Volunteering had never occurred to her. But when she entered the Faculty of Psychology at the University of Lisbon, where she graduated in Psychology with a master degree in Applied Social Cognition in 2008, it was the plurality of people she met that opened up other horizons. From this wealth, as she refers to, she realized that volunteering was the routine of the lives of many. It was when she realised that it was an area she needed to explore. Initially she chose to offer support in mental health, where she had had little contact, but she quickly realized that Psychology was her natural field of action, so why not try something completely new of her own knowledge.
Sónia is 34 years old and from Carregado. For many years, she stayed in Lisbon, because it was the city where all her routines took place. However, a few months ago, she decided to return to her origins in order to be able to have her own house and manage more freely all the costs. She works at the Faculty of Medicine of the University of Lisbon in the Innovation and Entrepreneurship Office, but before she worked for advertising agencies and did qualitative market studies. She also worked in the Epidemiology Unit of the Institute of Preventive Medicine and Public Health at FMUL as project manager of international projects for about 2 years, and later entered into a contract to work at the Innovation and Entrepreneurship Office.
Let's return to Carregado, to which she has several connections. It was there that she became aware of the existence of the Red Cross, when a friend mentioned the Institution where she did hospital pre-emergencies. "But this is scary", she tells me, remembering how it all started, now that she describes her night shifts and speaks with great familiarity about the way she helps others.
After signing up as a hospital pre-emergency volunteer and waiting for news for a year, she was called to the first meeting, where she was informed that, even though they are volunteers, everyone who enters the Red Cross works long shifts and some weekends a month, always with the purpose of helping the population. She accepted the challenge because the area of Health is hers par excellence, whether due to training or passion. But she accepted it knowing that the pre-hospital area is clayey ground for those who do not know how to deal well with stress and the unexpected. She looks very confident and stress does not seem to affect her.
She first learned first aid. Belonging to the Ministry of Defence at the time, she received training in drills, camp and cantonment, as well as about the history of the Red Cross and the importance of the volunteering spirit. Later she did the course in basic life support and other areas of hospital pre-emergency. It was 4 intensive months, every day and on Saturdays, interspersed with year 2 at the Faculty. She followed the normal process like everyone else, first as an intern, as the third element of an ambulance, where all the procedures were observed, and only afterwards she started working in the field. She says that the greatest learning of all is not done while training, it is the gesture of giving, giving without expecting something in return that teaches us above all. A hospital pre-emergency volunteer for almost 15 years, she has got used to entering people's homes and being available to observe and translate the vulnerability of those who receive her. Nowadays she is an INEM certified trainer in basic life support and a Red Cross certified automated external defibrillation operator. She has learned that safety always comes first, but she accepts that vulnerability generates vulnerability.
She reinforces that "we may be vulnerable in the face of a situation, but our safety always comes first".
Sónia Teixeira has been volunteer in pre-emergency hospital for almost 15 years at the Cruz Vermelha (Red Cross) Alenquer
In a relaxed moment with the volunteer team
But is it really so, at a time when we are seeing so many medical teams working on the razor's edge to save others?
Sónia Teixeira: Yes, safety above all, do you know why? If we are not completely safe, something bad can happen to us and to those who wait for us. But the availability for the other comes next, because we find people of all kinds, in difficult social situations, where there is a lot of hidden poverty, and I'm talking about a different universe of people in relation to Lisbon, these are in Carregado (about 30 kilometres away).
Has the fact of having studied psychology help you to acquire the basic knowledge and skills to attend to these more fragile people?
Sónia Teixeira: In the Red Cross volunteering work there is a very interesting aspect. There are volunteers from the most diverse areas. There are many people from nursing, medicine, clinical tests, imaging, but then we also have people from totally different areas. The Red Cross does not develop this area as much, but there is a psychiatric component in a pre-emergency, where I, in fact, provide training. Although we have psychological first aid, there is no big investment in it. But I can tell you that, more than academic training, a person’s profile is what helps the most. Of course, psychology also helped me, but the profile that each person has to adapt to the situation is what really matters.
What kind of situation are we talking about? What does a pre-emergency Red Cross volunteer do?
