Amanda McClelland working in an Ebola affected area in a Red Cross field hospital in Kenema, Sierra Leone. Credit:Tommy Trenchard/Australian Red Cross She's been held at gunpoint, accused by a Rwandan military commander of being a spy and tasked with building an Ebola hospital in a dense tropical jungle. But she is reluctant to call herself a risk-taker. Real responsibility Asked to describe her riskiest experience, McClelland doesn't proffer a tale involving bombs, guns or catching deadly infections.

Extreme precautions were required to prevent the spread of the disease. Credit:Tommy Trenchard/Australian Red Cross In West Africa at the height of the Ebola crisis, McClelland needed to corral thousands of local volunteers to help respond to the outbreak. "No one else was willing to work in this [environment] and [I was] worrying every day that one of them, or all of them, could catch Ebola," she says. Amanda McClelland says, from a health perspective, it can be too easy to say a problem can't be tackled. Credit:Tommy Trenchard/Australian Red Cross

But rather than relate some of her nightmare experiences, McClelland prefers to expound on how risks can be, if not eliminated, certainly reduced. This, combined with a philosophical take on probability, motivates her. Amanda McClelland is reluctant to call herself a risk-taker. "There is a big risk just being at home and walking across the street sometimes. I think if I am going to risk something, at least I am doing it while doing something worthwhile." The cigarettes and the packets of chewing gum she keeps in the pocket of her bag are basically there to mitigate some of the risks of what can often be very precarious situations.

"When I arrive at checkpoints [in conflict zones], I make sure I take my earphones out and offer a cigarette," she says. "It's the small things that make sure you don't create problems for yourself. It's the way you engage with people." No fail-safe Being part of the humanitarian Red Cross brand also helps. It has been working in some of these spots for 20 years. But even this is not fail-safe.

"I went into South Sudan with International Red Cross during the original conflict between north and south and I was in rebel-held territory tasked with dealing with communicable disease. "I was held at gunpoint by a tribal group while I was trying to bring back several gunshot-wounded victims." However, the local community intervened and rescued her from the situation. McClelland says doing your homework before taking on a risk is crucial. What matters, she says, is "knowing the context and knowing where you are working and understanding the conflict or the situation".

Danger zones However, as she readily admits, her job takes her into situations that are either unknowable or uncontrollable. As far as jobs go, "humanitarian work is one of the most dangerous in the world," she says. "I think we have seen that in recent months, with the two bombings of MFS (Médecins Sans Frontières, or Doctors without Borders) hospitals in Yemen. "What can you do when someone drops a bomb on you from above?"

Despite operating in an environment that most regard as well off the acceptable risk scale, McClelland says there are still limits, and notes that her appetite for it has reduced with age. The Islamic State crisis is one, she says, where the normal mitigation risks of building relationships and negotiating access are not possible. "It really has to be a balance. I went to Somalia during the famine and was under armed guard for the first time ever. "I had a team of 15 young guards [and we travelled in] blacked-out cars surrounded by guns." By way of preparation, she was drilled on the procedure for "when, not if" she got kidnapped.

"I had a code word and negotiator," she says. McClelland says she was told to make sure she had good shoes and a good bra, as she would be wearing them for the duration she was a hostage. She was even assigned a cook to ensure she would be properly feed during the expected kidnap period. 'If it doesn't go well' Committing to action in such extreme circumstances takes a particular kind of person, and a fairly blunt appraisal of the potential outcomes.

"I think Ebola and Somalia are the only two times where I thought 'if something happens to me, it will be worth it'," McClelland says. "I made a conscious decision that if it doesn't go well, it was worth helping." But while outsiders naturally focus on the potential danger, McClelland seems to thrive more on the challenge of the task at hand. The Somali operation was particularly gratifying because of the technical difficulties that had to be overcome, she says. "How do you treat paediatric patients that have malnutrition and cholera when you can't go inside the hospital because bombs were being set off?"

However, McClelland views the issue of risk through the lens of public health and believes we are too risk-averse. "I think we don't give enough credit to the mitigations we have in place. Ebola is a good example. This caused a huge panic. If we got a case [here], it would have been a case and we would have managed it. 'We have to make decisions about the best outcome for the greatest number." Weighing up the consequences is never easy when working in life and death situations. Read next

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