In August 2013, Wanda Chestnut, Kim Law and Kerra
Plesko, three members of the Nurses for Edna team, left for Hargesia,
Somaliland. Due to a death in the family
the last nurse, Sarah David, joined them two weeks later.
Each member
of the team had expressed a passion to improve women’s health around the world.
For almost a year they had planned and worked.
They held fund raisers to augment the already generous grant awarded by Barco’s
Nightingale Foundation for this mission. They sought free medical equipment and
found ways to cover shipping costs and logistics. They sent out hundreds of
appeals to friends and family to raise awareness of the plight of the Somaliland
women. They did all this in an effort to make a difference in a country still
struggling to recover from years of civil war. They traveled with little
personal luggage so they might fill their baggage allowances with donations of
medical equipment. The trip took more
than 24 hours; they arrived exhausted, but eager to begin work.
The Hospital director, Edna Adan requested they
teach a First Aid course while they were in Hargesia. What they didn’t realize
was how large the group would be – over 150 nurses, lab techs and public health
students. Nor did they realize that some of their teaching would need to be
done using pantomime and interpreters!
Although each member of the team expressed that the
teaching experience was both frustrating and somewhat overwhelming, they also
expressed that one of the best things about the trip was the positive feedback
that they got from their students. They can feel proud that they were instrumental
in teaching more than 150 students the necessary skills needed to provide basic
First Aid Care for the people of Somaliland.
“My
happiest moment is a culmination of positive feedback from my students and from
the university. Both have expressed gratitude for and positivity towards my
teaching and indicated they would happily
have me teach again. Having never taught in a classroom setting before,
and having experienced numerous frustrations throughout the course, the end
response was very gratifying,” Kim Law.
Besides teaching and working at the Edna Adan
Maternity Hospital the nurses also worked and taught in the
community at the
Abdi Idan MCH Clinic. This free, government funded clinic provides multiple
services including antenatal and postpartum care, low risk deliveries, a nutrition
clinic, a pediatric health and immunization clinic, and lab services in one of
the poorest neighborhoods in Hargesia.
While
they were not able to spend as much time as they had hoped providing women’s
health clinical care at the hospital, the nurses did both work, and provide
supervision to student nurses, on the wards. Three of the nurses identified
their biggest challenge, and saddest moments, came while resuscitating a
newborn infant with no doctor to guide them.
“We tried to get one of the nursing
students to go find a doctor, but she didn’t understand what we wanted. Finally,
the nurse anesthetist came in and we were able to partially stabilize the baby
and get it breathing. But, it was just a situation where no one in the room
knew what to do and we couldn’t find anyone to help us, Kerra Plesko.
It was during incidents like this one, and other
long neonatal resuscitations that the nurses felt pummeled with a moral and
ethical dilemma.
“My absolute worst experience here is the
ethical dilemma I am now constantly thinking about. We've done a few, long neonatal
resuscitations, and have been able to revive the babies, only to have them die
a few days later. If they had lived they would have been severely disabled. Is
it ethically responsible to do long resuscitations in resource poor countries
where the risk for long term disability is high?” Kim Law
However,
the nurses also expressed being positively impacted by their time in
Somaliland, They came home with a greater appreciation for everything available
to them at work and at home: medications, supplies and equipment.
“I now really appreciate being prepared
at every delivery, having the necessary equipment ready, or
even having it at
all, and having qualified trained people who know the importance of quick resuscitation and being efficient with what we are doing. I appreciated it before, but I had never seen
babies die from the lack of those things. I know we live in a rush- rush society and I do believe that we need time for slowdowns
often, but I also value responding to a task quickly, and Africa has shown me
how valuable that can be,” Kerra Plesko
They
also came home with a greater appreciation for their knowledgeable, supportive
team members at their respective work places.
Larger still, they returned with a sense of respect for the people of
Somaliland and a reminder of the importance of humility.
“The people of Hargesia are so poor and
despite being poor they are humble people. This experience reminded me to
remain humble in all situations and circumstances,” Wanda Chestnut.
The
nursing team also described moments of happiness along a difficult medical
mission. Moments of showing support for each other; of early morning work -out
sessions on the roof to decrease their stress; and spontaneous dancing in their
rooms after working all day to the point of exhaustion. But, the most
gratifying memories they report are of times they saw their hard work actually
bringing change in the nursing practice at the Edna Adan Maternity Hospital:
“My happiest moment was when I
went downstairs one morning after breakfast and saw the nurses and midwives put
two babies in the Embrace warmers! It was a proud moment. Not only did they do
it correctly, but they actually remembered to use them! It’s hard to tell when
you get through to some of the nurses, but at that moment, I knew that our in-services
and teachings had some sort of impact because the neonates were in Embrace,” Sarah David
The nurses report feeling proud of some of the
small, yet significant, changes they brought to the Edna Edan Maternity
Hospital such as putting together an emergency
resuscitation kit for the med/surg ward. They are particularly proud of the part
they played in the prevention of
neonatal hyperthermia.
“When
we first arrived at the hospital, neonatal resuscitation were being done on an
old cart with a heating pad. The babies would get extremely cold (like 34 C
cold). They had two radiant warmers shoved into corners so we decided to check
them out. One of them didn't work but the other one was in beautiful shape. It
took several weeks to get everyone to leave the warmer on and plugged in at all
times. But eventually, with perseverance and a little duct tape, we made it
happen.”Kim Law.
Although
the mission to Hargesia was challenging, each nurse expressed how very grateful
they are to have had this experience. Each feels this experience both gave them
a fuller appreciation of their nursing careers at home, as well as helped to
prepare them for future medical missions. Each member of the Nurses for Edna
team: Sarah David, Wanda Chestnut, Kim Law, and Kerra Plesko plan to continue
to volunteer in the global arena. One nurse at a time they will change the
world!
The nurses of the Nurses for Edna team want to
thank One Nurse At A Time as well as the Barcos Nightingale’s Foundation for
their generous support of this medical mission.