Nursing on the frontline

Dame Claire Bertschinger speaks to Chris Seekings about the reality of aid work in war zones, the role of charity, and how individuals can change the world

“Having to choose who to feed broke my heart. It was a harrowing experience, and the post-traumatic stress is something I have to live with every day.“

As a nurse working with limited resources in famine-ravaged Ethiopia, Dame Claire Bertschinger was left with an incomprehensible decision that could ultimately determine the survival of numerous starving children. But through the pain and suffering, her work has helped change the face of charitable giving, saving millions of lives by inspiring a new global response to poverty across the world.

While she may not be a household name, few can justly claim to have had such a wide-reaching impact.

Playing God

When a BBC film crew descended on Mekele, Ethiopia, in the 1980s, Bertschinger was running a feeding centre in a country besieged by conflict and drought. Working for the International Committee of the Red Cross, she could only accept up to 70 impoverished children at a time when there were thousands in need of food. “I had babies vomiting and screaming next to me, and a journalist kept asking stupid questions about how I felt having to choose who could come in for food,“ she says. “I just wanted to get rid of them as fast as possible.“

The journalist in question was Michael Buerk, who had managed to enter the country at a time when it was notoriously difficult for anyone to gain access without special papers and permission. “But I felt like he was telling me to stand here and there, positioning me with all the worst children, saying things like 'take this one, it's really on death's door'. I thought he was a prat.“ Little did she know that Buerk's news report would change her life and those of countless others forever.

When beamed into UK homes, there was one viewer for whom the image of Bertschinger surrounded by starving children would have a profound impact. Singer Bob Geldof was so moved by the report that he helped assemble a supergroup of musicians that would go on to pull off the biggest relief programme ever mounted. “In her was vested the power of life and death,“ Geldof said at the time. “She had become godlike, and that is unbearable for anyone.“

Band Aid

A few weeks had passed since Bertschinger's BBC encounter when she was listening to a shortwave radio. Then, through the crackling and popping, came a song that would go on to become an anthem for humanitarian aid. “I heard the lyrics 'feed the world' and 'don't they know it's Christmas' from this thing called Band Aid set up by Bob Geldof, who was supposedly raising money for Ethiopia.

I thought we are going to need more than a bloody band aid for a start! And, no, they don't know it's Christmas because they have a completely different calendar, so it is not Christmas here.“

Various spin-offs were forthcoming, such as USA for Africa and Live Aid, with the latter raising more that £150m and saving an estimated two million lives. “And then the Hercules planes started arriving with all this food – it was wonderful,“ Bertschinger says gleefully.

This was the point that she learned the value the media can play in highlighting the plight of others. “It was the start of people really thinking globally. Journalism, photography and films change the world now – and of course it all started off with that journalist asking me that stupid question. I have been back with him since.“

Happy returns

Ethiopia has changed drastically in the 35 years following her fateful meeting with Buerk, Bertschinger says. “There are new roads, hospitals, schools, universities, it is absolutely amazing,“ she says. “The role of charities can make a huge difference, but it's about capacity building and helping people to help themselves.“

“The role of charities can make a huge difference, but it's about capacity building and helping people to help themselves“

She explains how, in the 1980s, nurses were always worried about the under-fives, because even a short period of malnourishment at this point in life can lead to permanent brain damage. “But I have gone back and met some of 'my babies' as I call them, and they have gone to university and got degrees, setting up their own businesses – it is fantastic.“

For Bertschinger, education is key for Africa and lower-income countries. “There is such a lack of doctors, nurses and teachers, but these individuals are raring to go – they love education and want to help themselves.“

This is where some charities have fallen down, failing to solve the underlying structural issues that allow many countries to deteriorate. “With foreign aid, using architects and building materials from Europe and the US does not empower local economies,“ she says. “You need to empower local indigenous professionals and support people – everything I try to do is about empowerment.“

White saviours

The 'white saviour' concept is something that has been hotly debated in the UK recently, after MP David Lammy criticised television journalist Stacey Dooley for perpetuating “tired and unhelpful stereotypes“ about Africa in a documentary for Comic Relief. Lammy argued that celebrities should not be portrayed as heroes going out to rescue helpless Africans, saying “the world does not need any more white saviours.“

Bertschinger agreed with Lammy, tweeting: “Mekele in Ethiopia now, is a thriving, bustling city, capable of running itself! A difference between supporting others to help themselves & the colonial saviour syndrome.“ Bertschinger also notes that the images of her working with children in the 1980s were not staged – they were taken as she attempted to feed and care for up to 600 children. And as a patron for the African Children's Educational Trust (A-CET), she explains that all the images the organisation promotes intend to empower.

“We will not put pictures of skinny, impoverished kids on our website; instead we will put happy kids with a book in their hands having fun, and the A-CET asks for money to build schools,“ she says. “It is difficult to look at adverts that are playing on the poor, even with cancer appeals, and all you see is people with no hair – it doesn't have to be that way.“

Global challenges

It is not just Ethiopia where Bertschinger has witnessed the stark realities of poverty; her aid work has taken her to Afghanistan, Kenya, Lebanon, Sudan, Sierra Leone, Ivory Coast and Liberia. “There are no winners in war, and a lot more attention should be put on soft power, focusing on how we have to transcend our differences by making humanity our highest priority in life,“ she explains. “When you hurt somebody, it is not just that one person – it can affect a whole family or village, and you are only creating more hatred and pain.“

She tells me that transient populations caused by war are among the biggest structural problems facing the countries she has been to. Other immediate threats include antibiotic resistant infections, lack of medical personnel, and nuclear war – she has just come back from Hiroshima, where up to 80,000 civilians were killed when the US dropped an atomic bomb on the city in 1945.

“Our greatest threat is conflict, and more civilians being hurt. For me nuclear disarmament is a big thing, because the bombs today are at least 200 times more powerful than the Hiroshima ones, and I think soft power is key.“

Making a difference

“I am a global citizen, and I know that small changes are helping people thousands of miles away“

With numerous awards to her name, Bertschinger's achievements are even more impressive when you consider the fact that she is dyslexic and could barely read or write until the age of 14 – she actually believed she must have read the letter wrong when she received her damehood in 2010. However, she is a perfect example of how one person can have a huge impact, even by making small changes. “I recycle paper, tinfoil and bottles, I buy lead-free petrol, I recycle clothes and buy secondhand clothes because it is about being ecological, and that is about helping the planet,“ she says. “I am a global citizen, and I know that small changes are helping people thousands of miles away – you don't have to give money, there are other ways of doing it.“

She is also a patron for the Chocolate Run charity in the UK, which gives food that's past its sell-by date, but has not gone bad, to homeless people. “Don't ever invite me to your house and try to throw away an out-of-date yoghurt because I will take it home with me! These things can make a big difference.“

Today she is director for the Professional Diploma in Tropical Nursing at the London School of Hygiene & Tropical Medicine, giving first-hand experience of and preparation for the traumas that aspiring nurses may encounter abroad. “I always tell them the importance of understanding the cultures behind the countries they visit – find out why people do what they do before telling them how to change.“ As a Buddhist, though, there are deeper philosophical considerations that dictate her outlook on life. Her favourite quote? “Be the change you want to see in the world.“