Belluz described the nurses of Gulu who went from patient to patient making sure their patients were re-hydrated, taking their temperatures, and cleaning the patients because of the diarrhea and bleeding.

    When asked about the protective gear and equipment the nurses used at the beginning of the outbreak compared with what they would have in Canada, Belluz said, "In the beginning, the nurses didn't have much, mostly just their gowns." He described one clip from the documentary that illustrated one of the differences between a nurse in Gulu from one in Saskatchewan.

    "A nurse was taking a patient's pulse, but she's not using a wristwatch because she doesn't have one," he said. "She was holding a very large wall clock in one hand and she's taking a pulse with the other."

    He went on to describe that the pharmacies were half-empty, experiencing shortages of even common drugs like aspirin.

    "They didn't have the essentials," he said. "In the beginning there weren't enough gum boots, which are essential when there are so many bodily fluids on the floor, not enough gloves, not enough masks, no protective face shields or goggles."

    The personal safety equipment didn't arrive until a short time later when international aid began to pour in.

    "It took about a week for the World Health Organization and the Centers for Disease Control to have their people and an arsenal of modern equipment on the ground. They sent in a lab to test the blood," said Belluz. "They sent in specialists to not only help in the isolation wards, but also to help train the local personnel. Health Canada sent in three epidemiologists, including Dr. Bonnie Henry, who volunteered to work in an Ebola surveillance team. Dr. Henry, who appears in the documentary, and others volunteered to set up Ebola surveillance teams to look for
    suspected cases and bring them back to the isolation wards to stop the disease from spreading."

    One hundred seventy-three people died in the outbreak, including a doctor and 12 nurses. Belluz said more people were saved from infection or death because of the extraordinary job of containing the disease and educating people about what they should and shouldn't do.

    Belluz says his film has the following message for nurses everywhere: "This film is a tribute to all nurses, to all health care providers who have dedicated themselves to healing. This documentary is really going to strike a chord with nurses because many of our nurses would feel the same way as the nurses of Gulu who volunteered to work in the Ebola isolation wards. These people have a sense of altruism. That's why they become nurses because they want to make things better."

    George Manz is employment relations
    officer/communications for the Saskatchewan Union of Nurses.

    For more information about the film, now available in VHS format, contact the Web site of David Belluz's film production company, Alethia Productions Inc. www.alethiaprod.com <http://www.alethiaprod.com>

    Photos: David Belluz
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  2. 9 Comments

  3. by   pickledpepperRN
    PLEASE click the link to see the people in the article!
    http://www.revolutionmag.com/newrev12/out.html
    Janice Cibart wasn't looking for adventure when she went to visit friends in Zimbabwe in 1996. But she got adventure, and more, during her three-month vacation. She got a life-changing experience.
    Cibart had been working as a home care nurse for the Regina Health District in Saskatchewan, doing HIV/AIDS education. She was looking forward to the trip to Zimbabwe as an opportunity more than a vacation, she wanted to learn more about the disease devastating that part of Africa.

    On her third day in Zimbabwe, she met the director of the Zimbabwe AIDS Network, who invited Cibart to a convention focused on setting up and developing HIV and AIDS education and treatment programs in Zimbabwe's rural areas. It was there she met Auxillia Chimsoro, an AIDS victim who fought through the disease to advocate on behalf of African women.

    A mother of three children, Chimsoro had worked as a domestic for a wealthy family who paid to have her see a doctor to find out why she was so fatigued. The medical report and lab work uncovered she was HIV-positive. Shortly after that, she found herself pregnant with her fourth child. The child was born HIV-positive and died at the age of eight months.

    Chimsoro, however, was not going to let her misfortune get the best of her. She decided to let the world know about her illness and the horrendous pandemic afflicting Zimbabwe.

    "She made it her mission, until she died in 1998, to educate people on prevention and treatment of AIDS and HIV," Cibart said. "She spoke throughout the world, including Great Britain, Switzerland and Canada.

    She spoke about what it's like to be an African woman living with AIDS who has little access to the medical treatments that are available to most people in the West."

    Chimsoro is known as the first African woman to speak out for women's rights around AIDS and HIV," Cibart said. "She was the first person who went to the media and asked them to cover the plight of people living with the virus."

    Chimsoro lobbied the government incessantly, Cibart said. "While I was working with Auxillia Chimsoro," Cibart remembers, "the government finally passed a law that would make the female condom just as available as the male condom."

    Cibart and her new friends celebrated this important achievement on World AIDS Day in Zimbabwe later that year.

    Fashion Statement

    Cibart says the majority of the predominantly poor black people in the country can't afford the high cost of HIV/AIDS testing, so they go undiagnosed until the symptoms show up. This area of the world has an extremely high rate of HIV infection 60 percent with a 5-1 ratio between women and men.

    Throughout her travels in Zimbabwe, Cibart says, she never met a person who didn't know something about AIDS and HIV.

    "From the youngest people to the elders, everybody knew that HIV and AIDS existed, and the devastating effects it was having on their population, but they lacked minimal information about how the virus is transmitted and how to prevent it."