Sónia Teixeira: It depends, each day is a different reality. We may have cases of cardiorespiratory arrest, where you have to do basic life support. We help many elderly people and many of them are in homes. This is not a "nice picture ", because we have other people around and who see mortality in front of their noses. There are hard situations, like being run over. Then there is the social side of the poorest people, who are very unprotected. I will tell you another story that brings these two realities together.
Carregado is a heavily industrialized area with several brands whose restocking centres are located here. There are people who work in shifts and these distribution areas do not have sidewalks for those who can travel on foot. It was in October, during the night, around 4 am. It was raining and we were called because someone had run someone over, precisely in this area. A truck ran over a lady who was walking in order to start her shift. The rain did not allow the truck driver to see her and she was thrown into the air. The driver was desperate, he just couldn't see her because it was still dark and raining very hard. He called 112 and it was through CODU (Urgent Patients Orientation Centre) that they called us, as an INEM backup. At the same time, a VMER car was called, where a doctor and a nurse are always present. But we were walking to the place and when we arrived we didn't even see her. She had been thrown up in the air. See how vulnerable this makes us feel... We went across the field with a flashlight, where there was only grass and puddles and we didn't know what we were going to see. We could come across just any scenario... I found the lady alive and went straight to her head, a crucial point for brain and cervical stabilization (important note: the one who examines the head is the team leader, as required by the protocol). I got down on my knees and held her, while talking to her to understand her vital signs. We were covered in mud and a police officer was with us and covered her with a blanket because at any moment she could go into hypothermia. At this point the doctor, who is one of the best to work with in a pre-hospital emergency, arrived. It was up to him to decide what to use to transport the lady. She arrived at the hospital in stable condition. In fact, what worried us the most was the almost total amputation of her wrist, but within what could have been very serious, she was lucky. But note how there is also a social component here, this lady was on foot, in the cold, in the rain. I don't want to do politics, but what I feel is that if it weren't for our pre-emergency, these people would have no one.
You work a lot with poverty and loneliness, is that what you are telling me?
Sónia Teixeira: Have no doubt whatsoever! Especially old people who actually call only because they live in deep loneliness and especially at night, 3 or 4 am. If it weren't for INEM and the Red Cross, these people would have no one...
It is inevitable to bring the current pandemic into our conversation, especially when you tell me that one of your main procedures is to ensure your own safety. How safe are you when you need to intervene on a patient? Where does your safety end before you give it to another person?
Sónia Teixeira: This topic will always be very interesting. Do you know why? Now we are talking about the Coronavirus, but until now there has been more talk about this safety and HIV cases. And when you go to see people, they don't always tell you their medical history. Often when we get close to someone and ask them if they have a disease, the person replies "I'm fine", but forgets to say the medications he is taking, in fact, they feel well because they are medicated. We have to follow a protocol with many questions and this is where we detect inconsistencies that can help us understand how to deal with that specific case. As for the contagion part, we always wear gloves and a uniform that is only used in these occurrences, it is not everyday clothes. But it has happened to me to go to people who tell me, "Attention, I have HIV". Our attitude has to be rational, analyse if there are wounds or haemorrhages. If there is no blood, the risk is very low.
Of course, you always have the emotional management part, but you learn to manage. In relation to covid-19, the emergency team is not, for now, assigned to these situations, but there are teams prepared for this. We have an ambulance prepared to transport suspects referred by Saúde 24 with colleagues who are properly trained and prepared for these functions. But we all had 4.5 hours training with all these explanations. I am not part of that specific team because my working hours do not allow me to be assigned to these emergencies in advance.
With 2 volunteer colleagues during a training session
At the training session of the Red Cross to combat COVID-19
Because if you had enough time provide assistance, would you do it?
Sónia Teixeira: Yes!
Is there always some altruism when we are volunteers, or even first aiders?
Sónia Teixeira: I don't know ... (She is silent and sighs) I never thought about it... One thing I know, when I do the pre-emergency and going to help someone I never think: "how nice I am!", I do this because I think that I must give some of my time. I started with the idea of "why not?" and then I wanted to do it and learn more. I think it's a duty... it's almost a duty!
Have you ever lost someone before your eyes?
Sónia Teixeira: Yes. I lost a lot of people in basic life support, because the first few minutes are crucial and when we arrived too much time had passed. That is why it is so crucial that everyone knows how to do basic life support, because the first 3 to 4 minutes are critical and it can save someone's life. And I'm not just talking about mortality, but also neurological damage. Scientific evidence shows that an immediately assisted arrest increases the survival rate exponentially.
