Motivation
on Shona in Sierra Leone (Sierra Leone), 25/Feb/2011 15:39, 34 days ago
What is it that motivates us? What motivates us to go to work? What motivates us, or inspires us, to keep going when things are tough?Because things are very tough here in SL. There are so many barriers which keep nursing and medical staff away from work. Transport (and particularly traffic) is tricky. People work six days and week and the medical officers get no annual leave. Banks are only open 8.30am-3.30pm and there are no ATMs so you have to go during work time. The hospital has lost four medical officers since I started working here in September (there were eight previously so now everyone is unbelievably stretched). Hospital staff is employed centrally by the Ministry of Health and Sanitation so the hospital management currently have no ability to hire the staff it wants or to fire staff members who don’t come to work or are consistently late.The most difficult thing for me is that children die. Every day. Every day children die. It is so so difficult to keep going and keep positive when children are dying all the time. (Granted that I spend a lot of time in ER and ICU where the sickest children are, and not the general wards where they are getting better).So I’ve been asking some colleagues what is it that motivates them. What keeps them going when things are so tough?The staff nurse on ICU is one of the most motivated people I know. She is a pleasure to work with. I asked her what makes her so determined.“I imagine that it’s my child lying there sick, and I think how I would want the nurse to treat my child” was her answer. I think this a lot at home, especially when people are being rude or impatient. And no matter how bad my day has been, it is ALWAYS worse for the patient, and the family.A student nurse, also incredibly motivated and hard working told me that her mother was a matron and that her mother inspired her. That, and a desire to know more, to learn, to be able to progress in her career and life (and perhaps, sadly, move away from SL, as most of her family are in the States).Another nurse answered that she enjoys the patients, likes learning about interesting diseases and likes the“instant rush” of being able to help patients and make them better. Another said that she has a sense of duty to be here.One doctor told me he is motivated by his religion, his faith in God which has led him to help the people of Sierra Leone by training to be a paediatrician and continue working here. He also, very sweetly, said he was inspired by the international staff working here who have come to help his country (it’s always nice to be appreciated so thanks for that Ish!).Many are motivated by money, or simple survival. The other NGOs have used monetary incentive schemes to encourage nurses to come to work on time, as a top up to their meagre salaries. Many nurses still (unfortunately) try to charge the patients money for certain things.Others are motivated by career progression and the respect that it brings. It’s a hierarchical society and Respect is a big issue in this culture.A lot of people (at home) wonder what on earth possessed me to uproot my life, leave my husband and my comforts of home for a year to live in a place like Sierra Leone. And, believe me, I often wonder the same thing myself. So what was it that brought me here? What is it that motivates me? That keeps me going into work every day, when I am not being paid to be here? And what is it that I’m actually doing?So what brought me here? My parents worked abroad in the Solomon Islands when I was a child. They have always inspired and encouraged me. Eleven years ago I did my student elective in Malawi, and I always always wanted to go back to Africa, to work here and to try to make a difference. I studied parasitology and went to conferences at medical school with the amazing inspiring people who are part of Medsin (Medical Students International Network) and I never ever let go of that dream. My lovely husband has been unbelievably supportive with the whole thing.And what keeps me going? I suppose the answer is a mixture of all opinions of my colleagues– I find the medicine very interesting, I get a great buzz from being able to help the patients who get better and I try to empathise with the patients – how would I feel if were my relative who was sick, or me? The “its always worse for someone else” guilt. My faith is also very important.And there is always hope for the future – when a child you think is going to die turns the corner, when you see some amazing team work in ER, when the medical students say that they want to do paediatrics. And finally, my colleagues – local staff who keep going despite the odds, and the incredible international staff I work with (you all know who you are).I still don’t know what I’m doing sometimes, in terms that I often don’t know what I’m achieving or trying to achieve in the long term. (Reducing child and infant mortality in Sierra Leone is the overall VSO goal but I know that’s too big for me to do on my own. And we can go over the Aid Debate in another blog). But at the moment all those things and people that inspire me are going to keep me going. And the difference I’ll make, if any? I’ll answer that at the end of the year.