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Providing Essential Care in Worlds-away Places

A group of Katrina survivors await treatment.

A group of Katrina survivors await treatment.

By Jay Fields

When a small cadre of nursing professors and students from the University of Tennessee, Knoxville, arrived in New Orleans six months after Katrina, they met with scores of women residents who’d soldiered on—through mildew, muck and make-do living conditions.

“They’d stayed in the city, doing whatever they had to do to survive,” says Dr. Mary Kollar, family nurse practitioner and UTK faculty member. “And by the time they came to see us, they’d stretched out their medicines as long as they could or just finally run out.”

Some days the line cued up at 4:00 in the morning.

Operating out of a temporary clinic set up in the peacock section of the New Orleans Zoo, the team from UTK focused on women’s exams. “They were desperate for care,” says Karen Lasater, another School of Nursing faculty member. “It was a scene of shock but the attitude was ‘let’s face ahead and go forward.’ Everyone was so thankful. We conducted about 300 exams.

Women Health Entrance

One of the many temporary facilities used to provide health care after Katrina.

“We handed out blankets and many of the women told their stories,” she says. “I remember visiting with a distinguished-looking lady standing in line whose house had been devastated. She was truly grateful to be there.”

In addition to pelvic exams, pap smears, medications, and general medical aid, women at the unit could also take advantage of eye and dental exams, offered by volunteers from Remote Area Medical, a Knoxville-based non-profit and a partner with UTK. Lab results would later be sent back to the Health Department in New Orleans—and to the patients themselves—for follow-up.

“These women had been going along for months without any care at all,” Karen says. “We worked from dawn to dark, straight through.”

Mary Kollar recalls the improvisational nature of providing care. “Something unexpected can happen. For example, we ran out of some things and decided to pay for them ourselves. We were reimbursed, which is good, because I was running out of money,” she laughs.

Spanning the Globe

This same improvisational attitude, doing the best you can with what you have, is a hallmark of UTK nursing outreach. It’s visible in projects from villages in Ghana to the tropical landscapes of Costa Rica and the Dominican Republic, a 2009 destination for a clinical team from the school.

Ghana missions began in 2001, in concert with the University of Massachusetts at Amherst (Ghana Health Missions), and continued for four years, providing medical care to the coastal fishing villages of Sekondi and Takoradi.

For students and faculty on those trips, says faculty leader Karen Lasater, the word of the day was “respect.”

“The idea is to lift up local providers, to break down barriers on both sides, to get to know each other, to learn there are other ways to get the job done,” she says. “You’re wanting to respect and promote the autonomy of the healthcare providers who are there. So that’s what we did—and we developed a great rapport.”

Much of the work in Ghana centered around immunizations, gastrointestinal and respiratory illnesses, tropical diseases, management of village hypertension clinics, and the establishment of health education classes.

Hispanic healthcare

The College of Nursing has focused its international experiences in Central America.

In the past five years, international service learning experiences, open to junior, senior, and graduate-level nursing students, have focused on Central America, with teams from UTK assisting in Costa Rica, Nicaragua, Panama, and Belize.

Working as a faculty leader on many of these missions, Karen Lasater recalls that the team spends a lot of time with local physicians, getting to know them and how they work and think. “In Belize,” she recalls, “we had the opportunity to work with a physician from Cuba, who was there volunteering like us, pitching in.”

The numbers speak of the texture of the experience. In 2006, for example, in Costa Rica and Panama, UTK provided health services, including free medications, for over 400 patients; immunized over 200 infants and children; provided dental care, including extractions, flouride treatments, and cleanings, to 75 people; and conducted health education classes on disease prevention, proper nutrition, and management of chronic illnesses.

Closer to Home

From another perspective, the “world’s away” aspect of UTK volunteer nursing services doesn’t have to translate to literally being a world away. At a homeless shelter in Knoxville, acute problems like colds and lice, as well as conditions like allergies and asthma, require the same close attention as a medical issue in Ghana.

Administering a shot to a homeless man.

A volunteer nurse administers a shot to a homeless man in Knoxville.

Mary Kollar has been instrumental in providing medical services at the People’s Clinic of the Volunteer Ministry Center on Jackson Street since 2000, generally working side-by-side with students, as she did in New Orleans.

The effect on providers, cross-town or across the world, is cut from the same global, intercultural, bridging-of-diversity cloth.

Brad Stansberry, a graduate nursing student who helped Mary Kollar at the Ministry Center as a part of his clinical rotation, succinctly summarizes:

“It’s nice to be able to help people. Sometimes this is the last place a person can go for help.”