Prior to finding out about Mercy Ships, Christel A. Echu, RN, admits that if you asked her if she wanted to volunteer for any organization and not get paid, she would have said, “No.”
But when a friend who was an authority in the church she attended in Cameroon, Africa, she changed her mind. “I decided to volunteer with Mercy Ships because I was interested in being a part of the great work they were doing for the people of my country, and I wanted to help in any way that I could,” Echu says.
Mercy Ships Bring Hope and Healing
Mercy Ships is a non-profit Christian organization, she says, that sails across West and Central Africa with the mission and vision to provide hope and healing to patients who are poor and/or forgotten in countries there.
When Echu began volunteering with Mercy Ships, she had just graduated from nursing school. First, she worked as a volunteer translator when the ship, the Africa Mercy, was docked in the port of Cameron. She volunteered as a translator for 10 months.
Mercy Ships bring hope and healing
By then, Echo says, she was hooked. She ended up continuing to volunteer for another two years. “I transitioned from that [working as a translator] to working as a volunteer screening nurse until the end of my commitment,” she says. “Screening nurses, we see all the patients before they are seen by the rest of the hospital. We screen, assess, and ensure patients are healthy enough for surgery.”
She says that they pre-screened more than 6,000 patients in a day when they were in Guinea Conakry. “That was the longest shift I have ever had,” she says.
One of the aspects that Echu loved about Mercy Ships is that she got to work with nurses from all over the world: including the Netherlands, Canada, Australia, the United States, and others.
“I loved working with patients and with my team. We also worked alongside our wonderful translators, which was a blessing because they helped to facilitate communication between the patients and nurses,” she recalls. “I think I enjoyed the fact that we could learn from each other to provide the best care to the patients we served. I enjoyed seeing the joy the patients felt whenever we announced to them that they were getting surgery. “The dance of joy” was a thing in the screening tent and I enjoyed seeing the patients come back to show us their “new self” without the tumor or the deformity. Moments like that, reminded me why I decided to volunteer in the first place and kept me going on difficult days.”
Biggest Challenges
There were tough days. Echu says that one of her biggest challenges while working with Mercy Ships was being away from her family, home, and community. But another difficult part was when she had to say “No” to people they couldn’t help.
“This is a part of my job that we don`t talk much about. The ship has specific surgeries they do when they sail in a nation. However, there are patients who present with conditions that are not within Mercy Ships scope of practice and that`s when we get to do ‘no’ conversations. Screening nurses initiate that conversation before the chaplaincy team on the ship takes over,” she says. “That was the most challenging thing about my job—having those ‘no’ conversations was never an easy thing to do. Most of the patients we see come with the hope of being helped, but when we have to say no to them, it almost feels like that hope crumbles before their very eyes.”
Greatest Reward
She also, though, had many rewards—the greatest of which was forming relationships with the ship’s community. “The relationships I built during that time, [ones] that become an integral part of my life. The community is really special. Now, I have friends all over the world,” says Echu, who now lives in Minnesota. “I do not have family here in the United States, but I know friends with whom I worked with on the ship, [and they] are my family while I am here.”
Echu says she will never forget “the amazing patients I got to work with and their families and the joy they always had on their faces even without having much.”
If you’re a nurse thinking about volunteering with Mercy Ships, she says, “Do it! Go and see for yourself. Have an open mind and be ready to learn and receive as well,” she says. “Most volunteers go on the ship with the mindset of giving and serving which is good, but also go with the mindset of receiving. Receiving could be anything—like being welcome in the house of a local, or being encouraged by a patient who doesn`t have much, but they still have a big smile on their faces. It’s an experience that would change your life completely for good.”
In Pakistan, the pandemic did little to raise the profile or status of the nursing profession. However, it does seem to be inspiring a movement among nurses and even physicians to reform the conditions that are hampering the work of nurses and the well-being of patients.
Back in April 2020, in an editorial in Pakistan’s Daily Times, Dr. Ghulam Nabi Kazi wrote, “In practice, nursing remains a neglected and least preferred line of work, despite the noble duty performed towards the treatment and quick recovery of patients, post-operative management or specialized interventions. Ninety (90) percent of nurses are females working in a highly misogynist culture, [who are] liable to sexual harassment and treated sub-optimally. They are often encumbered with long working hours, low wages, and poor career or promotion prospects or perks in comparison with officers with similar qualifications in other cadres.” Events and occasional editorials in Pakistani media sing the praises of Florence Nightingale, but in practice, low pay and lack of respect are driving a “brain drain” exodus of dedicated nurses to move to Kuwait or venture even further to find better treatment and higher salaries.
