UAB Magazine Weekly - Features on Health Care
The School of Nursing’s work in countries such as Honduras and Zambia inspires students and faculty. In Zambia, for example, the SON is trying to enhance nursing opportunities through targeted educational programs, says Doreen Harper, Ph.D., R.N., F.A.A.N., the school’s dean and director of UAB’s Pan-American Health Organization/World Health Organization Collaborating Center for International Nursing (PAHO/WHO Collaborating Center).
The SON’s partnerships in Honduras have been dealt a setback by the country’s ongoing political instability; faculty members Karen Saenz, Ph.D., M.P.H., M.S.N., C.P.N.P., and Lygia Holcomb, D.S.N., C.R.N.P., had to cancel a trip there with students earlier this summer. However, Saenz expresses confidence that the bonds SON faculty have built with their counterparts in Honduras have grown strong enough to weather any temporary disruptions. “We’re planning on having some of those faculty come here this year—I think we’ve gone to Honduras enough, and kept in close enough contact with them, that the political situation isn’t going to make a big, long-term impact on what we’re doing,” she says.
One approach to enhance global nursing capacity and leadership is an international nursing leadership program that is sponsored by the PAHO/WHO Collaborating Center every other year. In January 2008, 18 nurses from Brazil, Chile, Colombia, and Honduras participated in the three-week program in Birmingham. During the program, nurses lived with volunteer host families, participated in a class on global leadership, studied English at the UAB English Language and Culture Institute, and developed projects to improve health in their host countries, all in collaboration with UAB faculty.
“It has been wonderful to see those nurses come to Birmingham,” Saenz adds. “Many of them had never had passports before; some of them had never even left their area of the country. So it was such an amazing opportunity for them to come and see what a university hospital was like. We’re trying to integrate them into research, scholarship, and teaching, trying to raise their perception of what a nurse is and can be. Often they only think of a nurse as standing at a bedside or treating individual people in a certain area, but we’re trying to show them, ‘No, you can do more. You can set up entire shelters; you can influence political changes and make a difference in a community.’ And I think they’re starting to get that idea now.”
“We have a network now that involves nurses from many different countries,” Saenz says. “The Chileans can talk with the Hondurans, and the Hondurans can talk with the Brazilians—it’s not just us giving out the information. Their situations have a lot of similarities, and they have to be able to solve those problems by collaborating with others in the region. By partnering, we collaborate on problems that our counterparts in Latin America are able to help us with as well.”
In July 2010 the International Nursing Leadership Program will be open to a total of 15 Latin American countries, and also will include a cohort of 10 nurses from Zambia. For further information about this program, or about serving as a host family for one of the nurses, contact Lynda Wilson at (205) 934-6787 or
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Holcomb describes the Latin American nurses they’ve worked with as “cultural experts” in their own right. “Sometimes when we suggest things that we’d like to come and do, they say, ‘No, that’s not going to be important here. Let’s don’t focus on obesity in children—let’s get people food first.’ At the same time, it’s interesting to see cultures collaborate and share so many common experiences. They’re interested in wellness and health care, and they’re learning, just like we are. Together, we’re making a difference.” |
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The School of Nursing is working on several intriguing projects in Zambia, notes assistant dean for international affairs Lynda Wilson, Ph.D., R.N., F.A.A.N. Wilson first partnered with Eleanor Msidi, registrar of Zambia’s General Nursing Council, and with other Zambian and international partners, to develop a distance-based program to teach nurses how to prescribe HIV drugs. The one-year diploma program was launched on June 15, 2009, with 31 nurses from all nine of Zambia’s provinces. “They had two and a half weeks of classes in Lusaka [Zambia’s capital], learning about all aspects of HIV care; then they did their next three and a half weeks in intensive clinical mentoring,” Wilson says. “Now they’ve gone back to their home provinces, where over the next 10 months they’ll be mentored 40 hours a month and examining some case studies.”
This, too, is a long-term project, says Wilson. “Eventually we’ll need more funding to make this a distance-accessible program,” she points out. “Not Internet-based, because Internet access is not reliable there, but we want to put a lot of this material on CD, and my dream has been to involve our nurse-practitioner faculty who know how to deliver distance education. We have identified several faculty members who have expressed willingness to go to Zambia and work with the Zambian team, because they know that when you teach in a distance format, you have to teach differently to get the students to engage with the material. And that’s going to be a big paradigm shift in Zambia, where they’re accustomed to sitting in a classroom and just writing down what the teacher says.”
