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Dean Marla Salmon and Dean Ada Fort (inset)
 

A dream shared
The vision of two leaders from different eras gives rise to an international nursing center for Emory

By Pam Auchmutey

 

It’s an ideal place and time—we can do things here that we cannot do anywhere else in the world. It’s natural for the Lillian Carter Center to be part of that.—Dean Marla Salmon

 

In many ways, the Lillian Carter Center for International Nursing (LCCIN) marks the realization of a dream shared by two deans who led the School of Nursing a generation apart.

The seed for an international nursing center was first planted by Ada Fort, who convinced health, business, religion, and community leaders to form the International Nursing Services Association (INSA) as a separate organization in 1972. Among INSA’s first board members was Lillian Carter, who lent her insight as a former health volunteer with the Peace Corps. No longer part of the nursing school, INSA operates today as Global Health Action, a nonprofit organization that empowers health and community leaders to improve health care in their own countries.

Nearly 30 years later, that concept has taken root in the nursing school again. When Marla Salmon became dean two years ago, she already had given considerable thought to establishing an international center focused on public health nursing, international nursing, and the global nursing workforce. Her dream was an ideal fit for Emory, which has a number of flourishing international programs and partnerships with organizations such as CARE, the Centers for Disease Control and Prevention (CDC), and The Carter Center. All are based in Atlanta, regarded by many health experts as the public health capital of the world.

“It’s an ideal place and time—we can do things here that we cannot do anywhere else in the world,” says Salmon. “It’s natural for the Lillian Carter Center to be part of that.”

As it evolves, the LCCIN will offer basic, advanced, and continuing education programs for nurses from the United States and other countries; international exchanges involving faculty, students, and visiting scholars; leadership and skill development for nurse leaders in government; and forums aimed at improving the nursing workforce and global health.

The Lillian Carter Center also provides a formal umbrella for international nursing efforts already under way at Emory. Several nursing faculty members have participated in projects in Africa, the Middle East, and the Caribbean. During the past year, baccalaureate and graduate students have gained new insight into health care delivery by working in Haiti and Fiji. The nursing school is developing a new international nursing major in the dual-degree MSN/MPH program. It is moving forward with agreements to establish a cultural exchange with Yonsei University in South Korea, scheduled to begin in fall 2002, and an academic exchange with the University of Alberta in Canada. Additionally, the LCCIN will open the door for opportunities like the Taiwan Nursing Education Partnership Program, which brought associate degree–trained nurses to Emory in the mid-1990s to advance their studies.


Partnership begins at home
Key to the LCCIN’s success are partnerships that build on the nursing school’s relationships with The Carter Center, the Rollins School of Public Health, the CDC, the World Health Organization, and others. A new ally is Medical Education Cooperation with Cuba (MEDICC), which offers elective courses there for US medical, nursing, and public health students. Formed in 1998, MEDICC has an advisory board that includes faculty from Emory’s schools of medicine and public health, and more recently, the nursing school, where MEDICC now leases office space. MEDICC offers electives and short courses in cooperation with Cuba’s National School of Public Health and the National Center for Postgraduate Medical Training. It has begun developing a nursing component with the LCCIN, which will enable Emory nursing students and faculty to study Cuba’s successful primary care health system firsthand. The first trip in January 2002 will be led by family nurse practitioner Diane Appelbaum, MEDICC’s director.

Diane Appelbaum, director of MEDICC, is developing a program so that nursing students and faculty can study Cuba’s primary health care system firsthand.

“Cuba has made tremendous improvements in its health care system in the last 40 years, especially in public health,” says Appelbaum. “The infant mortality rate is about the same as in the United States, and the maternal death rate is only slightly higher. There’s an extensive vaccination program. The health care system is based on prevention and community health, which obviates much of the need for curative health. It’s a remarkable system for students to study.”

Other partnership opportunities abound. An office next to MEDICC houses the new Support Center for Lymphatic Filariasis (LF), directed by Eric Ottesen, professor in the Rollins School of Public Health. Funded by GlaxcoSmithKline and $4 million from the Bill & Melinda Gates Foundation, the center is part of the Global Alliance for the Elimination of Lymphatic Filariasis, a coalition of public and private partners. Working with The Carter Center and the CDC, the Support Center will coordinate demonstration projects in the Dominican Republic and Guyana and evaluate projects in seven other countries to define the most effective ways to eliminate LF, a parasitic disease. Anne Haddix, an economist who established the Support Center, hopes the LCCIN will eventually become involved in development of LF treatment programs led by nurses in endemic countries.

Anne Haddix, associate professor in the Rollins School of Public Health, believes the Lillian Carter Center could play a key role in coordinating treatment programs in countries where lymphatic filariasis is endemic.

“Nurses definitely have the skills to treat people who have this disease,” says Haddix, associate professor in public health. “They can play a big role in training community health workers and setting up clinics. They also need to be involved in the triage process and in teaching good hygiene to prevent skin infections that often accompany and exacerbate the disease.”

Rebecca Penzer, a nurse from the United Kingdom, has also met with LCCIN staff to set the stage for possible collaboration. Supported by funds from the UK Department for International Development, Penzer is helping set up skin care programs in Tanzania and Guyana to treat complications of lymphedema associated with LF.

“The Lillian Carter Center and the School of Nursing have access to international networks of nurses, who can ensure that messages about skin care in relation to LF and other diseases get to the people who need them,” says Penzer. “They are developing a clear sense of what international nursing is about and how they can contribute to public health initiatives to improve health worldwide.”

The miracle of Global Health Action

If Ada Fort were alive today, she would probably stand up and cheer. The Lillian Carter Center for International Nursing operates on the same principle the former nursing dean held close to her heart: better nursing services mean better health care for people worldwide.

Robin Davis, 76MN, a former instructor in the School of Nursing, is the executive director of Global Health Action.

Fort first considered the possibility of an international health effort in the 1960s. Prompted by concerns about health conditions in other countries, Fort stood up at a meeting one day and issued a challenge. Virginia Proctor, 50G, 50TH, Fort’s director of student development at the time, recalls clearly what the dean said: “We are the best cared for nation in the world. This puts a responsibility on us to raise the level of health care around the world.”

Their diligence paid off in 1972, when the International Nursing Services Association (INSA) was founded as a private, nonprofit organization to provide health education and leadership training for nurses from developing countries. INSA conducted its first training programs with the nursing school until 1980. That same year, INSA expanded into other countries and other health professions and later changed its name to Global Health Action (GHA) to better reflect its purpose and outreach. The philosophy that gave rise to GHA remains the same today: to create healthier, self-sustaining communities by teaching nurses and health care workers how to lead more effectively in their home countries.

“Those leaders can effect the greatest change because they are part of the culture and the community,” explains Robin Davis, 76MN, executive director of GHA. “They are able to make a huge difference, even in times of political and economic turmoil.”

Now in its 29th year, GHA has trained more than 5,500 health professionals in 86 countries. In turn, those graduates and the community health workers they teach serve 72 million people worldwide.

GHA has numerous collaborative program partners from the United Methodist Church to the Louisiana State University School of Veterinary Medicine (which provides additional training for GHA’s Goat Project staff in Haiti) to the World Health Organization. In addition, GHA has an enthusiastic army of volunteers. As GHA’s founder, Virginia Proctor remains an avid speaker for the group today.

Says Proctor, “It’s been a miracle to see GHA have such far-reaching effects in the world today.”

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An Ambitious Agenda  |  Demented or Determined?  |  A Dream Shared

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