Nurses—Making a Difference in Global Health

GOAL 5: Improve maternal health

Did we really make a difference?

Author holding child at Cotlands.

By Katherine H. Murray Frommelt

As I began this year, my 37th as a nurse, I stopped to reflect on what it really means to be a nurse and was reminded of a very special journey. In March 2004, my daughter Molly and I had the privilege of traveling to South Africa with a delegation of nurses from the United States to help with the HIV/AIDS crisis.

The visit was under the direction of People to People Ambassador Programs. According to Chief Executive Officer Mary J. Eisenhower, granddaughter of former President Eisenhower, founder of the organization, her grandfather had the simple thought that “people can make a difference where the government cannot. Delegates represent the best of our hope, courage, openness and a love of peace.”

Our focus was to promote understanding, share information and ideas, be both teachers and students, and create ongoing communication. For me, the trip turned out to be truly a journey of the heart.

We had opportunity to visit a variety of health care agencies on our trip, including the University of Pretoria’s Center for the Study of AIDS, the AIDS Care Training and Support (ACTS) Rural Community Initiative, the loveLife Youth Center, Doctors Without Borders (Médecins Sans Frontières), Mothers to Mothers-to-Be, the Treatment Action Campaign, the Department of Health’s HIV/AIDS and Tuberculosis Unit, the Maternal and Infant Health Strategies Research Unit and one of my favorites, Cotlands Baby Sanctuary. We also met with United States Ambassador Cameron Hume at the U.S. embassy.

Before we left for South Africa, Molly and I were asked to do a live interview at a local radio station. Two questions the interviewer asked us haunted me throughout our journey. He asked us 1) if we really believed that the people of South Africa wanted us there and 2) if we truly believed that we could make a difference during the trip’s two-week time frame. I responded that I did believe they wanted us there and that if I could make a difference to even one person, if I could hold even one dying child, I would believe I had made a difference.

After visiting Cotlands Baby Sanctuary, I kept hearing those questions in my mind. Cotlands, founded nearly 70 years ago as a care center for unwed mothers and their infants, has evolved during the last decade into a shelter for abused, abandoned and HIV-positive, terminally ill children from birth to 9 years of age.

The organization’s staff members are awesome. The morning we arrived, one child had just died and two more were actively dying in the hospice wing. I watched staff members lovingly care for these children, some having a baby in each arm while using a foot to rock another terminally ill child in an infant seat. “AIDS orphans” and child-headed households are now commonplace in South Africa, a country with one of the largest populations of HIV/AIDS-infected people in the world.

We loved our time there and had opportunity to interact with these wonderful caregivers and some of the most remarkable children I have ever met. They were so happy to see us—they showed us around, posed for pictures, played with us and repeatedly asked for hugs.

We had supplies with us that had been generously donated by students, faculty and staff from our college. When Sister Stella, the head nurse, saw what we had brought—simple things such as toothbrushes, Chapstick, clothing and Tylenol—she looked at one of her colleagues with tears in her eyes and said, “Oh, it is too much, we will have to share.”

As we were preparing to leave Cotlands, I asked a little fellow if I could have a kiss goodbye. Suddenly, there was a whole group of children surrounding me, saying, “Please kiss, Mrs., please kiss.” A little girl to whom Molly had become very attached followed us everywhere, including to the door. As we left, our group looked back to see a row of tiny faces pushed against the window. Sister Stella looked to Molly and said, “You come back and fetch your girl now.”

Again, the interviewer’s questions came back to me. I knew the people in South Africa welcomed us, but I wondered if we had really made a difference.

When we arrived at the hotel that evening, Molly and I decided not to attend the group dinner, as I had been ill for two days and needed to rest. I ordered a sandwich for her.

Throughout our travels, we wore badges that identified us as United States ambassadors. We also had ambassador tags on our luggage. As the young man delivering the sandwich handed me the tray, he pointed to my badge and said, “Mrs., are you with the group?” I responded that I was.

“Is it true that you are from America?” Again, I said yes.

“My whole life,” he said, “I never thought that I would be privileged enough to meet someone from the U.S.A. Is it really true that you are nurses?”

I responded affirmatively and he said, “To be a nurse, you must be so proud. Nurses, they do such wonderful things, and now you have come to help us. Bless you. Bless you.”

I couldn’t remember the last time I had thought about how proud I was to be a nurse and what wonderful things I get to do.

Bowing, the young man started to cry and then asked the question I had learned to dread: “And Mrs., can you bring us hope, hope for this terrible disease that is killing my people?” I responded that there was not yet a cure, but that people in our country were working every day to find one, and people were now living longer and better lives, and we really wanted to help.

Still bowing and crying, he said, “Mrs., can you make me a promise?” I, of course, said I would try, depending on what he wanted. He said, “When you return to your country, will you tell more people to come here?” I said I would.

“I have another promise to ask for,” he said. “When you go home, will you tell our story?”

I told him I was a teacher, and that I certainly would tell his story to anyone and everyone who would listen.

“Bless you,” he responded, “and bless all those American nurses.”

I had my answer to the reporter’s questions, and my daughter and I have kept our promises. We have now given more than 18 talks on South Africa, and we continue to communicate with Cotlands Baby Sanctuary and send them support.

Molly’s girl is doing well. Every time we speak about our journey to South Africa, I share this young man’s story. I thank people for listening—just as I thank you for reading this—because every time I tell this story, I am keeping a promise. And I try to always remember to be proud to be a nurse.

Katherine “Kay” H. Murray Frommelt, RN, PhD, FT, is chair and professor of the Department of Nursing and Health at Clarke College in Dubuque, Iowa.

RNL - Reflections on Nursing Leadership - Published 3/3/2006 , Vol. 32 No. 1