Nursing Students Without Borders

By Charlie Feigenoff (PhD, English ’83)

Although San Sebastian, a town of 15,000 in the mountains of El Salvador, is well known for its beautifully woven textiles, it is far from prosperous. There are few doctors, and its citizens often suffer from a variety of conditionsÑskin infections, diabetes, and cervical cancer—that can be prevented or controlled with education about basic nutrition, hygiene, and safe sex.

In 1999, a group of U.Va. nursing students who learned about the plight of San Sebastian's people formed Nursing Students Without Borders (NSWB). Members of this entirely student-run organization make periodic trips to San Sebastian to work with local Red Cross volunteers on health promotion and team up with members of the Charlottesville-Albemarle Rescue Squad, among others, to provide first-aid training. The group also delivers medical supplies donated through MERCI, a project organized by U.Va operating room nurse Helen French.

"Our approach is very methodical," notes current NSWB president Lidia Niecko. "On our first trip to San Sebastian, we worked with the local health care team to determine how we could best contribute to the needs of the community." These programs continue to evolve. During each trip, NSWB members assess the effectiveness of their initiatives in preparation for future visits. On their return, they raise funds, seek expert advice, and solicit donations of necessary supplies and equipment.

NSWB has two other projects under way, one in Kysmolovsky, a Russian town one hour north of St. Petersburg, and the other at migrant worker camps in the orchards in and around Albemarle County. In each case, NSWB adjusts its services to local needs.

In Russia, Niecko says, the group will help nurses at the town clinic develop their professional skills as well as provide health education and promotion. "In Russia, nurses have much less autonomy than they do in the United States," Niecko explains. "They have asked us to help train them in communications and patient management." Another focus for the group will be heart disease and stroke prevention.

Closer to home, the NSWB created the Migrant Health Initiative to provide health education and health care access directly to Spanish-speaking farm workers. "Because of cultural differences, language barriers, and transient lifestyle, these workers receive only intermittent medical care," notes Kelly Davison, the chair of this initiative for NSWB. This year, NSWB members routinely visited a migrant camp twenty miles south of Charlottesville and presented information on health topics such as cancer prevention, first aid, and pesticide exposure. They also taught yoga and stretching, as well as conducting blood pressure and diabetes screening. Spanish-speaking members served as translators for physicians and nurse practitioners during physical exams, while volunteers provided transportation to appointments and obtained prescriptions for workers.

NSWB members understand that even small changes in health care can produce large gains in quality of life for people living in poverty, and they are eager to make that difference. At the same time, they are learning a great deal about overcoming real-world obstacles to provide effective public health. One of the group's last commitments in San Sebastian is to provide an ambulance. When red tape made their original plan of exporting an ambulance from the United States impossible, they switched gears and are making arrangements to outfit one locally. "One thing we've learned is that you have to be organized and adaptable," Niecko says. "This is the kind of experience you can only gain from firsthand experience."