Love and Healthcare in the Third World
Decade after decade we are subjected to the same images and videos of crying children with bloated bellies. Most of us are long tired or immune to the images and pleas for money. Many may wonder why the situation persists. Some are quick to point fingers. Others condemn the whole continent--a place populated with people somehow fundamentally "different" than the rest if us.
It almost appears that parents in the African bush don't seem to care when flies crawl over their child's face, or when their children play in contaminated water or sleep in flea-infested dirt-floor huts or catch diseases long eradicated here in the "developed" world.
But too often these images are aired to advance specific agendas. So, I wanted to check out at least some small part for myself, up close, not filtered through someone else's lense. I always thought the more I experience the landscape of human condition, the better I will be at nursing.
Nearing the end of five months on a journey across Equatorial Africa, I found myself with two nurses dispensing vaccines outside the village Jinka, Ethiopia. I rode with them through a parched landscape. The riverbeds were bone dry and the sun unremitting. We visited adobe-type huts filled with families. Children played and laughed. Babies were swaddled in colorful cotton, wrapped tightly against their mothers' backs. It is said that the feet of an Ethiopian child never touches the ground for the first year.
Here, in the USA, we worry about VAP rates, and we should. There, they struggle to maintain the integrity of vaccines without reliable refrigeration. Here, we worry about childhood obesity, and we should. There, they worry about malnutrition and dysentery. These nurses were like primary care physicians. But there are so few of them. The pay is desperately low and the supply chain for medicine fragmented. Much care is provided by foreign organizations.
We discussed the need for education in these rural areas. But in a country of more than 77 million people, there are only seven schools that offer a Bachelors of Science in Nursing. This results in a nurse-to-person ratio of about one per 4,900. Obviously, misery exists and the challenges are daunting. But, here, in this collection of huts, I saw love in the eyes of the mothers and the of play joy in children.
Outside one hut, I heard the rhythmic grinding of stones. Through the portico entrance, I saw a wrinkled neck of a woman. In her hand, she gripped an egg-shaped stone. She was crushing grain against a much larger large flat stone.
"Teanaste'lle'n", I said, "hello" in Amharic. She smiled and ushered me in. In some silly western way, I wanted to show her I wasn't there to gawk and snap photos. I motioned for the stone. In short order, my muscles ached and my sweat dripped into with the grain. I felt like a first-class fool.
I wished I could have told her what dignity I saw in her people. I wanted to discuss how many of us take things for granted and why it sometimes seems that the accumulation of possessions, like a parallel line, never seems to bisect the lines of contentment. I wish I could have asked her about all those television images of despair.
No, I see no exotic glamour living a life devoid of running water, electricity, or one with a healthcare net consisting of a single thread. We can argue whether our lives would be richer and we more sensitive healthcare providers were we to spend part of them without material comforts. Or whether this woman's lack of access to first-world medical delivery systems somehow reduces the amount of hope she has for her children or the amount of love she offers knowing they may die before their time.
I did know that I could not look at our healthcare system the same way. I knew that what we offered some our patients in our ICU, at least provided the chance of a life that afforded the possibility of happiness--that Holy Grail of human desire.
And I knew that, in large measure, love and caring was not dependant upon what we possessed, what we knew, or what we could achieve.Last edit by Joe V on Jan 13, '15
Joined: Jan '07; Posts: 404; Likes: 1,983
Critical Care RN; from US
Specialty: 14 year(s) of experience in Mixed Level-1 ICUFeb 15, '09Hi Interleukin,
Great post. I am a returned Peace Corps Volunteer and am currently applying to MSN/MPH programs. Once I earn my degrees, I would love to engage in work like yours. Could you tell me how you found this opportunity for work in Africa?
Thanks so much.Feb 15, '09Great post! The same like GlobalGouda...one day... I hope that i will be there ..is one of my dreams! You are a lucky one that you could help them! And an amazing nurse. I talked in Canada with one nurse who worked in Ethyopia for an international development agency... and was really great as she told me.
USAID is one... and a great one... you are young you can do it! Go for it! PM me I will be much than happy to be in contact with you! Is my dream also!Feb 17, '09Beautiful post- your captured the contrasts between the developing countries and the wealthy and privileged West. My Haiti trip is with me everywhere I go- I can't get over the tremendous waste I see here. Everywhere. My first shift back from my trip- got off the elevator to hear a young pt screaming at the food service person delivering her trays of food, yelling because they forgot ketchup for her french fries. Literally just off the plane after watching a young mother die from a pneumonia that would be treated with po antibx here. sigh.Feb 18, '09Great post, interleukin .
