|Karen Lee, FHNP ‘10, Building Leaders in North Korea Refugee Community: a letter to her faculty|
I was a FHNP/Global Health minor student from 2008-2010, and have since realized just how special those years were and how much of an impact they continue to have on my life today. I am halfway through my Fulbright Scholarship period in Korea, during which I have been working to empower and build leaders within the North Korean refugee community. I was also given an additional opportunity to work with the Korean government on their official development assistance (ODA) project to develop a Maternal Newborn and Child Health program in Cambodia. Somehow, despite my often feeling like I am completely out of my league in the work we are doing, I have been designated as the Field Leader and have been conducting the qualitative needs assessment in one of the provinces for the past week and a half. It is my first time navigating, let alone being so actively involved in, such a huge scale project and I can only attribute my success in staying afloat during this time, as well as during our pre-departure preparations, to the things I learned at Penn... essentially, to the things I learned from each of you. I was one of those students who often questioned whether I had made the right choice in choosing nursing as a career, and now I have nothing but gratitude for the perspective it's given me on health and people as they exist in their natural contexts. We've learned that interviewing is an art, and in the field, especially, it becomes quickly evident as to who possesses the skills required to understand an interviewee on such complex levels. When I am asked where I got my experience in qualitative interviewing or in the field, even with all the current training I get from the experts on our research team, I just say, "This is what nurses do... this is how we learn, how we're trained to think, and how we interact with people." Whether our work is medical, administrative, or social/anthropological in nature, I feel like I am able to transition comfortably and that is entirely because of what my prior nursing experiences have required of me. It's amazing how no other profession can cover quite so many bases. Through lectures, discussions, HPI exercises, clinical visitations, and global health field study trips, I learned lasting lessons from you all and am sincerely grateful.
Karen recently wrote us:
I can hardly believe it’s already been a year since I’ve returned to the States. Even now I can honestly say the sentiments written in this email have not changed. I’m excited to continue building on the strong foundation of my Penn education!
|Demere Kasper, BSN '10, RN, Making a Difference in Afghanistan|
Uniformed Police (AUP) checkpoint down to our West in Zamto Valley, and the Deputy District Chief of Police brought all of his wives, female relatives and other females from the valley to the checkpoint for the program. Susan (my teammate), Heila (our interpreter) and I sat down with all of them and spoke to them about the future school in Mya Neshin and the hope that eventually they would be able to teach young girls, but that it would start out as a boys’ school. We also showed them pictures of women’s shuras*, women’s soap making projects and girls’ schools in other parts of Afghanistan. I checked everyone’s blood pressure, and Susan handed out pots, pans, Tupperware and the women’s jackets. All in all, it was pretty successful. Twenty-seven women attended, which is the largest official gathering of women in Mya Neshin since the last women’s shura which was held in 1998. There were close to thirty-five children running amuck.
- In an attempt to reach more of the villages, Susan and I created a community health radio series that have been airing on the local radio. We are currently on episode number six, and have five more to record. Surprisingly, we have received feedback that even the Taliban enjoy and support the community health radio series, because they are for the good of the community. The topics we’ve covered have been health, hygiene , hand washing, child nutrition, vaccines and common childhood illnesses, burn care (villagers tend to put toothpaste and mud on burns), hydration and clean drinking water. All of the episodes are big hits, as most patients at the clinic mention the broadcasts when they see us. One older man that we see quite often told us that his daughter has taken the hygiene episode to heart as she now carries around a bar of soap with her, washing her hands after almost every activity. A five year old boy we saw the other day at our clinic proudly showed us his clean hands and clean ears. Another trio of young boys told us that they showered and washed their hands and ears before coming to see us at the clinic.
