World Health Day 2020 celebrates nurses and midwives' role and dedication at a very particular time, when half of humanity is confined due to the COVID-19 pandemic. Here again, they are in the front line for us, no matter what. But how do they contribute to the IAEA's mission and how does the IAEA support them in their work, including during the current pandemic?
"Nurses and midwives are the backbone of every health system," said Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO). There are 22 million nurses and two million midwives worldwide, accounting for half of the global health workforce and an additional nine million of them will be necessary to achieve the commitment of providing all people with access to health care by 2030.
The IAEA is currently running several hundred technical cooperation projects and coordinated research projects in the field of human health. Since its creation in 1957, the IAEA has supported countries to fight cancer, cardiovascular diseases, malnutrition and other diseases - including Ebola, Zika and now COVID-19 - with the use of nuclear and nuclear-related techniques. The IAEA provides education and training of personnel, guidelines, materials, tools and equipment, and the support of radiation safety and quality assurance. The health professionals that we train and support are part of medical teams in which nurses play a vital role.
Here are the many ways in which nurses support the IAEA's mission - and how the IAEA in turn helps them in their work.
Fighting COVID-19 pandemic and other viruses
The IAEA, in partnership with the Food and Agriculture Organization of the United Nations (FAO), is offering its support and expertise to help countries use real time reverse transcription-polymerase chain reaction (real time RT-PCR), one of the most accurate scientific methods for detecting, tracking, and studying viruses, including the coronavirus. We provide diagnostic kits, equipment and training in nuclear-derived detection techniques to the over 100 countries asking for assistance.
Nurses are involved in all stages of emergency management, including prevention, mitigation, preparedness, response and recovery. Proper training and protection are needed to keep them safe and healthy. The earlier the viruses are identified and analysed, the earlier one can halt the spread of the disease.
"As COVID-19 continues to spread, the people that comprise our best defence to contain and mitigate this epidemic also face the highest risk of becoming infected themselves: health care workers who are dealing each and every day with possibly infected patients," said May Abdel-Wahab, Director of the IAEA Division of Human Health. "It is therefore important to support, manage, and protect these individuals - which include not just physicians but also nurses, emergency responders, and all staff interacting with patients."
In this matter, an IAEA webinar on "COVID-19 - Challenges for nuclear medicine departments", in which nuclear medicine physicians from around the world share their best practices in various aspects of their work, such as rotation policy, use of personal protection equipment, disinfection of scanners, is available online.
Cancer is the second leading cause of death globally, and approximately 70% of deaths from cancer occur in low- and middle-income countries. Cancer patients have a much greater chance to survive the disease when they have access to affordable early cancer diagnosis and treatment, including radiotherapy.
As members of the radiation oncology team, oncology nurses are trained in addressing side effects and receive basic information about when radiation is used as a cancer treatment modality, including via curricula developed with the support of the IAEA. They educate patients about radiation treatment and, under the supervision of oncologists, can also contribute to supportive care, symptom management and follow-up of cancer patients after treatment.
"Nurses in cancer care, especially those in radiation oncology centres, seek evidence-based practice guidance from the IAEA to inform clinical care," said Lisa Kennedy Sheldon, Chief Clinical Officer at the Oncology Nursing Society in Pittsburgh. "Using the IAEA syllabus for training radiation oncology nurses and national resources, radiation oncology nurses are trained to provide skilled and supportive care to patients receiving radiation treatment for cancer".
Medical physicists, radiotherapy machine operators and nurses working together to provide cancer patients with quality care at Yangon General Hospital in Myanmar. (Photo: M. Gaspar/IAEA)
Health and nutrition
Proper nutrition is fundamental to health and well-being. Though, close to 2 billion adults are overweight or obese while 462 million are underweight, according to the WHO. The IAEA helps countries to combat all forms of malnutrition, through health-related technical cooperation programmes and food and agricultural programmes delivered in partnership with the FAO.
The WHO recommends mothers worldwide to exclusively breastfeed infants for the child's first six months to achieve optimal growth, development and health. However, exclusive breastfeeding has increased by only 4 percentage points since 2012 to 41%, a level that is still below the Global Nutrition Target, which aims to increase exclusive breastfeeding in the first 6 months of a baby's life to at least 50% by 2025. Midwives have a key role to play in informing, guiding and supporting mothers in their breastfeeding choice.
The IAEA supports experts worldwide in using a stable isotope technique to assess intake of human milk in breastfed infants. The method is already being successfully applied with IAEA assistance in almost 30 countries. This data can support policies on breastfeeding which midwives or nurses can relay to mothers.
Nurses also play a significant role in the safety of patients in many medical radiation procedures. The IAEA has prepared supporting material that helps nurses and other health professionals to learn about best practices in keeping patients and staff protected when using radiation in medical settings. This includes frequently asked questions for health professionals, training material and online training in radiation protection.
A webinar on best practices for chest computed tomography (CT) including scan parameters and related radiation doses with specific emphasis on COVID-19 imaging with CT will take place on 9 April and could be of interest for nurses with a responsibility for patients undergoing CT scans.
In case of a nuclear or radiological emergency
The IAEA has developed safety standards and generic procedures for medical response during a nuclear or radiological emergency and more material that include the special attention to be given to pregnant women, whose foetus is particularly sensitive to radiation exposure. Here again, nurses and midwives have an important information and psychological role to play to accompany the patients.
On this special World Health Day 2020, our hands are joining the global applaud for health-care workers.