How do you deal with all these processes of losses and episodes that you describe?
Sónia Teixeira: Post-traumatic stress is a very important issue and still has little formal support. But it is a huge burden because we get many situations. See the difference between Carregado and Lisbon, while I have one emergency per night, in Lisbon they have one per hour. Imagine the mind-boggling pace it is and the inability to deal with everything. Now, in terms of responsibility, it is the same, due to the quality of the training and to knowing how to provide excellent first aid. But the decision, at the moment, comes with each one’s profile and, of course, after the acquisition of knowledge. We know that we have to do the best we can every time, understand what a critical victim is, to see if we need more support ourselves, we have to evaluate everything. Then each person has to recognize what he is going to do and if he needs to ask for help.
Which means that in an ideal scenario there can be no egos...
Sónia Teixeira: But there are. It is very difficult not to have them. We always have people who think, "I am strong and I will endure this situation alone", and they never complain. It is not by chance that there is often a certain dark humour among these groups, but it is a way of dealing with the situation. Each person reacts in his own way. My way of reacting is to come home and talk about what happened. Then, there is another side that should not be forgotten and that is when someone dies, we are not only dealing with this situation, we have to inform family members. Theoretically, this process of communicating death is not up to us, but many times it turns out to be us. My death situations have been cardiopulmonary arrests and I know that very few are reversed, they are usually elderly people with morbidities, whose outcome is usually the same.
Sónia Teixeira with her volunteer team, 10 years ago.
During this interview
Do you remember the first time you had to provide aid?
Sónia Teixeira: I do. I remember it was precisely in my best friend's neighbourhood. It was a man who had a very advanced cancer. He was very tired, was having lunch and choked on his own vomit. I did compressions right away, because at the time we didn't have an automated external defibrillator, and ventilations through an insufflator. So I was just a relief technician. Sónia was not there, and she is never much, I protect myself a lot. I only realized for sure what I had experienced when I was no longer in that scenario. Fortunately, I never had children with an arrest, I don't know how I would react, but the positive thing is that they usually revert. Fortunately, I never had suicide, or extreme death situations, because the image is too strong.
It is important not to pretend that this side of death does not exists...
Sónia Teixeira: But it is a hard side, because it is associated with images, smells... It is not easy... I return to the idea of having the right profile, there are situations in which we cannot allow ourselves to be moved. Only after stabilizing the person and in the ambulance that the situation can move us more, because it is when we no longer need to reason.
Are these moments of rationality telling you what to do?
Sónia Teixeira: I don't really like to speak only about experience, because that is what sometimes causes addictions. It is knowledge supported by scientific evidence that allows us to assess people. It's funny, because the camps I attended while training allowed me to go on training accidents and similar situations; knowing the theoretical part is really important, because experience sometimes helps us make decisions faster, but too much experience stops people from following the right protocols and sometimes follow the wrong instincts.
Right now, Sonia is doing a new internship at INEM from 4pm to midnight, explaining that these upgrading sessions always make her evolve and be able to help others more. She thinks that even today, basic life support is little taught by doctors and nurses, many of them do not know how to do it when necessary, only those who are in hospital emergency rooms are be more used to so much stress.
Dynamic as well as cerebral, it was volunteering that gave her a different perspective of the other and even that she feels has changed over the years, since she sees that often volunteering is no longer associated with altruism as it once did.
On the other hand, she also learned that the human being is always surprising. On Saturdays she will give training at the Red Cross Higher School of Health, where she has already met younger students, older people and other very specialized people, making it an increasingly large public.
She says that she has been lucky so far because she does not carry along ghosts that have marked her. However, what particularly touches her is the social part, the loneliness of those she tries to save almost every day.
Final Note- Transport Ambulance Crew and Emergency Ambulance Crew volunteers are being called on to make COVID 19 screening available in hospital tents set up at the Hospital da Cruz Vermelha. They will soon be trained to work in screening so that nurses and doctors are more free to perform specific functions.
Credits: All photos related to the team work are from delegation of the Red Cross of Alenquer.
Joana Sousa
Editorial Team