Through a New Lens

Written by Shiree M. Southerland ’05, PhD, CHES

“Journeying to Durban, South Africa was an experience fraught with many expectations. I thought I would meet different people, experience different cultures, investigate the health care system and nursing roles, and see lots of animals. What I did not expect was to embark on an adventure that would forever alter my perception of professional practice and standards of care.

I had long viewed research as a process that involves numbers and charts, but by working in a lesser developed country such as South Africa I have been able to humanize the numbers and charts and realize the full power and potential of nursing research. I spent 11 weeks in Durban—or e Thekweni as it is known in Zulu—which is situated in KwaZulu-Natal, one of South Africa’s most diverse provinces in terms of its climate and geography. While in Durban I had the opportunity to work on a study at the University of KwaZulu-Natal in the Department of Nursing that dealt with the influence of pregnancy on the progression of HIV/AIDS in South African women. The HIV prevalence rate for pregnant South African women has skyrocketed from one percent in 1990 to nearly 25 percent in 2000. The study at KwaZulu-Natal is a three-year prospective study that will compare disease progression among pregnant and non-pregnant women in a rural and urban setting to ascertain whether or not pregnancy accelerates disease progression. I joined work on the study early, as researchers were dealing with recruitment of participants, but I nevertheless got the chance to see the perilous ups and downs associated with implementing a grant-funded research study.

I was also afforded the opportunity to visit many rural and urban hospitals and clinics. What I found is that nurses in South Africa face the same issues that nurses in the United States face—issues such as manpower shortages to rural areas, lack of access to services for economically depressed patients, and the burden of caring for too many critically ill patients at once. As a result, I have changed the way I look at nursing practice in developing countries such as South Africa. My perceptions and views were largely influenced by lack of exposure to individuals from these regions and my lack of initiative in seeking information. I had believed, for instance, that technology is key to providing quality health care. I assumed that we in the United States set the standards for everything and that we had nothing to learn from others. How wrong I was! Even though the institutions that I visited lacked many of the basic resources that we often take for granted, I found that the standard of care and practice was not lacking. I observed nurses caring for critically ill patients without the assistance of monitors and around-the-clock labs. Instead they relied on their critical thinking, collaboration, and physical assessment skills to provide quality and highly skilled levels of care. This put them proactively on the front line of patient care—and they were not only able to anticipate the needs of their patients, they were also able to respond to the needs of the families.

It is our similarities and philosophies of caring and compassion in this noble profession that unite us across the world. I found that if we open ourselves to dialogue, we can discover that there are many ways that we can assist each other in the achievement of our goal to provide the highest level of care to all patients regardless of economic or social standing.