Global Health Nursing & Midwifery

Dear Laxmi, I do appreciate your feelings about this situation. I assure you, do not get frustrated or feel bitterness, the fact that only 10% of your nursing staff are endorsed in health care delivery system. The head of the snake is that Our Governments are kneeling on knees in front of the Globe and the whole earth, which is only God Land and only God, being treacherously gripped by the international leadership, which I believe and think of as a big Fraud, The developed countries, you know took extraction of every good matter out of the developing world and again supported by our governments. Take yourself as an example, How could you proceed in your career without looking abroad to those North countries. The practice of discrimination is quite obvious on the world. Who can pay attention to what you are writing and keep repeating ? No body except us as scientists, who are supposed to behave like noble mankind. Is the service delivery system intact in those countries which are obtain your citizen nurses? Are they conducting the same poor service as in your country,Nepal?
Dear Laxmi, the journey is too long for us to run.The targeted ...

Dear Laxmi, I do appreciate your feelings about this situation. I assure you, do not get frustrated or feel bitterness, the fact that only 10% of your nursing staff are endorsed in health care delivery system. The head of the snake is that Our Governments are kneeling on knees in front of the Globe and the whole earth, which is only God Land and only God, being treacherously gripped by the international leadership, which I believe and think of as a big Fraud, The developed countries, you know took extraction of every good matter out of the developing world and again supported by our governments. Take yourself as an example, How could you proceed in your career without looking abroad to those North countries. The practice of discrimination is quite obvious on the world. Who can pay attention to what you are writing and keep repeating ? No body except us as scientists, who are supposed to behave like noble mankind. Is the service delivery system intact in those countries which are obtain your citizen nurses? Are they conducting the same poor service as in your country,Nepal?
Dear Laxmi, the journey is too long for us to run.The targeted aims and dreams are very much tortured and the change is major. We need to put the globalization upside down, the fact that it is built deliberately on the fact that poor human are to be crushed and jeopardized.The unfortunate fact is that we can only defeat these depriving agenda by potency, power persistence and hard kind of pressure.
You can,with patience and will, CAN drive, motivate Goverments, politicians, polict makers and excutives to adopt those Fronts and inflate the New Soul in hearts to inspire. Push them to say "NO".
I AM NOT ONLY TAKING, but telling real life examples ifrom my country. I have said it one time and saying it once again,let us stand, up rise up by our and on our own feet. What did the developed world offer to your country, Laxmi along and all through its history and for no price (except human sake)? Any achievement that was established in your country was by OWN CITIZENS HAND.
Then why can not live as dignified Mankind?

Hello,
In response to the discussion about nursing leadership, the Oncology Nursing Society (ONS) has developed a leadership development/capacity building program that we have conducted internationally and was received extremely well. The intent is to strengthen nurses both individually as well as organizationally. We teach culturally-sensitive empowerment, so that nurses view themselves as advocates (for themselves, their patients, and their profession.)
I would be happy to discuss this with anyone, and we are always looking for ways to partner with other nursing associations, hospitals, and so forth to bring this to various regions.
Best regards,
Kate
_____________________________________________

Kate Shaughnessy, BA, CVA
Member Relations Manager
Oncology Nursing Society
125 Enterprise Drive
Pittsburgh, PA 15275-1214
+1-412-859-6238 (phone)
+1-412-859-6163 (fax)


Oncology Nursing Society
Where Oncology Nurses Connect
Learn more about membership today at www.ons.org.


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Dear Elhassan, I couldn't agree with you more. Thank you for your suggestions and advice. I really feel good whenever I read your views and comments in different online discussions. It is really inspiring especially people like us who really want to make the difference in the society and in the lives of poor women and children.

I'm not going to give up my mission that easily to bring the changes in the health care delivery system of my country. The reason I’m doing currently my doctorate is also for that purpose.
Fifteen years I spent in the development sector of Nepal working through NGO, INGO and bilateral organisation but still despite having too many local NGOs (more than 40,000)/INGOs/bilateral and multilateral and donor agencies working and funding for the development of Nepal I hardly see tangible changes in the societies. Actually, I don't blame to our government it is the donor agencies we spoiled our policy-makers, planners and bureaucrats taking them unnecessary to international visits, not allowing or insisting them to work, not making them accountable to their commitments, providing too much financial support despite knowing the rampant corruption in the bureaucratic ...

