I write this editorial as the final evacuations from Afghanistan take place and, as I consider the articles included in this supplement, it makes me realise how privileged we are in the UK. We have access to healthcare that is free at the point of delivery, with cancer care being particularly privileged. We are able to focus, not only on the patient and their immediate needs, but also on carers and families.
The stark inequalities, not just in healthcare, but in many aspects of society around the world, are visible in recent images from Kabul. We are able to offer cancer treatments to patients that cost hundreds or thousands of pounds per cycle. We are able to educate, train and employ nurses in specialist roles, such as cancer nursing. Although funds are not limitless and the NHS is not perfect, we are able to go to work without fearing for our safety.
Nurses in Afghanistan have faced very different challenges to nurses in the UK, with healthcare depending heavily on international donors and non-governmental organisations.
Analysis of data from 31 343 households, collected between 17 July and 19 September 2019 throughout all 34 provinces in Afghanistan, found that 10 057 (32.1%) could not access healthcare facilities when needed in the previous 3 months (Noh et al, 2021). Nurses and midwives have also witnessed first-hand the violence within the country.
Nurses in Afghanistan now face uncertainty in their personal and professional lives, in addition to concerns for their own safety and that of their families. The Royal College of Nursing has released a statement in support of Afghan nurses:
‘Health workers in Afghanistan have already faced a great number of challenges in recent years, including incredible shortages of healthcare workers and deliberate acts of violence. We expect the international community to stand with nurses in Afghanistan now, and the communities they serve too … As a profession, nursing is about people and no matter how far away they may be from our shores we are compelled to act.’
Royal College of Nursing, 2021
As refugees arrive in the UK having left everything behind them—their homes, possessions, jobs, family and friends, it is heart-warming to see the reaction of the British people, with donations and offers of help gladly given. As their immediate needs are met, we must also think to the future, of how they can integrate into UK society and live independently. Among the 5000 refugees that the UK will take over the next year there will be nurses and we should welcome their skills. We can also support those who wish to specialise in cancer care to access opportunities to be able to do so.
The UK relies on nurses from other countries to supplement our homegrown workforce and there have been specific schemes bringing groups of nurses from other countries to work in the NHS. I qualified along with a group of nurses who came from the Philippines on such a scheme, and have had the pleasure of continuing to work with one of these nurses within cancer research.
The experience of refugees is likely to be different following a swift evacuation, with no choice or time to prepare. Refugee nurses will need specific support to enable registration with the Nursing and Midwifery Council, including the recognition of existing training, language support and educational support. One such scheme is already under way at Liverpool John Moores University in conjunction with the Refuaid charity. At least two small cohorts have completed the 4-week course this year (Nye, 2021). Hopefully similar schemes will be available across the UK for Afghan nurses wanting to join the NHS.
This situation provides nurses in the UK with an opportunity to show the best of our profession, by providing encouragement and support to our colleagues from Afghanistan. We can offer support in clinical settings, educational opportunities or mentorship via local schemes, and work with charities and organisations that facilitate refugees to find employment. Most importantly, we can provide a welcome to those who are in need.