Office of Global & Community Health Initiatives & Academic Affairs

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1 WELCOME! CULTURAL IMMERSION EXPERIENCES FOR GRADUATE STUDENTS October 11, 2013 Office of Global & Community Health Initiatives & Academic Affairs Presented by: Dr. Dorothy Powell Dr. Tondelaya K. Blackstone

2 Agenda Introduction to International Cultural Immersion opportunities and available clinical sites Process for pursuing global focus through residency, study, or research General program cost Questions

3 Student Experiences One of OGACHI s responsibilities is to identify, promote, facilitate, and manage cultural immersion experiences for students wanting to travel abroad as part of their academic program, for residency requirements, or for research purposes.

4 What can OGACHI do for me? Tailor-make opportunities to match your academic objectives Confer with advisors and residency faculty on objectives Investigate if your residency requirement can be met (MSN) Provide information on a country and health system Plan: Travel/ logistics / accommodations / orientation Cultural sensitivity training and discussion Roles and responsibilities during your program

5 OGACHI Around the World North Carolina Bermuda Nicaragua Honduras Jamaica Panama Switzerland Japan China India St. Vincent Barbados Ecuador Bolivia South Africa Tanzania

6 International Site Information Educational institutions with whom we collaborate Contractual agreements between the two institutions allow students to learn about the education of nurses, practice of nursing, and the health care system in the host country. University of the West Indies, Mona, Jamaica Kilimanjaro Christian Medical Center, Moshi, Tanzania Polytechnic University of Nicaragua University of Panama Barbados Community College Shanghai Jiaotong University, China Duke-Kunshan Campus, China Wuhan University, China University of Basel, Switzerland AMOS Health and Hope, Nicaragua (under contract) St. Vincent & the Grenadines Community College

7 Contacts of Potential Interest Official Government Organizations Ministries of Health in many Caribbean countries, Tanzania, Rwanda, and Nicaragua Pan American Health Organization International Council of Nursing, Geneva, Switzerland NGOs Teamwork Ministries / Teamwork City of Hope Child & Family Health International AMOS Health and Hope Nicaragua Nurses and Midwives Council of Tanzania Heifer International

8 Graduate Level Experiences with CFHI Nurse Practitioner Residency in conjunction with Child & Family Health International Bolivia Ecuador India Mexico South Africa

9 Amos Health and Hope: Managua, NICARAGUA Mission: Improve the health of impoverished communities by working alongside them in health, education and development. Urban and rural clinical sites: The urban site in Managua is where MSN / FNP students will receive most residency credit hours. The rural sites can be visited mostly for cultural experience and to gain better understanding of the organization s outreach strategy into different communities. Community-based health promotion and prevention Co-directors: Husband / Wife team. One director is trained in internal medicine and preventive medicine and runs the urban clinic; the other director is trained in family medicine and oversees the rural clinics and the health promoters who are trained by the doctors. Both hold masters in public health (MPH) degrees. Their vision is to work alongside rural health leaders to together bring health and hope to communities in need.

10 NICARAGUA - Managua Organized with AMOS Health and Hope Two MSN/FNP students visit for a onemonth international residency experience. Outpatient Clinic Amos Office Building Cultural Locations: Rural clinics San Juan del Sur Granada Barceló-Montelimar Laguna de Apoyo

11 Jamaica Kingston, Jamaica Organized through The University of the West Indies, Mona (UWI) FNP and Nursing Education Support from UWI Community Health Nursing Instructor

12 BARBADOS In coordination with Barbados Community College (BCC) Sir Winston Scott Polyclinic and Queen Elizabeth Hospital Practice Opportunity: Neighborhood behind clinic Sir Winston Scott Polyclinic

13 St. Vincent and the Grenadines In coordination with St. Vincent & the Grenadines Community College Three clinical sites: Biabou (suburban), Greggs (rural), and Urban Health Center. Potential for Beigi. Gain entry into assigned community and insights into the healthcare system Assume advanced practice role under preceptorship of nurse practitioners and physicians Hospital

14 Teamwork City of Hope in Ntagacha Village, Western Tanzania Ideal for Family and Pediatric Nurse Practitioner Students A Children s Home for Orphan Children whose parents, for the most part, died from AIDS Photo taken by: Geneva Hyman, August 2011

15 The City of Hope (TCOH): Mission TCOH is a humanitarian project working with local communities across Africa to address issues such as the orphan crisis, chronic poverty and hunger, health-care needs, education and training needs and economic development needs. Children s Home with capacity for 300 children The vision is where children are raised to be leaders and are taught life skills with a goal of self-sufficiency.

