NURSES: EMPATHETIC, EMPOWERED AND ESSENTIAL

On International Nurses Day, Doctors Without Borders (MSF) is celebrating our nurses and their skills, compassion and empathy as they accompany patients throughout their healthcare journeys, from new life to end-of-life, wherever they are.

Nurses are the cornerstone of healthcare around the world and are fundamental to MSF’s medical-humanitarian action. MSF relies on the dedicated efforts of more than 10,000 nurses worldwide—the largest professional group within our operations—to provide essential healthcare.

Often working in their own communities, nurses also carry the weight of collective challenges, but provide important support to people’s resilience as well.

The global healthcare worker shortage is acute among nurses. Low-income countries have a ten-times lower density of nurses compared to high-income countries, based on the State of the World’s Nursing report in 2025. Meanwhile, humanitarian emergencies displace healthcare providers and disrupt the systems they work within, endangering people’s access to essential care and their lives. 
 

“I've seen incredible demonstrations of humanity in the midst of this, and that's coming from nurses,” says Jean Stowell, inaugural Chief Nursing Officer at MSF. “It's nurses who are following these patients, and they're also following a lot more patients than is reasonable in many cases. And I think we forget that, in their day-to-day, they're seeing a lot of trauma… I'm always so incredibly proud to see how nurses in MSF still maintain their humanity, and I think that's a remarkable trait.”

A career inspired by human connection

Abdulrahman Arour’s path to nursing began in 2011, during the war in Syria. “With the bombing and destruction, I witnessed firsthand the suffering of people, which made me want to be part of the medical teams to help them and alleviate their pain,” he says. “I participated in transporting the injured and helping to rescue those trapped under the rubble, and providing first aid to the injured and transporting them to the nearest medical point in the area. This encouraged me to enrol in the nursing school in Aleppo.”

Abdularahman is now a nurse in MSF’s burns unit in Atmeh, in the northwest, where many people remain displaced and live in camps without basic services like heating and electricity. The fuel available for cooking or heating is of poor quality, and people are crowded in small tents. “All these factors have caused many burn cases, especially among women and children,” he says.

“When a burn patient arrives at the hospital, they usually suffer from several problems. A burn can cause psychological problems and physical issues like skin deformities.” In the shared aftermath of war, Abdulrahman cares for burn patients post-surgery and throughout their rehabilitation. 

Like Abdulrahman, Djibril Ouedraogo entered nursing to alleviate suffering. His face lights up when asked about his chosen path in his home country of Burkina Faso. “When I was at the National School of Public Health, I had a clear goal of working in the humanitarian sector. Supporting humanitarian efforts helps ensure that vulnerable communities have access to healthcare,” says Djibril. A nurse supervisor with MSF in Dédougou, in collaboration with the Ministry of Health, is part of a team caring for young and old.

“We have a lot of people who have left their hometowns and are currently in Dédougou,” explains Djibril, the legacy of waves of armed conflict since 2022. Some of them are living with chronic illnesses such as high blood pressure and diabetes, both hard to manage for people wherever they live. “These are patients we need to build confidence in and reassure right from the start of triage. Once they’re settled outside the treatment room, we … organise mental health support with a specialised team. 

Then in the consultation room, the patient feels at ease; if there was anything prior that they didn’t feel like talking about, now the patient feels confident and is genuinely comfortable discussing things with the nurse.” 

The nurturing effect of family encouragement

Susan Adingo is a trained palliative care nurse with the Ministry of Health, working in collaboration with MSF to provide care that supports people’s quality of life in the face of a life-limiting or terminal illness. At Homa Bay County Referral Hospital in Kenya, palliative care is available as an embedded service for admitted patients, through an outpatient clinic, and to people in their homes. Patients may have kidney disease, liver disease, advanced HIV or cancer, or be recovering from a stroke.

“I always had this special spot for those who are sick and those who are in need,” says Susan. “Then I got help from my parents when they realised my interest in helping others, especially the sick. Together, we made a decision that was mutual. And then I got admitted to a nursing school. And that's how my journey started.” 