Dear Elhassan, I couldn't agree with you more. Thank you for your suggestions and advice. I really feel good whenever I read your views and comments in different online discussions. It is really inspiring especially people like us who really want to make the difference in the society and in the lives of poor women and children.

I'm not going to give up my mission that easily to bring the changes in the health care delivery system of my country. The reason I’m doing currently my doctorate is also for that purpose.
Fifteen years I spent in the development sector of Nepal working through NGO, INGO and bilateral organisation but still despite having too many local NGOs (more than 40,000)/INGOs/bilateral and multilateral and donor agencies working and funding for the development of Nepal I hardly see tangible changes in the societies. Actually, I don't blame to our government it is the donor agencies we spoiled our policy-makers, planners and bureaucrats taking them unnecessary to international visits, not allowing or insisting them to work, not making them accountable to their commitments, providing too much financial support despite knowing the rampant corruption in the bureaucratic system and so on.

Dear Kate, Thank you for sharing your initiative in strengthening nurses both personally and institutionally. But I just wonder how effective it will be because our nurses’ leaders who were/are in Nursing Association had attended uncountable international trainings/conferences/seminars/ workshops but their attitudes have not been changed so far. In Nepal context we need leadership capacities development program which can changed their attitude and behaviours and make them action and resulted oriented rather than only being a garrulous. If you think your program do this then I would warmly accept your support and cooperation and start from the public major and oldest hospital, Bir Hospital. I am choosing this hospital due to number of reasons. Firstly, it will be the mirror to all other hospitals in the country if we can bring tangible change in the quality of nursing care and nursing leaderships. Secondly, current Nepal Nursing Association President belongs to this hospital’s Nursing College. Finally, Chief Nursing Administrator at the Ministry of Health and Population was the Matron of this hospital for many years.

Since I’m affiliated with Midwifery Society of Nepal and also a member of Nepal Nursing Association voluntarily facilitating Medical colleges, Ministry of Health, and hospitals of Nepal for the collaboration with professionals and international organisations I would be happy to assist in your noble work to introduce in my country. For further discussion about your proposal you can contact me at .

Dear Kate Shaughnessy,
I would love to learn more about your leadership program. Our PAHO/WHO Collaborating Center on International Nursing offers a nursing leadership program for 3 weeks every 2 years and we are always looking for ideas on ways to improve that program and make it more relevant and useful...Any information would be helpful! Lynda Wilson ()...University of Alabama at Birmingham School of Nursing, Birmingham, Alabama USA

Dear Laxmi, I always find you enthusiastic and critical thinker, I do agree with you in spite of the fact that you do not, but disagreement is a sort of need to more discussion.AS far as we are searching answers for burning questions. The cultural, social, political and other so many factors are impedance of communication. But the major obstacle is this narrow space of contact, having other responsibilities to run: researches, students, postgraduates,patients service, networking, communications and library. I do apologize for that , but we have to shoulder it all and by its all redundancy. Remember , Laxmi that the needs of our people override even our own
personal capacity.
This large number of NGOS is supposed to act a big focus for the development. Think of building them as Leaders,try to arrange them the fact that they are NGOs and do not forget to build on capacity continuously, establish collaboration,coordination, plans of action, determine priorities, structure strategies, identify objectives. Why not, These are considered as organizations, there for must be organized.Women activists and women unions can play a major role together with media and public motivation.

The problem of manpower seems to deem the whole Globe,leave a part the situation in developing countries including African ones. The fragmentation is crippling the whole system of most of our countries.
It is obvious that the capacity built of those countries is continuously collapsing and my view is that it is not only the capacity of health service system, but I am afraid that the human resources are very much deprived and the tendency of the situation is towards downhill. Nature has given to us what no body can imagine!. It is only the ever jeopardized human resources and add to that the so called (Brain Drain), which should not be very much annoying to us, as I can see , the fact the drained brain will continue to input for the sake of the mankind, what is wrong about that?.
By the way it might be strange to claim that , we as African and African countries are not Poor, but strange enough, considered as poor or some times described as developing. Are we really developing?. The answer is No, because we remain still very poor in front of the developed countries. I really feel very bad when I ...