- Another initiative we have been working steadily on is the implementation of the Community Health Worker program. Reportedly seven women and seven men finished the first third of the three-part training to become Community Health Workers at the beginning of this past week. This is a huge accomplishment, especially because Susan and I were able to successfully lobby the Provincial government to provide a trainer to actually come out to Mya Neshin. Originally we were going to train them, and we had only identified three couples who were interested, but our community health radio messages generated enough interest that the volunteers doubled and we were able to get an official Afghan trainer from Kandahar City. We did provide the provincial manager for Afghanistan Health and Development Services (AHDS) with the initial CHW kits. At the end of the month we are having another Cultural Support Team (CST) (that’s the type of team I am currently serving on – CST 42), who is a midwife by trade, come out to the district to teach a female health seminar. We hope to identify willing women who can attend two-day emergency birth training later this year, and we’ll have the same CST come back out to train them.
|Emily M. Hall MSN '06 MPH '07, Penn Alumna Working Side by Side with Rwandan Nurses|
While working in Rwanda during 2008 and 2009, part of my work focused on building nursing capacity at a district hospital in the eastern province. With the birth of as many as six new babies each day and 20 initial prenatal appointments each week, the nursing staff providing maternity care in our hospital had a 24 hour a day, 7 day a week job. Our unique program offered experienced clinicians the opportunity to share knowledge with their Rwandan colleagues while collaborating at the bedside in our rural hospital.
- By addressing training needs, we introduced our Rwandan colleagues to skills that help bring the best clinical care to our patients. In the prenatal care clinic, where ensuring healthy births is the priority, screening for pregnancy complications, such as high blood pressure and infections, complements prevention efforts against malaria and tetanus. Here, we mentored and trained Rwandan nurses in determining gestational age and expected date of delivery. Accurately estimating the arrival of a newborn is very important in rural Rwanda, where getting to the health center may take much as 6 hours or more on foot. By learning how to use a Doptone, ultrasound technology used to listen for fetal heart sounds, nursing staff assess the fetus’s development and expectant mothers can hear the heartbeat of their growing babies. Providing comprehensive prenatal services means healthier moms and babies.
- In the labor and delivery room, we worked side by side with Rwandan nurses and midwives, using patient cases to teach best practices for the rural patient population. As these are referral centers for high-risk cases from the rural health center network, nurses work with women who are facing miscarriage, pregnancy complications, or prolonged labors. Team trainings on lifesaving emergency measures, such as newborn CPR and prevention of hemorrhage teach nurses how to handle the most difficult cases.
This program paved with way for many nursing focused training programs at collaborating hospitals and health centers in Rwanda. Nurses in the rural setting are the foundation of the health system for the majority of the world. At the health centers located away from a district hospital, nurses are supported by doctors one day a week or sometimes less. Therefore, investing in nurses is an investment in the lives of patients.
|Changing the World through Healthcare and Finance|
Carol Hanselman, Nu '09, GNu '10, put her dual degrees from Nursing and Wharton to work as an intern for HOPE International, a faith-based non-profit organization, focused on alleviating physical and spiritual poverty through microenterprise development. Hoping to find an intersect between healthcare and microfinance, Ms. Hanselman and two businessmen colleagues formed LifeNet Medicine, a start-up endeavor created to distribute healthcare supplies to the world's poor.
"The Penn Nursing vision 'care to change the world' and Dr. Julie Sochalski's mursing leadership course [N370, the theory portion of the "capstone clinical" that seniors take during their last semester] taught me to consider the wider scope of nursing as a profession," Ms. Hanselman explained. "I helped srtart LifeNet Medicine to enable nurses in Africa to distribute medicines in their villages, as they may be the only healthcare providers their communities will ever see."
The LifeNet model leverages the work of existing microfinance organizations as distribution channels for lifesaving supplies in a method that's both sustainable and scalable. In the winter of 2008, LifeNet partnered with HOPE International to better understand the healthcare challenges facing microfinance entrepreneurs, selecting Burundi, one fo the poorest countries in the world, for the project's pilot location. Ms. Hanselman spent the past summer living and working in Burundi, where she provided first-hand research for the launch of the pilot program this Fall.
"I've already been overwhelmed with the need for help from nurses in all aspects of health," she wrote in her first week there. "Today I visited a clinic in the slums where 22 patients were staying in a room the size of my bedroom, with 3-4 people per bed. One child was going through a seizure as I walked into the room."
In Burundi, she learned from members of all health sectors, including rural clinics, private pharmacies, government hospitals, and the Minister of Health. Before her return to the United States, Ms. Hanselman began the registration process for LifeNet Medicine in Burundi, anticipating the start of operations in 2010.
"The critical thinking skills of a Penn Nursing degree enabled me to assess the needs of Burundian communities from a public health perspective, identifying high rates of malaria, diarrhea and typhoid and the lack of disease prevention such as mosquito nets and hand washing," she said.