Wilson has identified another possible solution to the challenge of long-distance teaching in eGranary, an idea originated at the University of Iowa. The eGranary concept involves copying as much information as possible from the Internet, getting copyright permission where necessary, and downloading it onto servers that can be purchased for as little as $700. In this way, the information can be accessed even on older computers, and without the problems associated with Internet access and bandwidth. The Ministry of Health has expressed interest in setting up similar installations in each of Zambia’s provinces, which could grow into regional education centers for nurses’ HIV training.
UAB’s Center for Infectious Disease Research in Zambia has received a grant from the Doris Duke Foundation to send two nurses to Zambia twice a year for three weeks at a time to help build assessment and treatment skills among the country’s nurses. The SON’s Karen Saenz, Ph.D., M.P.H., M.S.N., C.P.N.P., who has particular expertise in community and pediatric health, has been chosen as one of the nurses and will be helping to identify and mentor a group of 12 potential nurse leaders. |
UAB Reaches Out Around the World
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School of Nursing students and faculty in Honduras (click to see larger version of photo)
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While most of Birmingham was sound asleep at 2:30 a.m. on Thursday, May 28, Lygia Holcomb, D.S.N., C.R.N.P., was awakened by an earthquake in Santa Rosa de Copan, Honduras—another reminder, as if she needed one, that her dozens of trips to Central America over the past 12 years have been anything but vacations.
“The power went out immediately, as soon as things started shaking,” Holcomb remembers. “The bridges were out; the roads were torn up. We thought about trying to get out, but when we found out how difficult it would be to get to the airport, we decided we would just continue with our plans as best we could. We had a cold breakfast of tortillas and went on about our business.”
Holcomb’s story is emblematic of the mindset that has driven the UAB School of Nursing (SON) to establish partnerships in numerous low-resource countries in recent years. Faculty and students don’t just visit for a few days and go home. The point is to develop sustained relationships with nursing schools and health-care networks that offer long-term benefits for UAB nursing students, faculty nurses, and health-care workers overseas.
“We wanted commitment,” says SON assistant professor Karen Saenz, Ph.D., M.P.H., M.S.N., C.P.N.P., a veteran of the school’s outreach efforts in Latin America. “We wanted to stay, and the new dean—Dr. Doreen Harper—and all of the leaders at the School of Nursing told us, ‘We’ll commit to this, too. If you go, then we’ll give you the time to establish relationships and develop plans for future educational programs.’ And they did.”
The SON is one of 11 designated World Health Organization (WHO) Collaborating Centers for International Nursing. The school partners closely with UAB’s Sparkman Center for Global Health to accomplish its global outreach initiatives.
Honduras: A Two-Way Street
Saenz and Holcomb already had made numerous visits to Honduras when they joined the UAB faculty five years ago. The SON had identified Honduras as a priority country, as had the Pan-American Health Organization (PAHO), WHO’s regional division for Latin America and the Caribbean.
For three years, SON faculty have been bringing groups of students to a small nursing school in the western Honduran city of Santa Rosa de Copan for nine or 10 days at a time. For part of the trip, students work with and observe nurses and social workers in the city, getting a firsthand look at both the sparse resources available to Honduran caregivers and the resourcefulness those health-care workers exhibit as a result.
“The hospital is set up as big wards—30 beds in a room, one after another,” Holcomb explains. “On the end of each bed, there’s a chart with the patient’s information—and there are no curtains between the beds. It’s a very different system but very caring and professional. And they do it all themselves; the nurses and doctors don’t have a lot of ancillary staff.”
The SON students and faculty members also make trips into the countryside to deliver health care directly to people living in remote rural areas. “A lot of times we have to go in the back of a pickup truck, wandering down narrow dirt roads with cows coming up to the back of the truck and licking you, but it’s a wonderful model of what community and public-health nursing is all about,” Saenz says.
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Participants in the SON's Strengthening Honduran Families project with nursing faculty at the University of Honduras (click to see larger version of photo)
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The SON representatives bring valuable resources and treatment innovations when they travel to Honduras, but they receive equally valuable instruction from their hosts as well. “We aren’t going down there and showing them how to do everything,” Saenz says. “They show us quite a bit. They have excellent assessment skills, for one, because they have to get by on the bare minimum without all the technology that we have. Our students return to the United States and continually draw on their experiences.”
