Shepherd Boy, Tanzania
A Continent Away
When Winona State University graduate nursing students Kayla Bachand and Jeremy Ganong began researching the health care system in Tanzania, the need for help became obvious. So did the potential to make a real difference in the Eastern African nation.
Kayla Bachand, Dr. Lisa Schnepper, Jeremy Ganona.
Both Kayla Bachand and Jeremy Ganong, who are in WSU’s Doctor of Nursing Practice (DNP) graduate program, visited Tanzania twice in 2015. Their goal was to further develop the nurse practitioner role by meeting key personnel in the government and universities, and observe first-hand the issues they were facing. In the process, they had eye-opening experiences as they witnessed the stark contrast between health care in the United States and third-world Africa.
They toured a hospital under construction in a rural area. Some patients have to travel up to 50 miles over bad roads to reach it. Sadly, care at the facility is far below modern standards. When Kayla and Jeremy visited, there was no electricity.
“It’s something I would never have imagined,” said Jeremy. “It’s not what you and I think of as a hospital; it’s just a long building with doors, all open (inside). That’s going to be it.”
“Here (in the United States) we would never go to the hospital and expect not to receive food, medication or clean linens” said Kayla. “There, the families of the patients have to provide that.”
Kayla and Jeremy are completing their DNP studies at WSU-Rochester and will graduate in spring 2016. WSU’s DNP program began in the fall of 2013 with 18 students. In August 2015, the program received full initial accreditation from the Commission for Collegiate Nursing Education (CCNE) and has an enrollment of 66 students in 2015-16.
As part of their DNP studies, Kayla and Jeremy were required to complete a scholarly project in which they apply evidence to practice. Their advisor, Dr. Lisa Schnepper ’94, suggested they research how the nurse practitioner role could improve healthcare in Tanzania, based on her own work with nursing initiatives in that country.
Kayla and Jeremy first visited Tanzania for 10 days in February 2015, then returned for two weeks the following June. In addition to visiting facilities and volunteering at clinics, they worked to increase awareness of the nurse practitioner in a nation where, the World Health Organization reports, there is just one licensed physician per 100,000 people. They were the first WSU students to travel to Tanzania as part of the DNP program. Duke University School of Nursing is the only other program from the United States with a presence in Tanzania.
In the U.S., nurse practitioners (NPs) work as advanced practice nurses and perform examinations, diagnose and treat common illnesses and injuries, interpret test results, prescribe medications, and perform some procedures. NPs also provide counseling and education on healthy lifestyle choices and health care options.
“Our goal was just to gain buy-in from the leaders,” Jeremy said. “The biggest challenge was that they understood what the role of a NP is, but they didn’t understand the function.”
“We had to be careful,” Kayla added. “We didn’t want to seem like we were coming in and trying to change their health care system.”
Health care leaders in the country’s Ministry of Health and Social Welfare and universities were eager to listen and work with Kayla and Jeremy. Two WSU professors of Graduate Nursing, along with nurse practitioners from Duke, had already begun to raise awareness of the NP role in Tanzania. Kayla and Jeremy were invited to participate in a conference being led by Duke called Consensus Building Conference: Family Nurse Practitioner for Rural Tanzania. They found it both exciting and challenging to have access to key stakeholders in Tanzania’s health care system.
“From the first conference, it seemed like all the leaders agreed that this NP role is a good thing,” Jeremy said. “But Some of them called it a ‘super nurse’ who would work in big hospitals, so there were some misconceptions. The conference was about clearing that up and formulating a discussion and figuring out the next steps.”
For Kayla and Jeremy, visiting Tanzania was an incredible experience, personally and professionally. Kayla, a native of Brooks, Minn., is focused on becoming a Family Nurse Practitioner. Jeremy, who is from Menomonie, Wis., plans on working as an Adult/Gerontology Nurse Practitioner after graduation.
“Starting graduate school, I never would have imagined it would bring me to Tanzania,” Jeremy said. “There was such a juxtaposition between what we know as health care and what they know as health care. I’m hoping another group of nurse practitioner students continue where we left off and keep this momentum going.”
The foundation for WSU’s role in developing nurse practitioners in Tanzania was set in 2011. While on sabbatical, WSU Professor of Graduate Nursing Dr. Diane Forsyth ’72 re-connected with a former WSU nursing faculty colleague, Mary Ellen Kitundu, who was working in health care in Tanzania. Mary Ellen was trying to establish an undergraduate program, but found that Tanzania lacked educators with any teaching background or theory. Diane brought in some of her MS Nursing Education students and helped Mary Ellen with teaching techniques.
Dr. Schnepper took the next steps. While on her own sabbatical in 2012, Lisa, a Professor of Graduate Nursing, visited Kitundu at her hospital in Dar es Salaam, Tanzania’s largest city. She traveled to Tanzania a total of eight times from 2012-2015 and served as the advisor and inspiration to Kayla and Jeremy as they built on her work.
“From the day I stepped foot in Tanzania, I thought, nurse practitioners could change health care here,” said Dr. Schnepper.