The problem of manpower seems to deem the whole Globe,leave a part the situation in developing countries including African ones. The fragmentation is crippling the whole system of most of our countries.
It is obvious that the capacity built of those countries is continuously collapsing and my view is that it is not only the capacity of health service system, but I am afraid that the human resources are very much deprived and the tendency of the situation is towards downhill. Nature has given to us what no body can imagine!. It is only the ever jeopardized human resources and add to that the so called (Brain Drain), which should not be very much annoying to us, as I can see , the fact the drained brain will continue to input for the sake of the mankind, what is wrong about that?.
By the way it might be strange to claim that , we as African and African countries are not Poor, but strange enough, considered as poor or some times described as developing. Are we really developing?. The answer is No, because we remain still very poor in front of the developed countries. I really feel very bad when I find my self labeled as from low resource country among the international meeting which I used to participate in?. I am not poor, but my country for one reason or another is considered so.
This situation would have been changed, had it not been for the low capacity man power, which is every where, starting from the tip top of the political structure, which quite inconvenient in most of African countries. The lack of transparency is the major offense that insulting Africa, even more than tropical and sub-Saharan morbidity and mortality.
Out of all these we come to deliver the issue of Leadership, which is quite lost among the havoc of all that of politicians, policy makers, stakeholders and executives. When ever you and me come listen to a politician , we hear very nice humanitarian language addressing mostly the well being of people and respect of mankind . For how long are we going to fool our selves by taking and listening such address and speech?
I suggest to motivate and reactivate and use the common language of policy by injecting our faithful goals in side their Agenda the way that they come to love. Every country knows its politicians and hence their ever changing minds. A genuine representative of of humanity must be there among the framework of policy . This is mandatory.
The whole world must come to know about the importance of health sector and development of the Leadership among its staff. Even the (WHO) needs to give it another look, so as to consider the vitality, of the nursing and midwifery staff. The world must admit the major role of the midwife as essential, crucial and strong backbone of the whole service.
I wonder how does the G lobe come to ignore that fact although these years? In brief, this is not the situation in my country , where midwife is the first person I and my colleagues used to look for before starting any job either in side the hospital or out side, being academic, scientific, workshop, research work or even professional promotion. This may be to the fact that the Sudanese culture respects the female Gender too much, this helped gradually The Sudanese females to build their own Leadership as equally as Green natural ground grass of Africa.

Going back to discuss the issue of Midwifery as a global target, which really needs to be emphasized. The true facts are really required to address others by explains true facts. It had been a very long experience extended to around ten years back, when we, in Sudan started to think of the existence of midwives, nurses and other axillary staff. The biggest idea in Sudan concerning this issue is really dated back to very early, when we were students in the University of Gezira, The university was established in 1975 and the first batch intake was in the year 1978, since that time the university started its battle and the first global challenge concerning medical education . It was one of the first universities in the world which created the INNOVATION in the medical education.The story of Gezira is too long to be told by one person neither in quick comment It was very odd idea of innovation at that time when people used to call the medical schools as " Faculty of Medicine" and we were the first batches to be admitted to that school. Strange enough, we resisted the Dean Faculty Professor Basheer Hamad at that time very ...