16 Profile of Ntagacha Village Village of 26,000 people ½ of households headed by child under 16 High rate of HIV-AIDS Nearest health care facility is 45 minutes by car; 3 hours by foot High rate of malaria, TB, diabetes and other communicable diseases 1 doctor per 100,000; 2.2 nurses per 10,000 persons Farming is primary industry TCOH is the largest employer with approximately 40 employees Photo taken by Geneva Hyman, August 2011

17 The Health Center: Opportunities Work with primary care physicians and medical students to help assess and care for village residents across the life span Chronic Disease Management HIV / AIDS Care Children at TCOH and within village Health Promotion and Prevention Maternal-Infant Care (all stages) Public Health Community Outreach Provide first aid and triage for children Photo taken by: Geneva Hyman, August 2011

18 Tanzania Moshi Organized through Assistant Medical Officer Program, Kilimanjaro Christian Medical College Practice opportunity: FNP residency (Late June to late August) Residencies in Nursing Education OR other Customized specialist placements Health Center sample care: o Maternity clinic: Up to 50 births per month (10-15 births/day) o Health center with OPD o Up to 70 patients per day o General Care o HIV-AIDS Workday: 7:30-2:00 Paper records Staff speak English Experience with international students Assistant Medical Officer and Nurse in charge

19 Who is designated preceptor in Moshi, Tanzania? In Africa, Assistant Medical Officer (AMO) 3 years clinical officer training 5 years medical practice 2 years AMO training Many of the same rights/responsibility as physicians Lack depth to manage more complex needs Assess, diagnose, prescribe, routine surgery, established protocols In other areas (CFHI): mostly physicians

20 Moshi, Tanzania: Nursing Problems/Approaches Shortage of nurses and inadequate supply of nurse educators Too few advanced degrees for leadership in both academia, practice, and policy (current advanced practice: Post basic certificates) Nurses engaged in research primarily as research nurses only Research administration DUSON MSN graduates have access to active primary care clinics in Moshi community; outreach opportunities to dispensaries at centers in rural areas Evolving nursing research interest at Kilimanjaro Christian Medical Centre: quality of life, home visiting program, palliative care, end of life Nursing faculty seek to develop research capacity Nursing faculty and graduate students offer staff development Inadequate consumption and generation of research evidence for improvement in the quality of health care and patient outcomes Lack of study coordinators and mangers for growing number of studies Lack of advanced degree programs in country Duke OB-GYN setting up program at KCMC

21 China In collaboration with Wuhan University Beginning 2014 Potential graduate student exchange program Research monitoring available Public health experience

22 Planning Process with OGACHI MSN - FNP and NE students: Others Contact OGACHI regarding your interest OGACHI provides guidance on location, cost estimate, and travel dates based on residency period; students with residency faculty will also determine general residency objectives Cultural objectives negotiated with OGACHI/residency director Submit general objectives, personal statement and cultural objectives to advisor, residency director, and residency instructor; if approved, contact OGACHI to begin travel preparations and logistical planning Enhancement Opportunities for MSN / PNP: Potential for two-week clinical experience during break. Not a part of residency experience. Non-clinical experiences Enhancement Opportunities for PhD / DNP: Contact OGACHI regarding your research goals and interest in international site

23 MSN Program Cost 4-6 week estimate Nicaragua: $2,200 $2,500 Jamaica: $3,000 $3,400 Barbados: $1,800 $2,100 Tanzania: $4,200 4,800 St. Vincent and the Grenadines: $2,000 2,300 China: $2700 $3000

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