ForwardNursing

Badger nurses impact communities around the world

By Jessica VanEgeren

 

No matter where their journey takes them, Badger nurses share a goal: to change lives through their strong commitment to service. Whether it’s bedside care, nursing research, or addressing global health issues — such as poverty and access to care — service makes an impact on individuals, families, communities, and systems around the world.

For School of Nursing alumnus Sam Carlson ’18, RN, that commitment to service began long before he became a nurse. Carlson joined the U.S. Air Force immediately after graduating high school, serving as a munitions systems specialist building bombs and missile systems. Though he worked 14-hour shifts for six consecutive days, Carlson started volunteering at the base hospital on his day off. He found it to be a rewarding contrast to his military job.

While volunteering, Carlson learned it is U.S. military policy to provide emergency medical attention to anyone in need. Soon after, he witnessed an Iraqi mother, a large load on her back, running toward the base’s main gate. Troops were pointing guns at her and telling her to stop, but she kept running, set the load down at the gate, and ran away.

When he and others approached the bundle, they found two children covered in kerosene burns. They grabbed the children and rushed them to the hospital where they were hydrated, stabilized, and rushed off to surgery.

“That was really powerful for me to see,” Carlson said. “I remember thinking, ‘at least in this hospital, we are trying to do good.’”
He knew then that he “had no interest in staying in the military.”

“If you are a doctor, a nurse, a surgeon, or a tech working in a hospital, you’re doing something good for someone. You are trying to make their life better,” he said. “That’s when I realized I needed to be in the medical profession.”

Breaking the Poverty Cycle

After five years of service in the military, Carlson went to Kenya in 2012 to work for Beacon of Hope, a faith-based non-government organization (NGO). He and his then-wife ended up helping to establish an NGO of their own, Action Two Africa. The couple partnered with a local social worker, who helped provide the funding to get his vision off the ground.

Action Two Africa focuses on education as a means of breaking the cycle of poverty. It focuses its work in Kiambiu, a poverty-stricken area outside of Nairobi that is home to more than 100,000 people, and provides scholarships for impoverished children to attend private schools.

Carlson said students languish in the public schools. A private education is the only way to make it to a university, “which is the gold standard of success.”

“The government technically pays for education through secondary school, but the problem is the government is also corrupt,” he said. “You have entrenched politicians who steal money from people, leverage their power to make money and allow their children to thrive, while these poor communities stay poor.”

And because the stratification between rich and poor is “extreme and so close together,” the private schools are within walking distance of Kiambiu.

“There are malls just like in America, with people buying purses, shoes, video games, and electronics. And you can walk right out of the mall and one block away there are literally children passed out on the street sniffing glue,” he said.

Carlson brought these experiences back with him to Madison in 2013 and began earning his bachelor’s degree in nursing. He currently works at a VA clinic on the border of the Navajo Nation in northern Arizona. Like in Kenya, he navigates the effects of poverty when treating patients. His life experiences and education have taught him that he needs to take the time to talk to his patients, listen, and understand how their circumstances and culture affect their health and health decisions.

“I hear the phrase, ‘you can lead a horse to water,’ so often and it’s so aggravating to me,” Carlson said. “I understand people’s frustrations, but I don’t think that is a fair way of painting someone’s situation. At the end of the day, we all want the same things: we want to be healthy, we want to be happy, we want to go home to our families, and we want to live good lives.”

Improving Access to Care

In 2008, Amal Abu-Awad, PhD’11, MSN, RN, left her home in Jerusalem to begin earning her PhD in nursing education as a Fulbright scholar at the UW–Madison School of Nursing. By the time she came to Madison, her professional resume already was impressive.

She had a bachelor of science in nursing from the Arab College of Medical Professions at Al-Quds University in the Palestinian West Bank; a master of science in nursing with a focus on neonatal and pediatric nursing from the University of South Carolina Columbia; and had papers published in scholarly journals, including “Overcoming Challenges in Nursing Education,” published in 2006 by Bridges: Israeli-Palestinian Public Health Magazine.