In the Democratic Republic of Congo, nursing activity manager Lidah Fikaoussou Felicite continues to build her nursing and humanitarian career—a career that started in Chad but could have been something very different. “It was my father’s suggestion. I’d started studying law at university. But after my dad made that suggestion, I decided to go to nursing school, and I think it was the most wonderful suggestion my dad ever made to me,” says Lidah.

Regular fighting between armed groups has exacerbated people’s health and survival needs in the Mweso area, where Lidah is part of an MSF team supporting Mweso General Reference Hospital and six health centres alongside the Ministry of Health.

“In my view, nurses deserve a great deal of admiration and encouragement. Because we look after all the patients who come to the hospital, we ensure their well-being, and sometimes we can’t help but feel their pain. In this job, you feel the weight of what the other person might be feeling, and that’s the daily reality for all nurses, whether here or anywhere else in the world. And especially in [Mweso], where nurses are part of the general population. They too suffer the consequences of a complicated situation.”
 

Working harder due to the short supply

Data for nurses around the world reveals a chasm between low-income Afghanistan and Burkina Faso, for example, and high-income countries such as Australia, Switzerland and the US. On the one hand, nurses count less than 10 per 10,000 population; on the other, more than 100.  These low numbers typically reflect obstacles, including fewer opportunities for education in the first place, lower pay, and tougher work environments.

Nursing team supervisor Fatima Sadiqi has pursued her career with resilience in the face of such challenges. “I started working with MSF in 2014 as an emergency room nurse,” she says during a shift in the inpatient therapeutic feeding centre run by MSF within Boost Hospital in Afghanistan’s Helmand province. “Since then, I have grown within the organisation, taking on more responsibilities and developing my skills, which led me to my current role."

Helmand’s Boost Hospital is a major referral hospital for southern Afghanistan, and “many patients arrive in this hospital in very critical condition and require urgent and specialised care. Our challenges include a high workload, critical patients, and limited resources,” she says, “but we manage these challenges through teamwork, good communication with each other, and staying calm under pressure.”

But finding enough nurses to manage this high patient load is increasingly difficult.   Since 2022, women and girls have been banned from attending university, including medical and paramedical studies, meaning they can no longer join the workforce of certified nurses.

Protracted humanitarian emergencies are also disrupting nursing education and the nurse pipeline around the world. Schools have closed, and students are displaced or struggling to survive in other ways. Nurses have been unable to progress to advanced care practice as a nurse anaesthetist or nurse practitioner. Those who have fled as refugees may not be allowed to work.

Nurses participate in ongoing learning in all MSF projects, and the MSF Academy for Healthcare runs practical, workplace-based training programs for nurse aides and nurses in health facilities we support in several countries. But we cannot replace the years of learning and development that national curricula would normally provide.

Education is just a part of empowerment

“Part of the pleasure, I think, of being a nurse is becoming really proficient at your job, and all nurses want that. They want to be very good at what they're doing - they want to care for people in the best way,” says Jean.
In a medicalised world, however, nurses’ work and contribution can feel overlooked, despite a large body of research about the importance of nursing care. On the one hand, this has been attributed to a downgrading of caregiving associated with women.  Yet even in cultures where nursing involves men more than women, nurses are still not valued in the same way as medical doctors or some other specialised professions.

But Jean adds, “Good nursing care is often not noticeable,” especially preventive care, and the suffering avoided thanks to it. Nurses’ clinical judgement and decision-making can also be overshadowed at times by contributions perceived to be more critical in a crisis.  
 

For Lidah, “the highlights are the moments when we exchange ideas amongst ourselves, the nursing team, and also with the doctors. Through these discussions, it becomes clear that everyone is there to improve the quality of care and contribute to the well-being of the people who come to the hospital.”

In Homa Bay, Susan feels empowered when she can collaborate, but also be a patient advocate. 
While much of the work of nurses may not be front and centre, nurses are essential partners for patients, and for their health provider colleagues. Empowered, they can not only save lives—they can play a leading role in shaping the future of healthcare, wherever they are.