Helping Africa...with nursing knowledge

March 23, 2006 -- Today the Woburn Advocate (Massachusetts) ran an unsigned article about nurses at a local hospital who are sending nursing texts to several communities in Africa. "Nurses fund African medical libraries" explains that the nurses of Winchester Hospital have raised funds from each other and their physician colleagues to ship the libraries of up-to-date texts. The piece has quotes from some of the Winchester nurses involved. Several of their comments suggest the central role nurses play in health care in ways that are unusual for mass media products. The piece also underlines the life-saving importance of nursing knowledge in Africa. We salute the Woburn Advocate and the nurses of Winchester Hospital for highlighting a form of foreign aid whose value may not be evident in a society with little overall understanding of nurses' education or clinical expertise.

The piece says that the nurses will be sending complete libraries of nursing texts to three nations in sub-Saharan Africa, apparently to be chosen from the group of Malawi, Mauritius, Uganda, and the Seychelles. To its credit, the first paragraph states that the books "will enable nurses there to improve health care and even save lives." The libraries themselves, which cost $2,500 each, have apparently been created by the International Council of Nurses, with help from Merck and Elsevier Science publishers. They come in "bug- and weather-proof metal containers" and include "up-to-date reference texts on topics from terminal illness to malnutrition to epidemiology to female genital mutilation to AIDS." The project is the first for the hospital's new Magnet Nurses' Charitable Fund, and it has reportedly raised over $13,000.

Winchester's director of nursing programs Marlene Williamson, who "first came up with the idea of raising money to purchase the libraries," notes that "80% of all health care [in Africa] is delivered by nurses." Most commendably, she stresses that "[t]here's a direct correlation between better health outcomes and these nurses having this information," and that "[t]here's a good chance that there's a child in Africa who won't die of AIDS because of the nurses at Winchester Hospital." She says that the Fund was able to raise more than she expected because the nurses "really stepped up," and also because "over the holidays, the physicians donated a lot of money in honor of their nurse colleagues." Williamson also believes that the donations are a sign of the "high status" and respect the hospital's nurses enjoy: "You have to feel good about where you are to give at that level."

The co-chairs of the fund are nurses Sheryl Smith and Cathy Strong. Smith emphasizes that the Winchester nurses are "Magnet nurses" who "should be helping each other." The piece does not explain that Magnet is a certification given by American Nurses' Credentialing Center to hospitals that meet a set of criteria designed to measure the strength and quality of their nursing. Smith notes that the nurses in African refugee camps and remote villages lack the "resources" of her colleagues, observing that "[t]hey don't even have physicians." This suggests that physicians can be seen as a resource for nurses, when the vast majority of the media tends to suggest that nurses are at most a somewhat helpful resource for physicians. Of course, the professions are both key parts of the health care team. Smith notes that the Fund next hopes to help U.S. nurses who lack adequate resources. She also links the nurses' efforts to the founding of her hospital: "This group of nurses saw a need for a hospital, so they went out and did their own fundraising." Nurses, the driving force in setting up a hospital? Who knew?

Thus, behind the usual local feel-good story elements of the piece, there is a strong message: Nurses are serious professionals, with life-saving clinical knowledge, who can take the initiative to do things like found hospitals and start foreign aid programs. Of course, a piece like this is not going to seek comment from the rank-and-file about whether Williamson is correct about the "high status" of the hospital's nurses. And there has been much debate about how much Magnet status really means; many nurses regard it primarily as a hospital marketing tool. Moreover, there is a limit to the likely benefit of simply sending developed world technical books to a poor nation, because of economic, cultural, and educational differences. Most effective long-term foreign aid is closely tailored to conditions on the ground, and it often requires extensive local expertise and human resource development.

But be all that as it may, what most readers will likely take away from this piece is a vision of nurses not so much as noble angels, but as autonomous, community-focused professionals with life-saving skills. For that, we thank the Woburn Advocate and the nurses of Winchester Hospital.

See the article "Nurses fund African medical libraries" in the March 23, 2006 edition of the Woburn Advocate.