School of Nursingstudents spoke about the major health issues and health care systems they have witnessed in developing countries around the world at a presentation on April 24. Students in the pre-health professions program also attended the event.
Katie Howe ‘12, spent time in Ghana last November with a group from Boston Children’s Hospital. In a country where the life expectancy is age 60, there are just 93 nurses for every 100,000 people, and those needing services must pay before they are allowed inside the hospital, Howe was struck by how basics in care were nonexistent. The children’s ward “was incredibly hot, just unbelievably hot, and the windows were all open so flies and mosquitos, which pose a threat for contracting malaria, could come in,” Howe noted. “In the neonatal intensive care unit, babies were placed four to five in an incubator, which is something that isn’t seen in the United States.” Not surprisingly, water-borne disease, sanitation, and malaria rank at the top of the country’s health issues.
Kelly Kramer’s ‘12 experiences in Nicaragua on a trip sponsored by Professor Lydia Greiner and the School of Nursingechoed much of the same sentiment. “Because the taps don’t always run, their practice is to fill up a basin with water in the morning, then use that water for cooking or washing hands during the day,” she said, noting that each family uses the same basin of water for multiple purposes. In the preschool the class visited in the Ayapal neighborhood of Managua, “We did a hand washing lesson, then gave out soap, towels, toothbrushes and toothpaste.” The teachers will follow up to assess long-term effectiveness over the coming months, she said.
As in the U.S., non-communicable diseases such as cardiovascular disease, diabetes, and cancer are leading causes of death and disease. At the same time, the country’s health system also has to grapple with communicable diseases such as malaria and tuberculosis, which creates a unique “double burden” on the health care system.
Brazilian native Letica Moura, a senior nursing student from the University of Para State who has spent the past semester studying at Fairfield, gave an overview of the healthcare system in that country. All Brazilians are entitled to care under the public healthcare system, she says, while those who can afford it buy private insurance to supplement that care. Medical services are ranked according to a tiered system: Preventive services and the maintenance of health are the first level; chronic diseases (hypertension, diabetes) are on the second level and patients receive a monthly consultation with their doctors; those with a
referral from their doctor for a complex issue such as cancer or kidney failure can be treated at the third level of care. As part of their requirements for graduation, student nurses visit remote areas to provide healthcare, and thus are an integral part of the system of care. As in Nicaragua, healthcare resources are split among growing numbers of people with circulatory disease (heart conditions, hypertension) and cancer (primarily skin, breast and lung) and tropical diseases such as malaria and dengue, which occur mainly in the Amazon region.
Presentations such as this one on global health issues are extremely important for future healthcare providers, says Dr. Joyce Shea, undergraduate program director. “Our students’ ability to function in today’s healthcare environment requires a broad understanding of health and wellness, the role of culture and economics, and the impact of politics on access to care and disparities in health outcomes throughout the world.” Besides, she says it’s important to note “not everything is determined by high levels of technical skill. We have so many health issues that can be resolved by simple, low cost options such as adequate food, water, sanitation, and basic supplies.”
Dr. Curt Naser, associate professor of philosophy, concluded the program with a discussion on the ethical obligations of healthcare providers to respond to global health issues. The world is divided along political boundaries,” he said. “But ethics knows no such boundaries. Healthcare workers have to negotiate the conflict between the political and economic interests of nations on the one hand, and their personal responsibility to all who have need of their service.”
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