Two OHSU nurses heading to Rwanda, aiming to enhance nursing care around the globe

09/08/14  Portland, Ore.

by Lee Lewis-Husk

Two Oregon nurses will spend a year in Rwanda, leaving behind their jobs and homes to join an initiative by the Rwanda Ministry of Health.

Isabelle SouleIsabelle Soule, R.N., Ph.D., and Claire McKinley, R.N., M.S.N., both assistant professors at the OHSU School of Nursing, will collaborate with other health care providers to help raise the skill level of Rwandan nurses and midwives. “We’ll be trying to build partnerships that blend the best of both countries’ health care systems,” Soule says. Rwanda has steadily been rebuilding its infrastructure and health care system since genocide tore it apart in the 1990s.

They join a contingent of health professionals sponsored by Duke University, one of 23 American universities and academic medical centers in a seven-year partnership with the government of Rwanda. Among other goals, the Human Resources for Health Program creates a collaboration to transfer knowledge in various health fields, including nursing, and upgrade the clinical and teaching skills of Rwandan nurses.

“We’re not there to take jobs but rather to train the trainers,” says Soule, who will work with a nursing school dean near the Ugandan border. “I’ll be looking at the curriculum and perhaps helping develop tools to evaluate the nursing program,” she says. Although she’s never been to Rwanda, Soule is an experienced international traveler and has worked for the past 10 years with immigrant and refugee communities in the Portland area. “We’re trying to bridge America’s biomedicine and health care with the values of those communities,” she says.

McKinley, a pediatric nurse practitioner who’s worked at Doernbecher Children’s Hospital and also taught at the nursing school for 10 years, has been assigned to a maternity hospital in Kigali, the capital city. She’ll mentor nursing students in their third year who want to specialize in either pediatric nursing or midwifery.

“I wanted to do international work but didn’t want to leave my family,” she says. Instead she’s taking them along. Her husband, Andrew Yoder, was supportive of the year abroad and quit his job as a mechanic to go with her. He hopes to put his skills to work, perhaps in an orphanage. “Neither of us has been to Africa, and the only country he’s been to is Canada, so this is a big leap,” says McKinley. She says her 10-year-old daughter initially didn’t want to go because she didn’t want to get the shots, but now is excited to meet new friends and to learn French at the international school she will be attending.

Both women expressed an eagerness to learn how health care is done in another place. “Health care is very culturally bound,” says Soule. “I’ve never worked in East Africa so I’m going to approach my job with humility and openness before I delve in.”

McKinley says she’s excited to be part of helping people develop their own health care system. “It will have Claire McKinleya different cultural viewpoint – I want to be supportive and not judgmental – imposing U.S. standards on Rwanda may not be practical. Finding the balance between practicality and best practices will be key.”

Both women know that what they see in Africa will be tough on them, but hope to learn from the experience and their host country. McKinley adds that the U.S. pendulum has swung back to simpler treatments, such as “kangaroo care” where parents go skin-to-skin with their newborns to help regulate heart rate, breathing and temperature instead of keeping babies away from parents in an isolette. “Some things that are new and exciting for us have been done for a long time in countries with fewer resources.”

When she returns next year, McKinley hopes to have a fresh perspective to share with her students. “I feel I’ll be so much more open. Also, after being in another culture and being ‘the other,’ I hope to help my students with how families may feel who aren’t part of their own cultural background.” She adds that she’s thankful to the OHSU nursing school for granting a one-year leave of absence.

The Rwandan Ministry of Health states on its website that the program aims to train more than 550 medical specialists, upgrade the skills of 5,000 nurses and introduce formalized training in health management and dentistry. The program receives funding from the Clinton Health Access Initiative. At the end of the seven-year partnership, Rwanda hopes to be able to sustain an improved health workforce on its own without foreign aid.

Two Oregon nurses are headed there to help the country achieve its goals and bring home valuable lessons they can pass along to U.S. nurses interested in global health.


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