One of Humanitarian U experts and instructor on the MISSIONCRAFT 2015: Disaster Relief Operations workshop, Dr. Hilarie Cranmer is a seasoned humanitarian. From the first deployment to Kosovo in 1999, she has since been involved in major disaster responses. Hers was the responsibility of setting up the largest field hospital in Haiti right after the earthquake. Also to coordinate the deployment of healthcare providers into and out of West Africa during the Ebola outbreak.
In our conversation, she talked about those challenging experiences and also about MISSIONCRAFT. “I want to emphasize that we are making a big effort to accommodate everyone who wants to take the course. There is a big discount for those who come from low income countries. We’ll likely have a very interesting classroom, with people from places such as Syria, Lebanon and Iraq. So, even if it’s last minute, we strongly encourage everybody to get in touch with us and participate”, she says. For last minute applications, contact the MISSIONCRAFT team at [email protected]. But first, read the full interview.
Humanitarian U – How long have you worked in humanitarian health response?
Dr. Hilarie Cranmer – Since 1999, when I worked for Physicians for Human Rights. I deployed to Kosovo shortly after the refugee’s return from Macedonia. On top of my physician role, I helped with the War Crimes in Kosovo Report.
HU – What has been the most challenging situation you have faced in the field?
Hilarie – Used to be Haiti, because it was an extremely difficult situation. But, what evokes into my current practice is the work I did as a technical advisor on Ebola for International Medical Corps who received funding from USAid, and critical training from MSF, the latter being the biggest and most critical NGO on the ground.
It was incredibly challenging to get providers to West Africa, and then get them home safely without having them be ostracized in their work place, communities and neighbourhoods. Few health care providers were getting infected, but the public health consequences were immense and have changed the world in terms of response to emerging infectious diseases. So, that work for me was a huge challenge.
Everything that I had been doing until now led to that experience and I was able to come out of it as a better person. We were able to work and help improve organization and institution’s responses, as well as individual’s responses to these types of crises. We took real big steps towards improving West African healthcare and health economy, so I think this is going to be quite important in the years to come.
My mantra has always been “disaster response is the gateway to global health”, and this disaster was definitely a way to get people’s feet in the door and help them make a better healthcare system, which is critically needed.
HU – What have you noticed in terms of professionalization of humanitarian providers through the years?
Hilarie – The level of professionalization has certainly increased after more recent experiences, such as the Haiti and Nepal earthquakes. What happened in Haiti should never be repeated, and a lot of reform came out of that. One example is the new requirements for deployed medical teams. They now have to be registered and to meet certain standards. They are held accountable and must work more closely with the Ministry of Health, if that government is intact. This is to me a good example of the level of professionalization we’ve seen thus far. We have a long way to go, but I think we’ve taken amazing steps in the right direction.
HU – How did the experience of setting up the largest field hospital in Haiti after the earthquake impact your view of the humanitarian sector?
Hilarie – It was a very significant experience. What we were able to do at the field hospital was a great model of what can be done, in a good way. We knew what we shouldn’t do in terms of field hospitals and poor quality of care. We knew what was right. We were then able to take that model and influence the more than 700 volunteers that we had, and to care for over five thousand patients. We recognized that excellent care could be achieved in humanitarian care settings, without compromising accountability or ethics.
To me, the fact that it could be done, even in that setting that many years ago, shows that we have what it takes to move forward. Working in Haiti also made me realize how one person, one group, or one organization really can’t do it alone.
HU – How was the process of closing down the field hospital after five months?
Hilarie – All field hospitals should close within three to six months of it being built, unless there is absolute devastation and safety issues that make the return to the original healthcare settings impossible. It is predicted that within this timeframe the original system should be strong enough to support the demands of the population, with the collateral help of the organizations that first responded.
When our hospital closed down, exactly five months after the earthquake, every patient had a plan, and every supply was donated or burned in the case of it being expired. What exists there today is a community health clinic that provides care to quite a large area, and also a small town built to accommodate amputees and their families.
Their current director is a Haitian medical doctor that we prepared to take on the role. He had attended a course similar to MISSIONCRAFT and learnt how to deal with outbreaks and similar crises. Afterwards, he also successfully coordinated a response to a cholera outbreak in the same region.
HU – So the training was really important in this context?
Hilarie – The most important thing the training teaches is how to pull in resources when your own resources are overwhelmed. For example, in the field hospital in Haiti we started out with a well and diesel fuel, but those ran out at some point. In a situation like that, you need to know where to go find what you need because the work has to keep going. So, with the training and with intensive mentorship, we hope to provide workers with a better tool kit to access what they need when they are in the field.
HU – Have most people taking MISSIONCRAFT already been deployed?
Hilarie – Yes, the course is not “humanitarian 101”. It’s for people who have been and will continue to be in the field. They come to learn about management, stress, team building, as well as the critical components of delivering emergency healthcare, disseminating health information and working with public health in the field. Also, this is a course for professionals, not for students. A nurse that comes take the course already knows how to care for patients, and is now learning how to do it in a disaster setting.
David Bradt and Christine Drummond, the course founders, and I hope the course will build off of a skill set the participants already have.
HU – What is the role of online training from Humanitarian U in the course?
Hilarie – There is a lot to learn, and the online content does not replace the face-to-face discussions. Instead, it provides the participants with a safe place to become familiar with terminologies, acronyms, and with the players and actors involved in humanitarian crises. It also is helpful for the organizers, because we don’t have to spend 20 hours in class going over basics. So, when they come to class, we are all in common ground and the discussion can be much more interesting. It’s no longer “death by power point”.
HU – What would be your message for healthcare providers who are thinking about becoming humanitarian workers?
Hilarie – Yours is a journey that is tremendously altruistic. You will never get paid enough, you will work too hard, and you will never spend enough time with family. But the impact you will have is infinite. The lives that you touch will be inevitably changed for the better.
Photo: Justin Ide, Harvard Gazette