International Nursing Practice Experiences~ key framework themes

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International Nursing Practice Experiences~ key framework themes

International Nursing Practice Nursing Students/Faculty Internationalization of Postsecondary Institutions Shortage of practicum sites Desire to help those less fortunate Travel interests Commitment to nursing as a global force for social change Experiences driven by:

Frequently cited traditional rationales for INPE Cultural Sensitivity [TCN Framework] Cognitive development Broaden worldview Foster personal & professional growth

Current emerging INPE themes and means PHC Globalization Health as a Human Right Cultural safety/post-colonial scholarship Learning/teaching theory of Mezirow (transformational learning) Learning/teaching theory of Freire (education of the oppressed)

Primary Health Care Health Promotion/PHC renewal (federal-prov. PHC 2007 renewal) Limited dev. of PHC locally Challenge to find numerous rich exp. of PHC

Globalization Age old movement of goods & services Neo-liberal economic ideology Privatization of social services Increasing disparities b/w rich & poor

Health as a Human Right UN Declaration of Human Rights Increasing discourse of health as a human right

Emerging Critical Perspectives Cultural safety/relational practice informing INPE Postcolonial scholarship

In many houses in Guatemala there is a black and white photograph of people who no longer exist.yes Genocide Happened -UN documents/archdiocesan document Nunca Mas [Never Again].

Guatemala Statistics (U.S. State Dept. 2005) Population: 14.5 million (>50% Indigenous) 10% receives almost 50% all income 20% receives 66% all income 80% population lives in poverty 7.6 million live in extreme poverty

Statistics (PAHO 1993 stats) Infant mortality rate: 48.3/1,000 live births Literacy rate: 68.7 * lit. rate (male): 76.2 * lit. rate (female): 61.1

Five Project Partners although we met with and learned from many, many more AMES-association of women in solidarity Community of Sipicapa Community of San Miguel Ixtahuacan Health promoters of La Esmeralda Coop of Nuevo Horizonte

International Worker s Day-marching with the Association of Women in solidarity(ames)

Invited as guests to participate

Political action: accompaniment, strategies for action, coalition building, education

Critical Reflection Education is a right Not one more woman s death

AMES Asociacion de Mujeres en Solidaridad Association of Women in Solidarity Works with women labourers in free trade zone factories on health and labour rights, women s health issues, regional collaboration

AMES primary health care clinic Training centre, reproductive health, women s health campaigns, gynecological surgeries, labour and delivery

Free Auxiliary Nursing Program for factory textile workers: ~ 2 yr. certificate

Learning, Teaching, Listening, Sharing

AMES Youth Group: outgrowth of priority health issues identified by the women (gang/drugs/sexual health/identity)

AMES rural outreach post Hurricane Stan Women s Group History, leadership, group dev. Issues: income/health Visioning change

Dental health teaching/women s group/primary clinic

San Miguel Ixtahuacan

Goldcorp Inc. Canadian owned gold mine/canadian Pension Plan investment(cyanidebased leaching process ~ 99% foreign profits) Increased tensions and health challenges among community members

Key Health Issues: unstable housing, inadequate, contaminated water, increased stress, depression, skin lesions, respiratory conditions, alopecia

Infant with intact and open pustules covering body similar to that of numerous other children & elders

Narrative as Reflexivity Narrative as healing Narrative as political Telling our stories

Sipicapa Mother s Day Celebration

Resistance to Gold mining via election of local civic committee Project Ayudame: 15,000 Sipicapense with 2 high schools * view educational scholarships as key to resistance

Sipicapa Health Clinic serving 15,000 people ~overview of vision, challenges re: health human resources/supplies/health challenges, and successes

Health worker as member of Common purpose Putting education to service Patience Commitment Leading from behind community

Revisioning the Healthcare Professional If you have come here to help me, you are wasting your time. But if you have come because your liberation is bound up with mine, then we can work together Anon. Quote-Australian aboriginal woman

Health Promotion teaching/learning with student teachers

La Esmeralda

welcome brothers[sisters] in solidarity Cooperative of returned refugees from Mexico in 1997 no running water, electricity or volunteer high school teachers, volunteer health clinic, inadequate roads & transportation despite govnt. promises

Dental and Hand Hygiene Teaching in surrounding villages with skits/stories

Volunteer Health Clinic staffed by local health promoters and dental health promoters NGO financial/moral support re: training & supplies (students observed primary care work with health promoters/actively facilitated health promotion teaching)

Nuevo Horizonte Dr. Ernesto Che Guevara Popular Pharmacy

Co-operative of 400 former guerillas The only way to survive is to be united with a commitment to work for our grandchildren s children

Sharing with high school youth re: how to promote healthy relationships using theatre of the oppressed vision/techniques

Diabetic health-invitation, stories, skit, foot health care/stress management

Stories move in circles They don t move in straight lines There are stories inside stories and stories between stories, And finding your way through them is as easy and as hard as finding your way home. And part of the finding is getting lost. And when you re lost, you start to look around and to listen. Fischer, C. (Writer/Actor/Director). Greenburg, A., & Newman, N.(Writer/ Actor/Director). (1978). Coming from a great distance. [Theatre]. United States States: A Traveling Jewish Theatre.

Sowers of death mural art generates theme for personal and collective critical reflection

Economic development within framework of community health: Environmental health Food production employment Reforestation project 400 hectares Tilapia Fish Farm- 3000 fish/year

Aboriginal thoughts re: nursing (recounting by Darlene Martin) Develop a relationship that is not motivated by an agenda We have 2 ears/1 mouth for a reason: Take the time to listen and then listen again to what is not being said Set aside your priorities and engage with the community around their priorities Be willing to go with the process Be willing to commit patience and time

Challenges How do we support integration of student learning? How to we cope with emerging voice? How do we deal with anxiety re: paradigm evolution of nursing?

Selkirk College Nursing - Guatemala 2005 - onwards

Nursing: committed to fostering social justice as foundation for health for all