In this chapter, the author began working in international medical humanitarian aid, with an organization called Medecins Sans Frontieres/Doctors without Borders (MSF). Pediatrics and Pediatric Intensive Care are where the author’s nursing career had started. With assignments in the Democratic Republic of the Congo (DRC), Haiti, and South Sudan, the author have provided care for people who have been displaced due to conflict, victims of war trauma, women with high-risk pregnancies, malnourished and critically ill children, and people with HIV and tuberculosis, and responded to outbreaks of preventable illnesses such as measles and cholera. MSF opened the Sibut project, with a focus on providing care for young children and women of child-bearing age. The security system includes daily contact with all of the village leaders in Sibut, including the Catholic priests, the imams at the Muslim mosque, the village elders, and the militia leaders.
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This chapter reviews research and theory linking religion and health. It presents number of reasons why nurses should appreciate the role of religion as they provide health care. Social scientists describe facets of religion with typologies. The growing body of evidence linking religious belief with health care decision making describes the influence of beliefs on varied decisions, from those related to pregnancy and genetic testing to cancer and HIV treatment. Furthermore, a health-related event may have religious implications. Nurses have many reasons for recognizing patient religiosity. These include the fact that religion is prevalent, that some religious practices have health-related implications, and that some health-related events have religious implications for adherents of some religions, and professional mandates. Religion serves many functions, from social cohesion to intrapsychic comfort. When religion lacks personal spirituality, it becomes harmful.
Sikhism is an independent religion, based upon the teachings of its founder Guru Nanak and his nine successors. Sikh religion is theistic. It believes in One God who, as the creator and sustainer of the universe, watches over it lovingly as a parent. Sikhs view health and well-being as an asset of life. Sikhs are guided to maintain a balance by attending to the care of the physical and spiritual body. Most of the Punjabi Sikhs show a healthy and approved appetite for simple vegetables and milk products. The use of tobacco and other nonmedicinal drugs is strictly prohibited to the Khalsa Sikhs. Religious leaders such as Grant his at the Gurdwara offer Ardas for members of the tradition who are ill. A nurse might support the patient if he or she wants to attend the congregational worship at the local gurdwara.
Hinduism is an ethnic religion, not a religion with an organized ecclesiastical structure based on creeds. Devout Hindus seek an awareness of God in daily life. Although Hinduism views health holistically, the relationships among the components are understood differently than in Western theories. The biggest difference is that consciousness is associated with the soul, not the mind. A Hindu scientific approach to a healthy life is found in Ayurvedic medicine. Hindus attach considerable importance to the relationship between the mind and the body. Any disturbance in one affects the other and causes diseases. A Hindu patient may view illness as karma and rely on the principles of dharma to respond to it. Hindus may practice meditation or yoga to develop spiritual discipline. Hindus believe that it is important to keep mind, body, and environment pure and free of wrongdoing or toxins. Purity of body is maintained through strict hygienic practices.
This chapter examines the forces that encourage nurses to migrate; the consequences of uncontrolled migration; and the global interventions that are occurring or need to occur to balance the right of individual nurses to seek positive global economic, social, and professional development with the goal to ensure all nations can provide, at a minimum, basic health care for their own citizens. International nurse migration is the movement of nurses from one country to another in search of employment. The International Center on Nurse Migration (ICNM) agrees, noting that ‘nurses’ remittances represent an important source of added income and stability for individuals, families and communities around the world. To understand what is driving the global migration of nurses, it is first necessary to examine what are known as the “push” and “pull” factors of nursing migration.
The author’s career has included work with inmates in prisons, with adolescents in hospitals, program development for pregnant drug-addicted women, and day treatment for small children. However, after being a registered nurse for 44 years and an advanced practice registered nurse (APRN) for 40 years, having practiced psychiatric nursing in all areas of mental health care, she was ready for a new challenge. She finished up her teaching job, packed with the help of my daughter who was visiting from Morocco, piled onto a plane, and was on my way to Rwanda. Knowing there were people there with mental illnesses, the author wondered about their care. A physician who is married to a nurse midwife in my program was hired by the United Nations High Commission for Refugees (UNHCR) to manage health care in refugee camps in Rwanda.
The author and his wife are missionary nurses living among a remote tribal group in the jungles of Indonesia. Machine-dependent nursing practices have largely given way to community health preventative measures as well as a “ditch medicine” mentality here due to their locale. Many Indonesians believe that air rushing into one’s body can cause flu-like symptoms. Many of the nearby hospital staff also believed in masuk angin. Florence Nightingale held to this miasma theory of disease! It led her to implement the beneficial practice of maintaining well-ventilated and clean-smelling hospital wards. Littering is a huge problem throughout all of Indonesia. Cross-cultural communication also proved a challenge. Language-learning gaffes are always embarrassing. Missionaries to Japan helped stop the foot-binding of Japanese women and helped advance their place in society. In an effort to end polygamy in Africa, some missionaries encouraged divorce for polygamous couples.
In this chapter, the author’s initial desire to work with vulnerable children led her early in her career to Memorial Sloan-Kettering Cancer Center (MSKCC) in New York City. After several years of staff nursing, the author felt the need to broaden her horizons and expand her scope of practice. While in graduate school, nearly all of her clinical placements were in some of the most impoverished communities in New York City and included immigrants, both documented and undocumented, from virtually every part of the world. Children and their families received comprehensive psychosocial support, including access to psychologists and social workers; recreational therapy; a hospital-based school program; gifts, parties, and access to free summer camps. The only health care many children received was provided by nurse practitioner graduate students at school-based health clinics. Nearly all HIV-infected children acquired their infections from their mothers some time during pregnancy, delivery, or through breastfeeding.
The word “religion” has its roots in the Latin religare, which means “to bind together”. This bond can be between people themselves, and/or between people and a higher power. Some people may declare themselves to be affiliated with or committed to one of the major world religions such as Christianity, Hinduism, or Islam. Others may refer to other species of spirituality such as aboriginal spirituality, Wicca, Celtic spirituality, or New Age spirituality and they may consider one of those worldviews as their “religion”. A perusal of the health care literature will reveal that there have been many attempts to analyze spirituality and religion, each in relation to the other. Culturally appropriate care is an integral part of religious nursing care. Clients who are connected to various religions can be seen as belonging to subcultures within the dominant culture, and knowledge of such subcultures is important for nurses.
This chapter focuses on partnerships between low- and middle-income countries (LMICs) and higher income countries (HICs). It presents information about three types of international partnerships. The first type is partnerships that focus on academic education, prelicensure as well as advanced degree programs. The second type is partnerships that focus on advances in professional nursing, which provide professional development for nurse leaders and clinicians in specific settings and capacity-building measures for the profession in the host country. The third type is partnerships that provide direct clinical care or improve a specific aspect of health care in a developing country. The chapter addresses the host partner factors and presents a case study that reports on the educational partnership between the Alice Ramez Chagoury School of Nursing (ARCSON), the Lebanese American University (LAU), and the University of New Mexico College of Nursing (UNMCON).