    She worked with Chimsoro throughout the three-month period, setting up education and support groups in remote rural areas.

    "We would often travel for two or three days in the eastern highlands or in the desert areas of western Zimbabwe to reach villages where nobody ever goes. We met mostly with women and children living with AIDS or HIV because most of the men were away working."

    The first support group that Chimsoro set up was in Masvingo. ̉All the members were women who had one thing in common: They were all living with either HIV or AIDS," she said. "Most of them were widowed. Many of them had children who had died from AIDS."

    Support group members wanted to be regarded as equals, Cibart said. But one of her first questions of the group's members was why they all wore nice uniforms to their meetings "when none of them had any money, even for food. They were selling peanuts, roasted ants and fried caterpillars in the beer halls at night to buy the necessities of life."

    Janice says they quickly educated her to see that it's important to them that they're seen as equals.

    "If one woman came dressed in a very nice dress and the other women were in rags, they had a hard time seeing each other as equals fighting for equality. When a new member joins their group, they all donate spare change to buy her a matching uniform."

    Cibart has fond memories of attending her first World AIDS Day, where she took part in a huge march of more than 700 women in a small village.

    "I was the only non-African woman at the march so I was always singled out as the guest, not only because I was white, but because I was from the western world. In their minds I had the most wealth, in terms of both knowledge and the financial ability to access AIDS treatment. All the women I met there knew about the treatments that are available in the West. There wasn't one woman that didn't know what an 'AIDS cocktail' was and how it could help them."

    She says, "They treated me like a royal guest. They served lunch to me first, with the goat testicles on it. I quickly handed the delicacy off to Auxillia."

    Street Theater

    A big part of the AIDS and HIV education in the country is done through drama.

    "The women would be in the market where they would perform a one-act play that would educate the people about these deadly diseases."

    They also wrote and read poetry. "These women would stand up on a city bus and read poetry on how to protect yourself from AIDS," Cibart revealed.

    Song was another important method to convey the message about AIDS to the people.

    "Many times on a bus, they would stand up out of the blue and sing these songs about the importance of wearing a condom so your penis doesn't rot. I can't imagine doing that in Regina," Cibart remarked.

    "They really got their point across," she claimed, because people would stop and listen to the message."

    Cibart recalls Chimsoro's participation in the International AIDS Conference in Vancouver just before she died. After Chimsoro presented her paper about what it's like to be a woman living with AIDS in Zimbabwe, she was put up in the Hyatt Regency Hotel in Vancouver.

    "The hotel was totally out of her element," Janice said. "Auxillia saved all her food coupons, cashed them like traveler's checks, and bought a TV and VCR to take back with her. When she got back to Masvingo, her house was one of the few in the city that had a TV and VCR."

    Before Cibart left Zimbabwe, "I made a copy of the video I filmed of the AIDS education and celebrations and gave it to Auxillia,"

    she said. "People would come from all over Masvingo and surrounding area just to watch TV or the tape from her VCR. It was a big thing for people to be able to watch a documentary about their lives."

    Learning to 'Have Not'

    Cibart says Zimbabwe made her re-think her values.

    "I always said to the women I met in Zimbabwe, I would find it so hard to go back to my world to work with people infected with HIV and AIDS,' which is part of what I do with home care here. I find it difficult to make sense of a world full of huge discrepancies between rich countries and poor countries. We have so much available in the West compared to some of the people who mean so much to me who have nothing in Zimbabwe."

    Cibart says all the women she met in Zimbabwe with AIDS or HIV were often infected with herpes as well.

    "There was no treatment available because of the cost," Cibart recalled. "Through a lot of red tape, I was able to purchase a tube of Zovirax cream without a prescription and gave it to some of the women I met who were going to share it. It cost me something like $200, which is about a person's annual income in Zimbabwe."

    After the women shared the tiny amount of cream between them, Chimsoro later told Cibart, it was the first night's sleep she had in the last six years when she didn't wake up with pain from herpes.

    The incident was a 'huge eye-opener' for her, Cibart said.

    The Regina RN recalled other heart-wrenching stories as well.

    "We met a woman who was HIV-positive and her husband, who was in the final stages of AIDS, in one of the remote villages we went to. I wanted to see if there was anything I could do to make it easier on the family." Cibart remembers the man spoke very good English because he was a former ambulance driver. Everyone wanted me to go see

    him because we could speak with each other. It was a very emotional time. Everyone in the village was gathered around in the event of his forthcoming death."

    She recollects the patient was very sick.

    His flesh was coming off his arms, his hands and his feet. His wife wanted to know if I had any suggestions on how to make him more comfortable at night, how she could better position him. He slept on the cement floor in the hut. So I bought some thin rubber mattresses that we covered in plastic that could be washed and shared among other villagers."

    Cibart says when the man got his new mattress, his wife placed two Tylenol pills that the man had been saving for several months until the pain got really bad and he couldn't take it any more. Two days later, he died."

    She says it was a reality check for her.

    "When he died, the man was at a stage of the disease where people in the West would be on high doses of pain medication," she said. "Yet when I looked under his mattress, the two pills were still there."