I recently traveled to Ghana and really appreciate your experience. I especially liked this quote,
I wanted to discuss how many of us take things for granted and why it sometimes seems that the accumulation of possessions, like a parallel line, never seems to bisect the lines of contentment.Feb 18, '09Quote from MI_newgradThank you kindly, MI newgrad.Great post, interleukin .
I recently traveled to Ghana and really appreciate your experience. I especially liked this quote,
I would love to hear more about your experience. Did you go through an NGO? Thanks for sharing your story!
But I always traveled independently and sought out my own experiences.
It is often quite easy to find health care workers and tag along. They are eager to share experiences. Although I never wanted to "sign up" or commit myself to an NGO, those opportunites are there(of course it must all be before hand).
I just loved the hooby of traveling. Still, I am presently applying for a permanent nursing position in Addis Ababa.Feb 25, '09Great post! I went into nursing with the intention of going to Cambodia and helping people there.Feb 27, '09Quote from oncnursemsnI am a foreigner, coming from a poor Eastern European country and I could never understand how people can complain about the food they get served in the hospital...I am glad I am not the only one that feels this way. Being a foreigner, anything I say about things that shock me here, I always get replied with: "Go back where you came from if you don't like it..." Nice, isn't it? I am not criticizing, I am just merely try to bring to people's attention that we live a very privileged life (that sometimes we don't deserve, because we don't appreciate it). What is it going to take to make people realize that? A major famine, G-d forbid?Beautiful post- your captured the contrasts between the developing countries and the wealthy and privileged West. My Haiti trip is with me everywhere I go- I can't get over the tremendous waste I see here. Everywhere. My first shift back from my trip- got off the elevator to hear a young pt screaming at the food service person delivering her trays of food, yelling because they forgot ketchup for her french fries. Literally just off the plane after watching a young mother die from a pneumonia that would be treated with po antibx here. sigh.
There is a very realistic movie, it is called "The Death of Mr. Lazarescu", that reminded me why I immigrated here. All of you that are enjoying reading this thread would enjoy watching it. It is just the reality in other countries. We still have it pretty good here, with room for improvement, but pretty good, compared with the majority of the world.Feb 27, '09Are BSNs the only way of education for nurses there? I wonder if America and Canada are the only countries that use practical nurses. Sounds as if they can use them in the third world.Mar 3, '09I think one of the sisters at the compound we were staying said it well: We in the US think the world should live like we do- wasteful, luxurious, consumers of many resources. However, the reality is that if we don't do something to cut back and conserve, we will be living like developing nations. I have to believe that it's the poorest countries there will be wars fought over water- not oil, we won't have oil, but water and food. The riots in Haiti were over sky high rice prices...
Did you hear that CA has declared state of emergency over drought? Billions in crops won't be grown because they don't have water.Mar 12, '09What an experience. I have worked in Africa as an Embassy Nurse. I came back to th US to somplete a graduat degree. Can you share your contact information. I am interested in going back as working in anenvironment as such.
FulawmnMar 21, '09What a great post! I have yet to fulfill a dream of going to Africa one day to help , this is why I became a nurse...
I am a foreign educated nurse from Central America where nurses are challenged to still do good old dosage and drip calculations(without pumps) where you are expected to mix your own iv meds(not just call pharmacy for premixed) where you are to handle equipment that it is not disposable for dif. treatments and where there is not such a thing as menus. Yes there's lack of supply but there's also a socialized medical system where everyone without question is helped, I am thankful that it is not as bad as some parts of the world like the one of your post.
It makes me just sad to hear people complain and take for granted the advantages of working in a developed country. Some complain about burn out and Nurse/pt ratios and I've seen one RN take care of 30+ pts in a med/surg unit with only 4 LVNs and 4 CNAs where effectiveness of working as a team means you get through that day providing safe care to all and where improvising, prioritizing and delegating take full meaning and where there's no luxuries of having IV teams or wound care nurses to do your job. Of course alot of this doesn't even compare to the working conditions of healthcare providers in places like the one you described but it is another example of letting everyone know who lucky we are. I wish alot of people (me included) would take on an experience like the one you had. Thanks for sharing...
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