Going back to discuss the issue of Midwifery as a global target, which really needs to be emphasized. The true facts are really required to address others by explains true facts. It had been a very long experience extended to around ten years back, when we, in Sudan started to think of the existence of midwives, nurses and other axillary staff. The biggest idea in Sudan concerning this issue is really dated back to very early, when we were students in the University of Gezira, The university was established in 1975 and the first batch intake was in the year 1978, since that time the university started its battle and the first global challenge concerning medical education . It was one of the first universities in the world which created the INNOVATION in the medical education.The story of Gezira is too long to be told by one person neither in quick comment It was very odd idea of innovation at that time when people used to call the medical schools as " Faculty of Medicine" and we were the first batches to be admitted to that school. Strange enough, we resisted the Dean Faculty Professor Basheer Hamad at that time very much for one reason he adopted the nomenclature of the faculty to Named"Faculty of Health Sciences". We could never accept that odd name, the fact that we considered our selves as Doctors and Doctors should be labeled to a faculty of medicine and not of health science or applied medical sciences. I t went so far that we argued him very much and finally went into a famous strike. Responding to our little minds at that time the faculty was Renamed the "Faculty of Medicine". We did not know that the Innovative idea of our teaching staff was decided to be kept silent, they planned for a long journey that one day the essential and genuine need for the name Health Sciences will arise and the applied medical education will come to appear as urgent and crucial need. Long time later, around the year 2000 we came to admit that Professor Basheer Hamd and the rest of the staff were really pioneers and so much creative to built such idea among the potent power of conventional and gigantic traditional schools. Now a days in Sudan and in many parts of the world the innovative medical schools are well known and well reputed. The main point of view is that the medical education can not go the correct way unless it is accompanied in parallel with the other applied and health sciences namely Midwifery, nursing, technicians in laboratories, pharmacy, dentistry, anesthesia, medical assistants and other so many branches of health science. Now we got (26) medical universities , all of them having the nursing and midwifery curriculum and certificates. Further more the President of Sudan was convinced to allow so many workshops in that issue and took the matter very serious. He and the whole government declared the (Sudan Declaration) which was witnessed by the the (WHO) and it was adopted and taken under the patronage of the presidency. The main mission of that declaration was to bridge the gap between the Doctors and the so called at that time the para- medical staff , who were graduated from the low quality schools and inferior certificates to function as nurses and no more than that. They used to remain as nurses and midwives for their lives. The message was to upgrade their education to high level institutes and take them up towards educational professionalism. The step further was to establish the Federal Ministry of Health Academies at local areas of undeserved and learn high quality science over there, graduate, certified by the Federal Government and endorsed in the serves by Job and Job descriptions. The story of University of Gezira has been too long , global, creative and made the change in the frame of respecting the whole health team by decent education, professionalism, career building, human and woman capacity building high up towards Leadership. Now we accept the name "health sciences", midwifery staff and women leadership and women activists.

Nurses is Nepal work in a "functional nursing system" constrained by the budget and lack of resources. To say the leadership is poor, is to blame the victim for the crime. I invite members of this group to read my blog www.joeniemczura.wordpress.com about the status of bedside nursing in Nepal.

Dear Joe,

I respect your view but at the same time I am bit cynical with your opinion. Being a nurse with public health background I have worked directly in the national public health care delivery system and had 15 years experience working in the development sector of my country, Nepal so I know the situation very well. I'm not talking about the nurses working in the district and zonal government hospitals, where resources are limited.

Instead I'm talking about the leadership of Nepal Nursing Association, Nepal Nursing Council and Bir Hospital managed by the National Academy of Medical Sciences from where they can play major role in influencing policy makers and planners in strengthening quality of nursing care, and services in the public hospitals effectively and efficiently mobilising the limited available resources and strengthening nursing profession. In this world especially in resource-poor settings nothing is sufficient. There is always constrained of resources and budget but we've to learn to work in such situation and we have been doing this since our early age and career. By pointing out the contrained of resources and budget, there is no excuse for our nursing leaders. If they can't ...

Dear Joe,

I respect your view but at the same time I am bit cynical with your opinion. Being a nurse with public health background I have worked directly in the national public health care delivery system and had 15 years experience working in the development sector of my country, Nepal so I know the situation very well. I'm not talking about the nurses working in the district and zonal government hospitals, where resources are limited.

Instead I'm talking about the leadership of Nepal Nursing Association, Nepal Nursing Council and Bir Hospital managed by the National Academy of Medical Sciences from where they can play major role in influencing policy makers and planners in strengthening quality of nursing care, and services in the public hospitals effectively and efficiently mobilising the limited available resources and strengthening nursing profession. In this world especially in resource-poor settings nothing is sufficient. There is always constrained of resources and budget but we've to learn to work in such situation and we have been doing this since our early age and career. By pointing out the contrained of resources and budget, there is no excuse for our nursing leaders. If they can't do anything to bring the changes in the quality of care and strengthening nursing profession in the country then they do not deserve to hold the positions. They should handover to other nurses who can do it. This is my major concerns. I'm not blaming to anybody but I'm very much concerned with the future of newly graduate nurses and care of the patients who are lying on the beds.

