Not long into Anna Freeman’s career as a nurse, she felt an urge to go abroad too loud to ignore.
“At the time I was still quite young, so I didn’t really know what that could mean,” says Freeman. “I knew it would mean working in places where people had less access to health care, where there were more infectious diseases and where other factors — like poverty or underdevelopment — contributed to poor health outcomes.”
Her first assignment with Doctors Without Borders/Médecins Sans Frontières (MSF) was in the Democratic Republic of the Congo, where Freeman witnessed the direct impacts of major conflict that impacted health, like injury caused by fighting. She also became aware of the indirect consequences as well, what she described as having a “ripple effect on people’s health.”
“Living in a war zone meant that children don’t get vaccinated. It meant that women cannot receive prenatal care,” says Freeman. “It meant that food insecurity is something that people live with, and children became malnourished. These are issues that are not directly the result of fighting, however they are absolutely the indirect consequences of fighting.”
Freeman also worked for MSF in the Central African Republic during and after a coup d’etat followed by a civil war. Fighting destroyed the local hospital, forcing providers to “essentially lay the railroad track in front of them” as they served patients. Freeman saw lines of women with infants, some only days or weeks old, who had delivered their babies in hiding when it was not safe to go to a hospital.
