Over the last 30 years, Sabine Rens has played a pivotal role at the world’s leading crisis relief organization: Médecins Sans Frontières (Doctors Without Borders). Throughout her career – both with MSF and other organizations – Sabine has worked tirelessly to support communities in areas struggling with man-made and natural disasters, including Chechnya, Burundi, Angola, Indonesia, and Mozambique.

Everywhere she went, though, she and others noticed something was missing: There was a severe lack of local personnel with the skills to deal with a range of healthcare needs, both in the immediate aftermath of crises and thereafter. This meant that, after the initial humanitarian support offered by MSF, local healthcare staff would have to grapple with the prolonged challenges of a crisis.

It grew to be a passion of Sabine’s and so she became one of the loudest proponents of a new initiative within MSF.

The MSF Academy for Healthcare was launched in 2017, with the goal of upskilling healthcare workers within the communities MSF serves, safeguarding people against future crises. EF is proud to be a supporter of the MSF Academy’s work, putting our passion for education into supporting people to live safer, healthier lives, as well as training the next generation of healthcare workers.

As part of our multi-year partnership with MSF, we are also investing in the MSF Emergency Fund, resulting in a comprehensive support structure for communities in need, from acute response to long-term resilience.

Although Sabine has recently left her role as Director of the MSF Academy, we asked her to share her unique journey and knowledge of the MSF Academy for Healthcare with us.

I started working with MSF in 1995, having worked in international law and public relations in the private sector. I was always drawn to the development sector, though, and I volunteered with MSF a few times before I eventually joined as a staff member in ‘95.

Since then, I have worked for some other organizations; I even went back home to Belgium to work for the public health sector. But I remained connected to MSF even when I worked elsewhere, sitting on the MSF board, so I haven’t really left since I joined. For the last six years I have been working at the MSF Academy.

MSF has always excelled as a humanitarian organization responding to crisis-hit regions. For decades, however, it’s faced a lack of human resources and a lack of skills in the countries it operates in. There was clearly a need to train local people in providing medical care. MSF did organize ad hoc training on specific subjects, but the need for competency development required a much bigger investment in education – something MSF expected other actors to take on. There was no obvious way for MSF to do that at the time.

It varies country to country, region to region, of course. Often, we work in remote areas, with dirt roads and sometimes inconsistent electricity and water supply. Many of the staff have received initial training but often lacked mentorship to help them apply what they have learned. And with nursing staff stretched across a hospital sometimes running at 150% capacity, it’s difficult to provide quality care.

In healthcare centers at the primary level of care, the lack of general practitioners (MDs) means many staff providing the consultations have never received any formal training on translating symptoms into a diagnosis or deciding a course of treatment.

Helping them to develop critical clinical reasoning is crucial to improve the quality of care provided: being able to understand why someone has an elevated temperature or why someone might feel pain is vital in providing care.

When MSF arrives in an area, it might partner with an existing hospital or set up its own, depending on the facilities available. If required, MSF Academy then reviews exactly what is needed to facilitate quality healthcare training and where gaps exist in the nurses’ knowledge.

Where we differ is other training programs often take staff out of the hospitals, bring them to the city, teach them for a week or two, and send them back. People then usually revert to their old habits, as there is limited support in putting what they learned into practice.

For us, however, we know how short-staffed our hospitals are and how vital the nurses are to the people they serve. We have a blended style of learning where they can learn while still providing care in their hospital. They learn the theory in class time and then immediately apply it in their work, when they are also guided by a mentor.

Changing behavior doesn’t happen in one day, or even one week, so we help them – little by little, block by block – to put their learning into practice and create long-term improvements in the standard of care.

Once the nurses have been through a training program, they will get a competency certificate that is recognized by the local health ministry. This doesn’t necessarily mean they will get a promotion or move up the ladder in the professional classification of professional trainings, but it does provide them with a clear recognition of quality care and will make future job applications much easier.

Naturally, many people and organizations are drawn to support the MSF Emergency Fund in the immediate aftermath of a crisis, because there is a clear short-term need for support.

In our first conversations with EF, however, it was clear EF was very interested in the educational side of the MSF Academy and long-term, sustainable support for our ongoing work following a crisis. There is a great synergy in our goals, and we are very excited to have EF backing this program.

With this support, we are able to remain financially independent and plan for the future of the MSF Academy.

The funding from EF and some other donors has afforded us the credibility and autonomy within MSF to make positive impacts in the places we operate and show how we can positively benefit MSF’s overall work.

That has been our focus this past year – now it’s time to look to the future and think about how far we want the MSF Academy to go. Until now we’ve developed a few learning programs, but how far could we take it?

We train by focusing on a specific role or function and dividing it into competencies, creating a full curriculum covering everything they need to know. Until now, we’ve focused on very clinical roles, but we want to expand that to, for instance, a ward supervisor function, covering all competencies from the clinical to the management requirements.

Another important challenge is figuring out how to access harder to reach areas, perhaps via e-learning, where it’s hard for MSF staff to accompany local healthcare workers.

It’s an incredibly exciting time for the MSF Academy.