As beneficial as the student visits are, they’re just the start of an intensive, long-term collaborative relationship between the SON and Honduras, says Lynda Wilson, Ph.D., R.N., F.A.A.N., assistant dean for international affairs and deputy director of the school’s PAHO/WHO Collaborating Center for International Nursing. Using a grant from the Sparkman Center on Global Health, former SON professor Ellen Buckner, D.S.N., R.N., purchased computers and Internet access—a rare commodity in Honduras—for both the nursing school and the hospital in Santa Rosa de Copan so that nurses there can maintain communication with UAB faculty and students. And while the student trips have been part of an elective course at the SON, Wilson says the school is exploring ways to allow students to do some of their required clinical hours in community health and obstetrics in Honduras.
“What we’re talking about is something that could really give students some excellent clinical experiences while building on the school’s missions of service, education, and research in Alabama and beyond,” Wilson explains. “The school’s strategic plan articulates our commitment to partnership and collaboration, not only at home but abroad via our collaborating center.”
Zambia: Building a Nursing Force from the Ground Up
On the opposite side of the world, the sub-Saharan African nation of Zambia faces a similar dearth of resources but different health issues. The most overwhelming, clearly, is HIV/AIDS. Although the United States committed $15 billion through the President’s Emergency Plan for AIDS Relief in 2003 to provide Africa with drugs and education, those resources opened up a new set of challenges—how are they to be distributed in a country like Zambia, where there are only 12 doctors for every 100,000 patients?
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UAB nursing faculty and members of the curriculum group in Zambia (click to see larger version of photo)
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UAB has had a presence in Zambia for about eight years through the Center for Infectious Disease Research in Zambia. In 2006, SON dean Doreen Harper, Ph.D., R.N., F.A.A.N., asked Wilson to travel to Zambia to find ways for nurses to play a role in the country’s battle against HIV. In just three years, the partnership between the SON and Zambia’s Ministry of Health has paid off with a wealth of innovative projects, including a program to teach nurses how to provide HIV drugs and a novel method of delivering computer-based HIV information to nurses in rural areas with limited Internet access. (To learn more, see “Zambian Innovation.”)
“I’m delighted,” Wilson says, “to have partnered with medicine, nursing, and other health professions programs to build nursing capacity in order to improve the health of the people of Zambia.”
More Information
To learn more about the SON’s international activities, click here.
What’s next for the School of Nursing’s international efforts? See “Taking Up the Challenge” to learn more.
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UAB Cancer Care Follows a New Path
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Cancer survivor Jason Green (right) was able to meet with his entire treatment team—including surgical oncologist Martin Heslin—on his first day of appointments at UAB.
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By Josh Till
A cancer diagnosis is a passport into unfamiliar territory—a land that can be frightening and confusing, where the people speak a different language and follow unusual customs. Because the journey can be a long one, it helps to have a map, good directions, and experienced guides who can show you where to go and what to do. You’ll find them at the UAB Comprehensive Cancer Center, which has embarked on a far-reaching effort to make that journey easier—and quicker—for patients from their very first visit.
Essentially, the Cancer Center’s new Integrated Multidisciplinary Cancer Care Program (IMCCP) makes cancer treatment at UAB easier to navigate. Cancer Center director Edward Partridge, M.D., says the initiative brings together all of the various aspects of cancer treatment, streamlining the process for patients and improving the overall experience for them and their families.
“Cancer patients will get ‘one-stop shopping,’” Partridge says. “They want rapid diagnosis, same-visit consultation with all their specialists, and good communication with their care team. The IMCCP can provide all that and more.” He adds that the Cancer Center has long been a proponent of multidisciplinary care—combining various specialists from different fields into one team to provide more efficient and effective care—and he expects the IMCCP to raise that care to the next level.
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A Mother’s Journey at UAB
By Lisa C. Bailey
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Liz and Mike Lorbeer with their daughter, Sarah
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After only nine months of marriage, Liz Lorbeer convinced her husband, Mike, to make a “big, bold jump” and move to Birmingham from Chicago. Liz’s new job as associate director for content management at UAB’s Lister Hill Library of Health Sciences was the primary motivating factor, although both she and Mike admit that the barbecue was a really big draw. Little did they know that it would be burritos, not barbecue, that would signal an even more significant change in their lives.
“We really wanted children, but we never thought about it, we never planned it,” Liz says. “We said if it happens, it happens; if it doesn’t happen, it doesn’t happen. So I didn’t even have a doctor here. But I did see a nurse practitioner at The Kirklin Clinic for the annual, routine gynecological checkup. And in June of 2007 I said to her, ‘Well, so is it possible to have a child? You don’t see any problems or anything?’ She answered, ‘No, you can have a baby if you want to have a baby.’ I think that was the first time I had ever asked anybody.”
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