Citations for human rights and nursing awards 2023

Ruggero Rizzini

Ruggero graduated as a nurse in 1993 in Pavia, Northern Italy, and began his nursing career at the Istituto di Ricovero e Cura a Carattere Scientifico, the National Cancer Institute Foundation in Pavia, where he gained experience in Paediatric Oncohaematology as well as infectious diseases and general surgery. He now works within the field of infectious diseases. Ruggero has been chosen as a recipient of the Human Rights and Nursing Awards for 2023 in recognition of the exceptional contribution he has made to the development of health and social care in Pavia and Guatemala, Central America.

In 1998, five years after graduating, Ruggero made his first visit to Guatemala, which inspired him to form AINS Onlus, the Italian Social Nursing Association, a non-profit organisation that builds collaborative alliances to address the determinants of health, such as living and working conditions, as well as access to food, clean water and health services.

Initially, AINS Onlus was involved in a range of small-scale community projects, but In 2012 Ruggero opened Comedor Infantil-Casa, an Institute in Santa Getrudus, Guatemala, caring for 50 children and 26 older people on a daily basis. This facility offers children one meal a day, employs a teacher for after-school care, organises recreational activities for the children and engages a doctor and a nurse once a week in an outpatient clinic where anyone with a health problem can find appropriate care. The Comedor Infantil-Casa is an open place that meets the needs of children and takes care of the parents, especially mothers and older siblings, finding answers to their needs.

Some 26 elderly people attend the facility and receive weekly home visits from the nurse. They are given food packages once a month and every fortnight they have the opportunity to have lunch in the facility. It engages four people with a permanent contract in addition to the services of a doctor and a nurse. The Comedor Infantil-Casa was also established with the aim of creating jobs. In a context where there is a lack of work, the few possibilities are precarious, badly paid and without rights. The workers are employed with contracts according to the labour legislation of Guatemala, and the Comedor Infantil-Casa’s activities are all accredited by the various ministries of Guatemala.

The Comedor Infantil-Casa has recently opened a soup kitchen that is open 3 days a week for people not otherwise using their services. Ruggero continues to visit Guatemala three times a year to progress his work there.

AINS Onlus is also active in Pavia where Ruggero has led on a range of projects, including a Neighbourhood Nurse Scheme to offer health and social activities to vulnerable people. For the last 3 years he has run a project called In and Out, which has led to the development of a Day Centre that is located a few steps away from Pavia railway station. It accommodates up to 25 people who are homeless and offers them physical, psychological and social care. In and Out is supported by a multidisciplinary team including one manager, three educators and one psychotherapist. The team carry out health and social education activities aimed at social integration and enhancement of healthy lifestyles.

A strong thread within Ruggero’s work has been raising awareness of health and social issues often through cultural events including a recent photographic exhibition called Si passa e si va (‘It passes and goes’) that included images of fragility in Pavia. The event included activities for nursing staff to consider the issue of fragility further.

Both in Guatemala and in Pavia, Ruggero organises and works with projects that favour networking with other voluntary associations and with public administrations, promoting nurses and the values of solidarity and charity. He has taken leadership roles in key nursing organisations and used considerable skills to ensure the success of his projects, including raising the necessary funds.

Ruggero’s nominators highlight that his achievements are inspirational and demonstrate what can be achieved by a nurse with a focus on the right to health, education and nutrition. He exemplifies nursing practice that is planned and constant over time can lead to profound change. Ruggero is, thus, presented as a most worthy recipient of this award.

Nurses from the community mental health teams in Ukraine

Before the Russian invasion in 2022, Ukraine already carried a heavy mental health burden and it is estimated that 30% of the population was affected by a mental health disorder. The impact of prolonged conflict and war on mental health has been widely researched and the World Health Organisation (WHO) has calculated that almost 10 million people in Ukraine may now have a mental health condition. Indeed, a recent UN survey showed that Ukrainian people believe that the most significant impact of the war was on their mental health. At the same time, the war in Ukraine has also placed additional pressure on an already strained mental health system. Many mental health institutions have been partially or completely destroyed while others have been evacuated to save the lives of patients and staff. ¹ Access to mental health services may also be hampered by the stigma and discrimination experienced by users of these services. ²

In 2021, Ukraine launched a mental health service model Community Mental Health Teams (CMHTs) with the support of WHO. CMHTs were created and provided person-centred and recovery-oriented care to people with severe mental disorders throughout the country, particularly for people living in remote regions with limited access to mental health services. Since the war began, CMHTs started to use remote consultations, such as phone calls or video calls, in addition to home visits, thus continuing to care for people who stayed locally or in neighbouring countries. Priority areas included among others: promoting human rights of people with mental health conditions and psychosocial disabilities and scaling up community-based mental health services. Since the start of the war in Ukraine, CMHTs supported by WHO have provided 23,000 consultations for 1400 people with severe mental health disorders. It is reported that 99% of the people accessing these services have been directly affected by the current military conflict. ³

Every multi-professional CMHT has a nurse who has the most intensive contact with the patients and carries out multiple functions, acting as the backbone to the team. The nurses have to master a new way of working, using a recovery approach based on human rights. Since the war started in February 2022 they have to do so under extremely difficult circumstances. Instead of fleeing and saving their own lives, the nurses have been among those who have stayed with their patients rather than with their own families, hiding in cellars and evacuating patients while under fire. Many patients struggle with fear and despondency as a result of the war and for many, the members of the mobile teams and the nurses working in them are a source of comfort, reassurance and hope. In some cases, the nurses are patients’ only resource. In addition, the mobile teams organise group activities in which nurses also encourage patients to learn from each other and to support one other. Patients speak of nurses singing Ukrainian songs with them as the shooting continued. The stigma of accessing mental health services has also been reduced by the potential for patients to meet with health care professionals outside a formal health care setting. ⁴

During the conflict, the nurses of the CMHTs have been building their capacity to deliver quality mental health services and act as models to support the development of a stronger and more sustainable mental health system in Ukraine following the war.

There is much evidence of the severe impact that conflict has on mental health of the Ukrainian population. However, mental health issues are often not given the attention and resources they merit. The contribution of the nurses of the CMHTs in Ukraine to the care of the most vulnerable people, in challenging circumstances, has been characterised by a great commitment to patients. Their contribution requires significant resilience, courage and resourcefulness. Such a contribution is recognised and honoured in the Human Rights and Nursing Award for 2023.