In this letter, Faryal Ghafoor, a Pakistani nurse and an MScN student at Aga Khan University School of Nursing and Midwifery outlines the key issues and the solutions nurses are pursuing to modernize the profession in Pakistan.
Despite our rigorous education and training, in developing nations like Pakistan, the respect for the nursing profession is little higher than it was in the West before the advent of Florence Nightingale.
Because in Pakistan the role of nurses is poorly defined, the general public has many misconceptions about the norms and values of the profession. The public views a nurse as a sort of servitor who dispenses medication on the orders of a doctor. Other roles of nurses are altogether ignored, and in the public sector, our ability to act as caregivers is often rigidly constrained by outdated mores and traditional practices. As a result, nurses are often unable to utilize their education to provide counseling, engage in advocacy or collaboration and remain restricted to the administration of medication.
A waste of an educated labor force
Many traditional and ongoing practices cause nurses to be overwhelmed with responsibilities that reduce the time they have to care for patients. In addition to performing inventory on supplies and managing staff, a nurse on a unit assists not only CNAs but ward attendants, Aya, and sanitary workers. The unavailability of service structure and monotony of tasks reduces the time they have to treat patients and—adding insult to injury, a nurse working in a Public sector job often ends up retiring on the same scale on which s/he was first appointed.
The perception of nursing as a profession designed to serve actual health care providers may correlate with the gendered nature of the profession in Pakistan. We are seeing more male nurses entering the profession but there remains substantial resistance and misconceptions about male nurses are almost as troubling as those about female nurses.
The impact of the commercial nurse education industry
Another significant issue that needs to be addressed is the burgeoning number of private nurse education programs. Despite the labor, long hours, and low pay, limited employment opportunities in Pakistan make nursing a highly attractive career option and as a result, private investors are cashing in by building new nursing schools to meet the demand. Unfortunately, their primary concerns revolve around profit and the bottom line, and the quality of education often seems to be an afterthought.
This is high time to bring reforms in Nursing Profession. There is a need to construct a positive image of nurses, without deconstructing the traditional image, the progressive image of nurses, and the quality of their services.
How can we improve conditions and keep nurses in the country?
Following are a few suggestions to reform the role of nurses, increase respect for the profession in Pakistan, and improve the conditions that are driving talented nurses to seek employment in other countries:
There must be a clear job description for nurses. There must be different domains of ward administration to look after the affairs of inventory, supplies and staffing. Nurses should be dedicated to patient care.
Nurses should use social media platforms to convey their values and concerns. By speaking out, they will help the public better understand the roles of nurses and the nursing profession.
There must be accredited courses of therapeutic communication in nursing to familiarize and encourage student nurses to communicate with patients. Thus, the gap between patients and nurses can be eliminated.
There must be specific tools to evaluate the care provided by nurses to patients. Nursing is a unique discipline. So, there must be a separate and unique audit system to assess and evaluate Nursing skills.
There must be criteria to include ongoing training programsspeak in every Nursing institution to meet the learning demands of nurses and to keep them updated about advances in knowledge.
Government lawmakers need to formulate service structure policies for the upgrowth of the nursing profession.
Visitors from UMP included the head of the nursing department and a few professors who spent a day touring ASU’s facilities, meeting faculty, and learning about their unique nursing program offerings. ASU Dean of Nursing Teri Pipe took the visiting group on a tour of the Downtown Phoenix campus, allowing them to explore their state-of-the-art simulation and learning resources lab, and observe students in their learning environment from a debrief room to watch their evidence-based curriculum in action.
Tran Thuy Khanh Linh, dean of the UMP nursing department, tells ASUNow.edu, “Vietnam is a developing country so we need to expand and improve a lot in nursing and we would like to see the health-care system in Vietnam evolve so that nursing is an important member in the health care systems. These observations and this trip is very helpful for us so that we can learn from ASU and we hope that we can implement part of it.”
The ASU College of Nursing faculty have been working with UMP nursing faculty in Ho Chi Minh City for almost 10 years, spending time on their campus in Vietnam to help their faculty grow and develop their program. Both schools are exploring new opportunities for developing a longer term relationship, feeling that both institutions have a lot to be learned from each other. UMP is particularly interested in learning how others are meeting the challenges of the quickly evolving healthcare industry.
To learn more about UMP’s visit to the ASU College of Nursing campus and how the two institutions are developing a mutually beneficial international relationship, visit here.
