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Darfur, nursing, and network drama

May 2006 -- On March 27, the Liverpool Daily Post (U.K.) ran a good story by Mike Chapple headlined "City-based nurse joins ER crew in Africa." The piece tells how "expert" nurse Marielle Bemelmans, from Liverpool's School of Tropical Medicine, spent six weeks on location in South Africa advising the producers of the U.S. television drama "ER." The producers needed help with several episodes set in the ravaged Darfur region of Sudan. The story includes significant comment from Bemelmans about African refugee camps, and we salute Mr. Chapple and the Post for the piece. We also commend "ER" for its Darfur episodes, which have now aired in the U.S. They have exposed millions of viewers to basic aspects of that crisis, including the ethnic cleansing and the massive human suffering, in a clear effort to spur the developed world to do more about it. Sadly, the "ER" producers were not inspired enough by Bemelmans's expertise or the key role nurses actually play in such settings to alter their dramatic approach. The Darfur episodes focus almost exclusively on the heroic work of physicians, while the nurses who do appear are relegated to their usual role as skilled sidekicks.

The piece explains that the Dutch-born Bemelmans "has considerable experience setting up emergency relief programmes at refugee camps in several African countries," and that she is "programmes coordinator for the Liverpool Associates in Tropical Health." It reports that "ER" producers wanted her expertise for episodes "in which the cast of doctors and nurses are transferred" from the ED in Chicago to a field hospital in "an African refugee camp" (the reporter presumably either did not know or was not at liberty to say that the episodes were set in Darfur). The story gives a little information about what Bemelmans did for the producers, including Christopher Chulack and Richard Thorpe: "I would give advice on what type of diseases would be most common in this kind of setting, such as diarrhoea and hepatitis, how you could treat them and what type of equipment would be available."

As for "ER" nurse characters being "transferred" to work in Africa, we wish some "ER" nurses actually did go, as so many do in real life--more nurses volunteer with Doctors Without Borders than any other type of health professionals, as Suzanne Gordon noted in Nursing Against the Odds. However, among the regular characters of "ER," only physicians have ever been called to provide their life-saving skills to war-torn African nations, specifically John Carter, Luka Kovac, and Greg Pratt. In the Darfur episodes, aired in March-May 2006 in the U.S., a few scenes do include nurses. And they are certainly seen as skilled health workers making a positive contribution, consistent with "ER"'s regular approach, which is clearly better for nursing than any other U.S. drama. But the nurses are still physician sidekicks. Despite Bemelmans's advice and the real role nurses play, these episodes focus overwhelmingly on the exploits and travails of Carter, Pratt, and newcomer Stephen Dakarai. This is nothing unusual; "ER" and other U.S. television dramas commonly employ on-set nurse advisors to enhance the "realism" of unrealistically physician-centric depictions. Then, while claiming credit for raising awareness of the health and social issues the producers intend to address, they deny any such impact on the image of nursing.

Commendably, the Daily Post piece also includes some information about Bemelmans's work at the School of Tropical Medicine and in Africa. It notes that the "consultancy arm" of the school where she works aims "to improve the health of people in the less-developed world, by helping to set up health programmes for overseas governments and other organisations." Programs work to help pregnant African women and to fight TB in China. Discussing her work at African refugee camps, Bemelmans says: "In these camps, there are people coming in very exhausted from their home villages, suffering from different diseases and trauma. It's very difficult, though, because there are so many complex issues going on, especially when all these people come in at once. You have to try to find out who actually are the village leaders or the people in the community who will listen to you, and take appropriate action quickly because there are people dying every day." This is a good example of nurses' community-based approach to health problems.

The article also underlines the importance of getting information about African refugee crises out to a mass audience, which it suggests was a key reason Bemelmans agreed to assist "ER." The piece notes that "ER" has "colossal viewing figures" worldwide. Bemelmans says that:

[b]ecause ER reaches such a huge number of people and countries, it made it a great motivation for me to be part of the series, in which it addresses issues in Africa, which might give a bit more understanding about them to members of the general public, and make them aware of the major problems, such as AIDS, affecting many of the countries over there. ... The refugee situation is very serious over there and people are suffering on a massive scale, but there are things that can be done about it. ... There is no need for such suffering, when the diseases are easily treatable if the right kind of drugs are made available.

This underlines the importance of spreading the message about what is happening in Darfur, and in this respect, it must be said that "ER" has done well. It's hard to imagine any other U.S. television drama devoting several episodes of its season to Darfur, and although the show has certainly lost a lot of U.S. viewers in recent years, these episodes still reached in the neighborhood of 12 million U.S. viewers each on their first airings.

We commend Mr. Chapple and the Liverpool Daily News for highlighting the expertise and important work of Ms. Bemelmans.

See the article "City-based nurse joins ER crew in Africa" in the March 27, 2006 edition of the Liverpool Daily News.

For more information on Darfur:

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