[health-vn] Mentoring & Education for Nursing Development (MEND): A global nursing program (2)

[Vern Weitzel]

Subject: [procor] Re: Mentoring & Education for Nursing Development (MEND): A 
global nursing program (2)
Date: Tue, 26 May 2009 11:31:20 -0400
From: Alice Grainger-Gasser <alice.graingergasser at worldheart.org>
Reply-To: Global Dialogue <procor at list.procor.org>
To: Global Dialogue <procor at list.procor.org>
CC: Sara Noonan <sara.noonan at menzies.edu.au>, Mark Engel <Mark.Engel at uct.ac.za>

Dear Rhonda,

Great to hear about your work!

RE: Need for training materials on RHD: The World Heart Federation is working 
hard to increase public awareness about RHD, increase health system's capacity 
in RHD screening, and train health professionals to diagnose RHD and give 
effective secondary profylaxis, and raise its priority within the health systems 
of countries where it is common and mobilize funding internationally and nationally.

WHF's online resource, RHDnet offers training materials, register databases and 
other tools that have been developed and tested through the WHF project in the 
South Pacific, run in conjunction with Menzies School of Health Research in 
Darwin, Australia. It also includes materials used for RHD in other parts of the 
world, and a forum where health professionals working in RHD control can develop 
exchange on best practices, barriers, and other useful information:

http://www.worldheart.org/about-us/scientific-advisory-board/rheumatic-heart-disease-network/

RHDnet is coordinated by Sara Noonan, a nurse who has years of experience in RHD 
control in Australia and the Pacific. She can be contacted through the forum or 
through the information address on the site.

We are currently working to translate the materials into Portuguese and also 
hope to get French versions.

You are probably also aware of the ASAP programe 
http://www.pascar.co.za/c_asap.asp , which is being coordinated out of South 
Africa; it has been developed in close association with the Pacific program.

Hope these resources and contacts can be of use as you work to develop nursing 
capacity to deal with RHD and other CVD.

Alice

Alice Grainger Gasser | Demonstration Project Manager | World Heart Federation | 
7, rue des Battoirs | P. O. Box 155 | 1211 Geneva 4 | Switzerland | Phone +41 22 
807 03 33 | Fax +41 22 807 03 39 | E-mail alice.graingergasser at worldheart.org | 
Web www.worldheart.org

The World Heart Federation is committed to helping people achieve a longer and 
better life through prevention and control of heart disease and stroke, with a 
focus on low- and middle-income countries.

Join us at World Congress of Cardiology Scientific Sessions 2010 | Featuring the 
3rd International Conference on Women, Heart Disease and Stroke | 16-19 June 
2010 | Beijing, China | www.worldcardiocongress.org


-----Original Message-----
From: Rhonda Martin [mailto:marcopolotravelhealth at yahoo.com]
Sent: Friday, May 22, 2009 2:05 PM
To: Global Dialogue
Subject: [procor] Mentoring & Education for Nursing Development (MEND): A global 
nursing program

[The MEND nurses in Boston look forward to communicating and cooperating with 
other nurses who are working on similar endeavors. Much of our planning takes 
place over steaming cups of coffee in the many Boston-area coffee shops. We all 
share our expertise and ideas to make these programs a success. With the 
internet and programs like ProCor, there is no reason not to have a "Global 
Coffee Shop" connecting similar-minded nurses the world over. - Rhonda Martin]

Throughout the developing world there is a growing need for nurses who have the 
necessary education, training, and mentoring to provide high-quality, complex 
patient care. Nurses have more education than community health workers and are 
better trained to assess patient and community health needs and provide 
appropriate education.

However, after graduation from either a two- or three-year nursing program, they 
are largely on their own in terms of continuing education, preceptorship, and 
mentoring in new specialties. They often find themselves without a network of 
professional colleagues with whom they can share ideas and information, as well 
as give and receive support.

Unfortunately, nursing is often the missing link in global health initiatives, 
for both hospital and community-based programs.

The MEND program (Mentoring & Education for Nursing Development) offers a simple 
and cost-effective road to improved patient outcomes, despite the absence of 
advanced medical facilities and diagnostic equipment. Started by nurses in 
Boston, Massachusetts, USA, MEND's goal is to develop and sustain coordinated 
relationships with host-country hospitals or community centers where we have 
been invited to implement the program.

Two projects, in Rwanda and Nepal, are currently operating. Each project is 
different in scope, but their shared focus is one-to-one mentoring, formal and 
informal teaching, provision of educational resources (professional nursing 
journals and a nursing library with relevant books), and working collaboratively 
to procure supplies and equipment.

In both Rwanda and Nepal, MEND nurses have identified rheumatic heart disease 
(RHD) and cardiovascular diseases as rapidly growing health problems.

In Rwanda, health care suffered terribly after the genocide of 1994 as many 
doctors and nurses were killed. Untreated streptococcal infections in the 
community resulted in RHD and valvular heart disease. Our primary focus in this 
setting is to perform cardiac surgery and give new heart valves to approximately 
10 to 20 patients each year who are in heart failure as a result of RHD.

A team of about 40 (including doctors, surgeons, anesthesiologists, nurses, 
respiratory therapists, a chaplain, etc.) travels to Kigali, Rwanda, each April, 
bringing our own supplies, medicines, and equipment. April was selected as it is 
the anniversary of the 1994 genocide which claimed over a million lives within a 
three-month period. Our motto is to bring hope and mend hearts from destruction 
and despair.

In Kigali, we set up beds, monitors, IV poles, and supplies in a section of 
their ICU. Rwandan RNs worked side-by-side with us, learning the basics of 
cardiac surgery. They are fluent in either English or French, and several 
members of our team speak French. A nurse educator has accompanied our team to 
provide critical discharge teaching to our patients and their families, as well 
as to the nurses we were mentoring.

As my patients became extubated (breathing tube removed) after their surgery, 
they told me they were already breathing better and described how their lives 
had slowly changed over the last several years: they became easily fatigued, 
felt weak, and grew short of breath with the most minimal exertion. They had no 
understanding of why these things were happening to them. Rheumatic heart 
disease was unknown to them and they struggled to find the connection between 
the sore throats they had in the past and their current situation. There was a 
lot of teaching to be done for these deeply grateful patients who would bring 
that information back to their families and communities.

In Nepal, cardiovascular disease is becoming more prevalent. During my 
exploratory visit I attended the morning rounds on the ICU patients with both 
the doctors and nurses. As expected, I found patients with hepatitis, trauma, 
and lung disease secondary to smoking and pollution, but was surprised to find 
patients in middle age having myocardial infarctions, and many other patients 
with diabetes and hypertension as their secondary diagnosis.

Over the last decade, rural farming families fled to the relative safety of the 
Katmandu valley from their villages because of the Maoist revolution and the 
violence and death that resulted. This has eventually led to a more sedentary 
lifestyle, more access to junk food, and exposure to pollution and second-hand 
smoke.

Working with nurses in a Katmandu hospital, we strive to meet their needs and 
desire for more knowledge about cardiovascular disease and prevention. There is 
a need for educational materials that are easy to use and translate, and that 
are culturally appropriate.

For more information, contact: Rhonda Martin, RN, BSN, MPH, at 
marcopolotravelhealth at yahoo.com.