    Cibart was appalled by the lack of services in the country.

    "Basic needs weren't being met, things like basic nutrition and hygiene. Water to wash in. I rarely saw a bar of soap. At one point, I had one pair of latex rubber gloves that I would wash between patients."

    Little Moments of Joy

    She fondly remembers the night before she left Zimbabwe to return to Canada.

    "Auxillia had introduced me to her cousin, Celestio Peo, but everybody called him C.P. The village had a big party for me. Everyone wanted me to take photos of C.P. because he was the sickest person in the village. Not one of the people in the village had ever seen themselves in a photograph. So I took lots of photos that night and sent them back to Zimbabwe."


    When Cibart's photos finally showed up, C.P. got to see himself in some of the photographs. He died two days later. "C.P.'s family and friends are convinced that he was staying alive so he could see his picture before he died," she said.

    Cibart reminisces about the children and elders in the villages she visited. They knew she was a nurse from the West and thought she had all the answers. "They wanted to know if their child had AIDS. Can you make him better? Can you send some AZT?"

    "It was moments like this that reinforced in me how little I could really do to help," Cibart said.

    But Cibart recalled positive impressions of Zimbabwe as well.

    "They call it home-based nursing in Zimbabwe, but very few were actually nurses because of the lack of education in the country. We helped women graduate from two-week up to six-week home-based nursing programs. These women were all HIV-positive themselves and learned how to take care of people with AIDS. When they graduated, they got a 12-inch long bar of soap, a pair of rubber gloves and a uniform to wear. Then they went out and did their home-based nursing."

    When she compares community nursing in Saskatchewan and Zimbabwe, there are huge differences.

    "As a home care nurse, I clock the number of kilometers I drive every day," she said. "In Zimbabwe, it's nothing to walk eight or nine hours in a day. They judge their day by if they got up at three in the morning, they'd be able to walk so far to get to their first home visit and then get in a few more visits in other nearby villages."

    The women she met is Zimbabwe were amazing," Cibart said, recalling a pact she made with Auxillia. Before she died, I told her I would continue to tell the stories of her life so people would always be aware of the situation in her part of the world." Cibart has been doing just that ever since.

    A few years ago, Cibart was awarded one of the YWCA of Regina's Women of Distinction Awards for her work around AIDS and HIV in both Canada and Zimbabwe.

    George Manz is employment relations officer/communications for the Saskatchewan Union of Nurses.
  4. by   Blackcat99
    Would I risk my life to save my patients? No I would not risk my life. My mother is 82 years old. If something happened to me she would end up in a nursing home. My responsibility is to my family first.
  5. by   loriLPN
    i agree black cat- you need to put what is best for your family first. being some kind of hero is not going to raise my son or love my husband. it sounds selfish, but i don't even like the overtime or helping out during a shortage because time with my family is way more important to me than my job. after 40 hours, my time is MINE!
  6. by   canoehead
    WE all are at risk every day but to a different degree.

    I remember having a man arrest in front of me and not having a mask, but I couldn't stand him going without breathing for the time it would take for me to go get one so I did mouth to mouth. Yuck! He had old man dehydrated cooties on his lips! Well, I don't recommend doing that but I can see how I just wouldn't be able to stand NOT doing something in a situation, even if it put my own life at risk.
  7. by   fergus51
    I think every situation is different, so I don't know what I'd do. I did keep coming to work during SARS, but I wasn't directly looking after SARS patients....
  8. by   Hellllllo Nurse
    Quote from canoehead
    WE all are at risk every day but to a different degree.....
    I agree. I work with HIV+, Hep B/C +, pts daily. I've also worked w/ pts w/ West Nile.

    I've had several needle sticks throughout my career. Thankfully, I have tested neg for everything, so far. We all risk our lives every day in nursing.
  9. by   pickledpepperRN
    Quote:
    Originally Posted by canoehead
    WE all are at risk every day but to a different degree.....

    Quote from Hellllllo Nurse
    I agree. I work with HIV+, Hep B/C +, pts daily. I've also worked w/ pts w/ West Nile.

    I've had several needle sticks throughout my career. Thankfully, I have tested neg for everything, so far. We all risk our lives every day in nursing.
    I had a similar experience once. Now have one of these on my key chain and in my car, plus a box of gloves. My DH uses them when painting too. Mine is from the ANA. Drug store chains also sell gloves and such.
    http://store.yahoo.com/allheart/cprshields.html


    Remember a mental health nurse killed by a patient? The article was posted on ALLNURSES.COM a couple years ago. There were at least two in newspapers attributed to insufficient staffing.
  10. by   athomas91
    i agree we are at risk every day...but doing things ie.. IV's, NGT's are in a normal scope of practice wherewith we accept the risk...otherwise...there is no way on this green earth that if i didn't know you - you would get mouth to mouth....sorry..but you would be up the creek w/o a paddle.
  11. by   Rapheal
    Not only are we exposed to infection, but every time a fire drill or small fire erupts in the hospital we close the fire doors and stay with our patients. It is expected of all of us.

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