Now with more than 30 years of clinical and nursing education experience and nursing licenses in Palestine, Jerusalem, South Carolina, and Wisconsin, Abu-Awad continues to use her knowledge to improve the lives of Palestinians and all residents who live in Gaza and the West Bank.

After graduating from UW–Madison in 2011, she became the director general of education in health for the Ministry of Health in the Palestinian West Bank. She remained in that role until earlier this year when she was named the chief nursing officer of Augusta Victoria Hospital in East Jerusalem.

Augusta Victoria Hospital (AVH) is a program of the Lutheran World Federated Department for World Service in Jerusalem. It was started in partnership with the United Nations Relief and Works Agency (UNRWA) as a major health care facility in Jerusalem after the 1948 war to care for Palestinian refugees.

Her employer is the only hospital to provide radiation therapy for cancer patients in the Palestinian territories and is the only health care facility in the West Bank offering pediatric kidney dialysis. In addition, they offer other specialized treatments not available in most hospitals in Palestine, such as cancer care, hematology and bone marrow transplantation, dialysis, pediatric care, and long-term care facilities.

“I wanted to work at AVH to serve a very special group of patients who have limited services [available to them] related to their disorders,” said Abu-Awad during a Zoom interview from her office in Jerusalem. “I wanted to be an advocate for these patients, to contribute to their treatment, and to support their families.”

One hurdle the hospital encounters when providing care is the inability of Palestinians to come and go freely between the territories and Jerusalem. Years ago, the hospital worked with the Israeli Civil Administration to issue permits for Palestinian patients and their families to enter Jerusalem to access the hospital. Now, the hospital offers a busing service that allows Palestinian patients to cross through the Israeli checkpoints with their approved travel permits.

The hospital also has a program that allows Palestinians who need extended care, such as radiation therapy, to stay at a special hotel just for patients, eliminating any risk that medical care could be disrupted by denied access at a checkpoint.

Abu-Awad explains that because she lives in Jerusalem, she has a Jerusalem ID that allows her to move freely throughout Jerusalem and the Palestinian territories.
It is now her job to advise senior executive management on the best nursing practices, create retention programs, plan new patient services, and coordinate day-to-day operations of the nursing department.

“The UW–Madison School of Nursing has improved my capacity in three essential components: research, education methods, and the translation of research into practice,” she said. “These three components are the foundation I am using to fulfill my duties as chief nursing officer of Augusta Victoria Hospital to improve the quality and safety of nursing services to our patients.”

It is also her job to promote the hospital’s image — the mission, standards, and values of the Lutheran World Federation and the Palestinian community the hospital was created to serve 73 years ago.

“I totally agree with the importance of knowing and interacting with the patients. This is key to knowing what they are suffering from and what can be done to help them,” Abu-Awad said. “This approach to care is universal. It is simple but very essential with all patients, regardless of their culture, gender, or religion.”

“I totally agree with the importance of knowing and interacting with patients. This is key to knowing what they are suffering from and what can be done to help them.” — Amal Abu-Awad, PhD’11, MSN, RN

Answering the Call to Care

Jessica Starich ’07, RN, CPN, first went to Africa while she was a nursing student at UW–Madison, traveling to the small town of Maseno, Kenya. “We were there for about three weeks,” Starich said. “I just loved the experience.”

It was this trip that set up the dueling passions of her life: working as a pediatric oncology nurse at Duke University Hospital and being called “Mama Jess or Auntie Jess” by children at Jemo House, a home she would establish in 2012 to care for children orphaned by HIV/AIDS.

Her path to opening the house was at times dangerous, and a leap of faith made possible by support from her family and her strong religious faith. As a volunteer at a local orphanage in Maseno, Starich stumbled upon information that the orphanage was “highly exploitative and atrociously mismanaged” by the woman who was running it.

