When a humanitarian crisis hits—whether it is a natural disaster, a disease outbreak or an armed conflict—the first thought is to save as many lives as possible. But for graduating public health student Anna Voeuk, her focus is also on those who won’t make it.
“It’s very difficult for people to understand,” said Voeuk, a family physician and palliative care specialist who will receive her master’s degree in public health on June 7.
“Unfortunately, we can’t save all lives. But we can try to relieve suffering. And we can try to preserve dignity. And that’s what palliative care is all about.”
Voeuk has travelled to disaster zones around the world, encouraging health-care teams to ensure those who are fatally ill don’t die alone and without comfort.
“In these acute emergencies, time is of the essence. And there are big decisions that people have to make when resources are limited,” acknowledged Voeuk. “But what about those people who will die imminently? Can we make them comfortable for the time they do have remaining? We have to recognize that dying is an important phase of life as well.”
Voeuk worked at a field hospital near Mosul, in northern Iraq, scene of years of fighting between Iraqi forces and Islamic State of Iraq and the Levant (ISIL) insurgents.
A man came into the hospital with burns so extensive that it was obvious he would not survive more than a few hours.
Instead of reacting as if nothing could be done, Voeuk and the medical team asked themselves what could be done.
Nurses took time to sit with the patient. They played some music. They gave him some medications to help relieve pain and agitation as his organs started to fail.
“That gives me hope, to know that there are things we can do in situations like that,” said Voeuk.
Voeuk developed her caring attitude toward the most vulnerable as an undergraduate student in Vancouver when she stumbled upon L’Arche. Founded by the late Canadian philosopher and humanitarian Jean Vanier, L’Arche is a federation of international faith-based communities where adults with and without intellectual disabilities live together.
Voeuk, who grew up in Alberta’s Crowsnest Pass as the child of immigrants, felt immediately accepted at L’Arche.
“Having grown up in a small town, I was missing that sense of community while going to school in a big city,” she said.
She found the L’Arche philosophy resonated with her: “That idea of being together, and showing compassion, and giving people a sign of hope—recognizing that they are valuable.”
Voeuk lived in L’Arche for a year and a half, and the people she lived with became like a second family to her.
“I think it really did influence where I am today,” said Voeuk. “The philosophy of L’Arche and palliative care are quite similar.”
The value of hard work
Voeuk received her medical training at the University of Calgary and did her rural family medicine residency and palliative care fellowship through the University of Alberta. She worked as a locum family doctor in communities around Alberta for five years, then focused on providing palliative care to patients in the Edmonton area, where she still works.
Her parents tried to talk her out of becoming a doctor when she first became interested in the profession during high school.
“People think parents always want their children to go into medicine, but in fact my parents did not, because they saw how much work it required, particularly in a small town,” she explained. Once she made up her mind, though, “they were very supportive.”
Her parents knew all about hard work, as owners of a small-town restaurant. Voeuk had to help out in the restaurant too.
“My friends didn’t have to work,” Voeuk recalled. “Or if they did, they had other jobs that seemed to be more interesting. Because this was just helping out my family it didn’t seem like a real job.”
Voeuk’s father had a post-secondary degree but couldn’t work in his field in Canada. He encouraged his children to seek higher education as a way to have career choices.
Her father also encouraged Voeuk to travel. High school trips to France and Italy were followed by trips to Niger, Cuba, Ecuador and Haiti.
“It opened my eyes to the need that is out there, beyond the comfortable setting we have in Canada,” said Voeuk.
When Voeuk was asked to help set up and run a treatment centre during the Ebola virus outbreak in Sierra Leone in late 2014, she felt prepared to work with patients but found she lacked non-clinical skills in policy, program planning, assessment and evaluation. She decided to pursue her master’s in public health to fill those gaps.
“I thought to myself, if I had actual formal training in public health or global health, could I contribute more? Could I make more of a difference?”
As part of her program, Voeuk did her practicum at the World Health Organization in Geneva, monitoring and co-ordinating responses to global health emergencies. She is on standby for non-governmental organizations that respond to humanitarian emergencies around the globe and has just returned from South Sudan, where civil war has raged for six years.
“I don’t choose the locations or the responses, they kind of choose me, so I never really know what’s next,” she said.
“For me it’s important to be where there’s a need and to see if my skills can actually contribute to meeting that need or bridging a gap.”
While she waits for the next call to go and help overseas, she will continue to work as a palliative care physician in Edmonton. She serves on the boards of L’Arche in Edmonton and the Canadian Society of Palliative Care Physicians.
Voeuk would like to see equitable access to palliative care for patients, both in Canada and around the world.
And putting on her public health hat, Voeuk challenges everyone to step up and help.
“It’s not just physicians, it’s not just the health-care team. It’s every member of society’s responsibility, I think, for us to look out for one another and to be there to support people,” she said.
“We need people to lean on and to help support and encourage us.”