Working with colleagues in Zambia and Ghana, nursing students from UBC’s Okanagan campus often find what they experience changes their understanding of what it means to be a nurse.
“Many of our fourth-year nurses go over to Africa expecting to change the world, but it is their view of the world that changes the most,” says Fay Karp, associate professor of nursing.
“Students develop advanced levels of cultural sensitivity. They also discover what words like ‘global citizen’ and ‘advocacy’ truly mean.”
Each year, a group of fourth-year nursing students at UBC’s Okanagan campus travel to Ghana or Zambia for six weeks, consolidating four years of nursing theory and practice into one practicum. They work in a variety of clinical settings, including medical and surgical units, pediatrics and maternity, HIV clinics and community health outreach in remote villages.
“One of the most important aspects of this experience is the community development model we embrace—we are not there to fix problems or tell the Zambians or Ghanaians what they need,” says Muriel Kranabetter, associate professor of nursing. “We assist as colleagues and follow their lead as to what supports them in their needs and objectives.”
Fallon Smith, who graduates this month from the School of Nursing at UBC’s Okanagan campus, was one of 24 students who travelled to Zambia last spring. Eighteen others went to Ghana.
During her practicum, Smith worked in the Lewanika General Hospital in a variety of areas, including the HIV clinic. Alongside two Zambian nurses and a few Zambian clinicians, she attended to 150-200 HIV patients a day. Smith also worked in the villages of Chunga and Mukambi.
“Working with the Zambian nurses has allowed me insight into what nursing looks like in an undeveloped country,” says Smith.
“Their strenuous work hours, tough working conditions and lack of supplies has left me with a new appreciation for our own medical system, resources, and working conditions as a nurse. I also learned a lot about accepting, respecting, and coordinating the balance between compromising and maintaining my nursing practice standards and ways, while collaborating with other nurses who have a different set of standards and practices.”
One of their Zambian partners says what the UBC nurses lack in familiarity with local conditions is more than offset by their knowledge in other areas and ability to respond quickly to changing situations.
“The collaboration with Canadians has helped to improve nursing care by providing audit and quality assurance in areas such as patient monitoring, critical-care nursing and neonatal resuscitation,” says Dr. Seke Kazuma, a medical officer from Lewanika General Hospital in Mongu.
“One thing I like about Canadian nurses is they are sharp and know how to respond to emergencies. They may not have a lot of experience with tropical diseases and infectious conditions, but they are well trained.”
One of the most difficult parts of Smith’s practicum was performing procedures without pain medication on children, and seeing children die who may have lived if treated in Canada.
“I had never seen a child die before Zambia, and it is a haunting image and helpless feeling I don’t think I will ever forget,” she says.
One of Smith’s most profound lessons was learned from a woman on her deathbed. Smith bathed her, changed her clothes and sheets and made her comfortable. Next morning, the woman’s bed was empty.
“I advocated for my patient to have her right to a humane death,” says Smith. “This is my most significant memory of nursing in Zambia, because it is never far from my mind when I am in practice here in Canada.”
Smith notes both the ups and the downs made the experience rewarding.
“I learned a lot about myself, my strengths and my abilities. My critical thinking and problem-solving abilities grew tremendously. My ability to step back and take in the bigger picture improved. I found strengths that I didn’t know I had, such as being able to remain calm during emergency situations, and making decisions under extreme stress.”
Students accepted into the practicum in Ghana and Zambia cover their own $5,000 travel expenses, but they can apply for a $1,000 grant through UBC’s Go Global program. In addition, nursing students fundraise approximately $10,000 annually to support health care in Africa.
Among the biggest challenges is finding funding, says Karp. Committed financing would ensure that fourth-year nursing students get the international experience, and allow the School of Nursing to continue supporting the work of colleagues and partners within Zambia and Ghana.
The School of Nursing plans to increase practicum placements through local connections and partnerships in Africa, develop potential student and faculty exchanges with the University of Zambia, and create additional collaborative research initiatives in health areas identified as priorities by Zambians and Ghanaians.
“Our academic partnerships with colleagues and communities in Africa provide UBC’s Okanagan nursing faculty and students with invaluable opportunities to develop and contribute as global citizens,” says Patricia Marck, director for the School of Nursing and associate dean for the Faculty of Health & Social Development’s international partnerships.