She went to the police and to local churches with her concerns, but no one offered to help her.

“In a country with an overwhelming number of under-served children, sometimes a relatively safe place to sleep with access to food is considered to be good enough and better than some. But I strongly believe that a child who is unloved and forgotten suffers as much as a child without enough to eat,” she said. “I knew before I took this woman on that I had to have a place for the children to go.”

She was 25. Over the next year and a half, she sent money to the orphanage, despite what she knew, and returned numerous times. She began working with another woman in the village to try and get children out of the orphanage and into another home. They began succeeding, one child at a time, until they got to the point where they were focusing on finding the relatives of four children.

One day, as she was packing up and getting ready to head to the airport, a woman on a motorcycle pulled up to her door.

“She starts asking me, ‘Are you Jessica? Are you the nurse trying to take these four kids?’” Starich said. “In my mind I was thinking, ‘I don’t know. It depends on who you are.’”

The woman turned out to be a schoolteacher who had temporary custody of four of the children at the orphanage. She had put them in the facility thinking it would be better for them while she looked for a more permanent place for them to live.

The woman pulled a document out from her bag that stated the magistrate and the children’s extended relatives granted Starich custody of the children. Starich recalls the paper just read, “We give custody to Jessica.”

“There was no last name because that doesn’t matter over there. The paper was signed and stamped. All I had to do was sign my name,” she said. “Just like that I had four kids. That’s how it started. I now have the great honor of being one of their mother figures.”

In 2014, she launched Too Little Children, a nonprofit with an annual budget of $45,000. It oversees Jemo House and the Pad Project, a program started by her twin sister, Emma Stober, that provides reusable maxi pads for girls and women in impoverished areas of the world.

Too Little Children operates on the belief that children need more than food and shelter to thrive. Education is key. And in a country with no credit system, children must pay upfront to attend school; roughly $800 for high school and $3,000 for college. Jemo House now has six high schoolers and three college students attending Kenyan universities.

Her advice for anyone reading her story: If this is your calling, go for it. She recommends finding a contact to help you along the way, taking the time to understand a community’s problem before working with locals to fix it, and being resilient.

“We are all looking to be happy and find joy,” she said. “It is wonderfully joyful. It is worth the jet lag, all the sleeping in airports, weird food — and the occasional intestinal distress that comes along with it. Any profession that helps people indirectly, directly brings joy. That is why we do the majority of what we do.”

Global Health at the School of Nursing

These stories are just a few examples of the impact Badger nurses are having around the world. For nursing students without these lived experiences, the School of Nursing presents numerous opportunities to expand their own experiences through immersion programs and listening to the stories of professors and alumni who have served in a variety of global health roles.

“It is a really good opportunity for people, especially if they have never been overseas before and been exposed to poverty. I’m not saying poverty doesn’t exist in the States — it certainly does,” Carlson said. “But it can look very different overseas.”

Badger nursing students are required to take the three-credit course, “Social Justice in Local and Global Settings.” The School also offers a 13-credit, undergraduate certificate in global health, as well as study abroad and immersion programs in Ireland, Malawi, and Thailand.

Additionally, the School’s doctor of nursing practice students can join the UW’s physician assistant program and practice their primary care skills in an immersion program in Belize. The School of Nursing also partners with the School of Medicine and Public Health to offer graduate and capstone certificates in global health.

“If you are coming to the UW’s nursing program, it is a great place to expand your global knowledge and your opportunities to work globally.” — Karen Solheim ’73, PhD, RN, FAAN

“If you are coming to the UW’s nursing program, it is a great place to expand your global knowledge and your opportunities to work globally,” said Karen Solheim ’73, PhD, RN, FAAN, clinical professor and global health program director at the School of Nursing.

Global health teaches students a mindset that is about more than setting foot in another country. It is about learning respect and being curious about every patient’s story — it is recognizing that we are not intrinsically different from each other.