Nursing Students from UA-Fort Smith travel to Uganda, East Africa

In May 2009, a group of four nursing students and three faculty members from the University of Arkansas at Fort Smith boarded a plane that took them halfway across the world to a place they will never forget. As part of the first Maymester International Studies program, this group traveled to Uganda, East Africa, to work at CURE International Children’s Hospital.  CURE International is a non-profit faith-based organization that provides state-of-the-art care to children around the world. Little did this group know they were about to embark on a trip that would change their view of nursing care forever.

Each day began with a 15-minute walk to the hospital from the hotel. The hotel was clean and nice and included amenities such as a fan, mosquito net, wash pan for doing one’s laundry, and an occasional gecko (a little lizard that eats mosquitoes). After arriving at the hospital, activities included working in the intensive care unit and ward, assisting with treatments (commonly a cerebral tap to drain excess spinal fluid) and observing surgical procedures. One particularly interesting story involved a 6-year-old boy from Nairobi, Kenya. His name is Roger,* and he had been diagnosed with a malignant tumor of the brain and admitted for craniotomy and tumor removal. Students were able to see and talk with Roger and his mom prior to surgery, observe his surgery and then care for him post operatively. Students far away - back in Fort Smith, Ark., also participated in Roger’s story. As part of an international community service project, the UA-Fort Smith Student Nurses’ Association donated the money ($1,000) that totally funded Roger’s surgery.

The students and faculty members quickly immersed themselves quickly, into Ugandan culture. With the slow pace of African culture, there is never a sense of urgency or hurried activity. Teatime is important, and they take it daily at 10 a.m. and 2 p.m. (whether vital signs have been completed or not).  Meals usually consist of beans, rice, greens and fried flat bread.

Nursing care has a different focus in Uganda. Each mother, not the nurse, is responsible for bathing and feeding the child, changing the bed, and washing the sheets (in a bucket) and hanging them outside to dry. The mother sleeps alongside the child, usually in the same bed. The nurses’ responsibilities consist of technical tasks including medication administration and assessment of vital signs. There are few stethoscopes, and the assessment of changes in a child’s condition is more of a nurse’s instinct rather than a systematic approach. Because of the hospital’s lack of an organized head-to-toe assessment and complete documentation, changes in a child’s condition may have taken longer to detect. This is one area where the students and faculty may have made a difference. They modeled head-to-toe assessments and eventually developed a pediatric systems assessment tool to assist with the identification and documentation of daily findings. Students were surprised to find that a list of potential nursing diagnoses for each child is located at the front of each chart.

Although air conditioning is not available in the patient care areas, advanced technology included modern laboratory equipment, a CT scanner (one of six in Africa) and up-to-date sterilization techniques in the theatre (surgical suite). The hospital does observe surgical asepsis, as well as meticulous hand washing.

While there are many parallels between Ugandan healthcare and healthcare in the United States, there are significant differences. This experience made it clear that there is more than one correct method to achieve satisfactory results. Future trans-cultural health experience trips will offer students university credit as well as exposure to international health care.

 This group of people began the journey thinking they had a broad base of knowledge to share. What they discovered is the entire experience at CURE International Children’s Hospital contributed to each member’s enhancement of cultural awareness and personal growth.  • 

*Name changed to protect identity.