Editor’s Note: The following guest post was submitted by Amanda Judd, FNP. Ms. Judd is a member of the Board of Directors of One Nurse at a Time, a nonprofit organization that provides scholarships and funding to offset the cost of volunteer assignments for nursing professionals.
“I have a very interesting family that you will want to meet,” exclaimed the team leader. Being bilingual with a gaze that said, tell me about yourself, I was not surprised that this gifted team leader had been able to make a connection with this fascinating matriarchy.
I had seen the family that she was referring to – four generations in all – as they smiled and waited patiently to be seen in the medical and dental clinics. Little did I know that we had generations of wisdom and knowledge sitting on that bench.
The matriarch, Salome, had been a practicing midwife in the community for a generation. As a child, Salome loved to take care of other children in her village. She was known for her doting ways. She knew that when she grew up, she wanted to be a doctor, but because of the exorbitant costs of medical school in Guatemala, she knew that she would never be able to afford it. Life went on and she eventually had a daughter, Ana Sofia, who she raised having never been able to fulfill her dream of medicine, but never quite giving up on it either.
As Ana Sofia started her own family, Salome came across a remarkable thing: an advertisement for an affordable lay-midwifery program. She could get trained, certified, and begin to care for the mothers in her community by completing this program. She immediately registered. It took her two years of monthly training, but she earned her Certificate of Midwifery from the Guatemala Ministry of Health and Social Assistance and began to practice.
As a midwife in Guatemala, Salome faced challenges that we would never consider in the US. In the national hospital, women were frequently sent home after being told they were not in labor. After being turned away from medical care, the pregnant women walked for miles on dirt roads through steep, mountainous terrain, only to find themselves having to deliver a baby alone on the side of the road. These situations were dangerous for the mother and the child, so Salome preferred to deliver the babies in her home where she was well-equipped for uncomplicated labors and deliveries. She was (and remains) dedicated to the safe care of women in her community.
Since that time, her daughter Ana Sofia and all three of Ana Sofia’s daughters have studied midwifery and become prominent midwives in their community, but Salome quietly told me that she wanted more training. She felt as though she could learn more by working with midwives and doctors on volunteer assignments from the US.
After hearing her request, I jumped into action. I asked the generous team leader if we could arrange a day of training for the family of midwives. My proposal was met with a cautious excitement. As it turned out, I learned something about health care education in low-resource countries that day — it is not simply economic barriers that prevent people from getting education. There may be cultural barriers as well. I was told privately that we would be able to arrange a day of learning, but that I must keep this day quiet, as some communities did not want to share knowledge with other communities. Maybe this hesitance to share knowledge was due to the deep-rooted ethnic independence of the different communities, or perhaps it was financial, but either way, it existed. Additionally, there were local nurses involved in our volunteer project that were not open to training local community health workers, nurses, or midwives.
Fortunately, not everyone on the project felt this way, and we arranged a day of training for the family of midwives. Two days later, they showed up for their training with identification and midwifery certificates in hand, ready to go. They were able to spend the majority of the day training in the hands of a gracious and experienced midwife from the US. There was a brief, but fantastic exchange of knowledge on that day and I was glad to have played a small part in facilitating this educational opportunity.
Afterward, I thought: Here we were, a team of doctors and nurses providing care for a community. We brought our own students from the US to train, and yet we had resistance to training local staff! Why don’t more international volunteer projects dedicate time to training local community health workers, nurses, and midwives?
The education of community health workers is critical to the sustainability of international volunteer projects, and the global health workforce overall. After all, it’s the local community health workers, nurses, and midwives who are there when we leave.
At One Nurse At A Time, we are aware of how important the education of community health workers can be. In our upcoming book, Lessons Learned, Karly Glibert writes about cholera education in a Malawian community in her story “Education: A Catalyst for Change.” Educating local Malawian community health workers (and the community in general) on infection prevention techniques effectively stopped the deadly cholera outbreaks that had previously occurred on a regular basis in the community. Ms. Glibert’s story is one of many examples of how health education packs a wallop against disease, disability, and the cycle of poverty that endemic disease can create. (One Nurse At A Time: Lessons Learned available June 2018 on Amazon.com. Beyond Borders and On A Mission available now electronic and print.)
The World Health Organization estimates that by 2030 global demand for healthcare workers will double, creating a deficit of 15 million health care workers. The effects of this shortage will be catastrophic, and resource-scarce countries will be hit the hardest. How can we, as humanitarian health workers, make a difference?
We can begin by asking whether our volunteer project is contributing to the formal training of community health workers, nurses, and midwives. We can ask if we can will be working side-by-side with community health workers, thus allowing for the exchange of knowledge. As in the case of Salome and her family, we can seize any opportunity to facilitate training. We can also look to organizations like Health Volunteers Overseas or Seed Global Health, which actively educate nurses and doctors in underserved settings, and we can seek out organizations like One Nurse At A Time that help eliminate financial barriers for nurses planning to participate in education-based volunteer assignments through qualified non-profit organizations.
The teaching and mentorship we provide as volunteers will help break down barriers, creating a ripple effect that will help educate and impact generations to come. On International Nurses Day, join us in making a commitment to global health and nurses worldwide by using knowledge to empower others.
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