One area we all can help on the above 'bulk' of issues that are continuously intertwined is helping to increase awareness of our younger generation through education - socio/political/economic/cultural not just the essentials of nursing. I remember throwing out a question to senior nursing students during a recent lecture in a developing country, '... oonsidering that most went to nursing for a job abroad, what are you going to do, now that there is economic meltdown and hiring is frozen?' - the room was quiet. 'Anyone helping in their community?' and so I went on to put that challenge to them. Hoping that it will make them think outside the box and focus on the wealth they can do to help the community even for an interim.

I do agree that professional nursing organization will have to be strong proponents to the interest of the country, and so does the Dept of Health to looked into ways to be able to utilize this educated nurses and find ways to decrease 'brain drain'. School nursing will be a great avenue to utilize nurses who are not working.

Mandela took a stand on this issue to reduce brain drain. Would be lovely ...

One area we all can help on the above 'bulk' of issues that are continuously intertwined is helping to increase awareness of our younger generation through education - socio/political/economic/cultural not just the essentials of nursing. I remember throwing out a question to senior nursing students during a recent lecture in a developing country, '... oonsidering that most went to nursing for a job abroad, what are you going to do, now that there is economic meltdown and hiring is frozen?' - the room was quiet. 'Anyone helping in their community?' and so I went on to put that challenge to them. Hoping that it will make them think outside the box and focus on the wealth they can do to help the community even for an interim.

I do agree that professional nursing organization will have to be strong proponents to the interest of the country, and so does the Dept of Health to looked into ways to be able to utilize this educated nurses and find ways to decrease 'brain drain'. School nursing will be a great avenue to utilize nurses who are not working.

Mandela took a stand on this issue to reduce brain drain. Would be lovely to meet you, we will be in Patan mid October.

Dear Tess,

I would appreciate if you could elaborate bit more about School Nursing as an avenue to utilise nurses who are not working.

Regarding the brain drain I'm not that much concern because wherever they go at least they are contributing for the mankind and we can't stop people mobility. I believe that it is a natural phenomenon to have wear and tear (i.e. people come and go) in this world. If some goes and other will come or produce, it is a continuous process. And in the case of Nepal, each year 5000 nurses are graduating and they find very difficult to find out the jobs because government of Nepal is not adequately absorbing them.

On the other hand, although government of Nepal says that there is a shortage of human resources in the health sector I don't agree with this because every year 1000 of medical students (doctors), 5000 nurses, 500 public health professionals, 1000 paramedics and 1000 allied health professionals are graduating within the country but government is not taking any steps to mobilise them efficiently to improve the health status of the rural people. In Nepal, we've 11 medical colleges ...

Dear Tess,

I would appreciate if you could elaborate bit more about School Nursing as an avenue to utilise nurses who are not working.

Regarding the brain drain I'm not that much concern because wherever they go at least they are contributing for the mankind and we can't stop people mobility. I believe that it is a natural phenomenon to have wear and tear (i.e. people come and go) in this world. If some goes and other will come or produce, it is a continuous process. And in the case of Nepal, each year 5000 nurses are graduating and they find very difficult to find out the jobs because government of Nepal is not adequately absorbing them.

On the other hand, although government of Nepal says that there is a shortage of human resources in the health sector I don't agree with this because every year 1000 of medical students (doctors), 5000 nurses, 500 public health professionals, 1000 paramedics and 1000 allied health professionals are graduating within the country but government is not taking any steps to mobilise them efficiently to improve the health status of the rural people. In Nepal, we've 11 medical colleges, and around 200 nursing colleges including public and privates so there is a great concern on the quality of medical/nursing education because of the lack of proper clinical placements for students for their hands on clinical practice during their training period.

Glad to know that you are coming to Nepal. It would be great if we could meet but unfortunately at present I'm out of country, in Sydney for my study. If you are going to Patan in October then you can meet our Birth/Reproductive Health Centre's Chairperson, Rashmi who also works in Patan Hospital as a Deputy Nursing Director.