Patterns of community relationship: nurses, non-governmental organizations and internally displaced persons

Background: Internally displaced persons (IDPs) are one of the largest at-risk populations in the world. Nurses provide health services to IDPs as staff of non-governmental organizations (NGO). IDPs are also employed to deliver NGO services. The way that NGOs and field staff (nurses and others) interact with employed IDPs can enhance or diminish IDP quality of life. Aim: This report describes patterns of relationships in a community formed by an American NGO, its field staff and IDPs as they worked together in a refugee camp at the Thai-Cambodian border over 13 years. Methods: This qualitative case study describes relational patterns from the NGO perspective. Content analysis was used to process data from in-depth interviews with organizational leaders (n = 4) and organizational documents (n = 234). Findings: A health care training and service mission, carried out between an NGO, its field staff and IDPs, was based on a philosophy that turned programme activity and authority over to IDP staff. Over 400 IDPs, assisted by 235 field staff, delivered effective health care to 85 000 people over 13 years. Conclusions: Work-centred relationships between NGOs, field staff and IDPs are significant; they can be consciously created to promote effective, autonomous IDP management of health care.