Ms Askew's first overseas mission for Red Cross was to Juba in Southern Sudan in 2003. "The people in Southern Sudan had been at war for 20 years with the north, and everything was broken. Health, education, roads - everything was broken.
"People came from the rural areas into Juba for safety. They came carrying what they could and for many of them, that was their children."
The two-year deployment, working with displaced people in mudbrick health clinics, was the first of three missions to Sudan over the next 10 years.
The second, delivering services to rural villages in western Darfur, was the most dangerous, she said.
"We were out in areas where there were roaming militia, and I was involved in three armed hold-ups."
She also worked in Indonesia in 2005 after the Boxing Day tsunami - during which time the second Bali bombing and a devastating 6.8 magnitude earthquake struck.
Another assignment took her to Iraq in 2009 and 2010, where she said explosions at checkpoints could make travelling risky. "It was potentially dangerous but it's not something I worry about while working. I have a job to do and I do it."
Ms Askew said she tries to spend six months at home in Gisborne between each mission, and in her last break has been working for the Cancer Society.
She heads to Lebanon next month, where she will work with Syrian refugees.
She admits the dangerous locations worry her 87-year-old mother.
"I try to explain to her that what she sees on the news is the worst that the world can drag up on that day, and for the most part people are going about their daily business of living, and that's what I'm involved with; the living."
The 59-year-old mother of two and grandmother of one said she would continue aid work while she could.
New Zealand Red Cross secretary- general Andrew McKie said the medal recognised Ms Askew's outstanding commitment and devotion to duty.
"Janet has exemplified the personal qualities of courage and bravery many times during her career," he said.
