My name is Mary Ellen Biggerstaff, I am a Family Nurse Practitioner living in Olympia, WA and working at a rural health care clinic. I recently attended a Conference at University of California of San Francisco, which was designed as a boot camp for mid-career professionals wanting to incorporate global health into their careers. At this conference, I had the pleasure of meeting Sumitra Sharma, a nurse from Nepal. After the conference, I was curious to know more about nursing in Nepal and asked her several email questions and she was happy to share her answers with the Global Nursing Caucus.
What is your job as a nurse in Nepal?
Currently I am doing masters in community health nursing in Nepal. It’s a three year course and now I am in the final year. Nursing is a core profession in hospitals and other health care settings but it is equally important in community settings too, but this is yet to be realized and acknowledged in our setting. The scope of nursing beyond health facilities still needs to be explored in Nepal.
I have been engaged in household surveys, a health awareness and education campaign, study on risk factors of non-communicable disease, assessment and needful interventions of elderly populations, screening for breast and cervical cancer and more. Recently I have been doing an internship in one NGO where I am assessing the status of various primary health care services of one of the remote region of our country and have been conducting focus group discussions (FGDs) with the mother’s group led by female community health volunteers (FCHVs).
What does the nursing profession look like in Nepal?
In Nepal, there are nearly 52,000 nurses. With the growing scope of nursing globally, there are hundreds of nursing schools in Nepal. Diploma programs, university level and post-graduate programs are there but are limited to females only. There are very few male nurses who have studied and for further degrees they need to go abroad. The scope of nursing has been increased but it is still limited within health care settings and colleges only. The scope of practice to work within the community needs to be increased. Also, I feel the absence of nurses in the ethical boards of hospitals and department of health where the policy making and basic principals are endorsed. And because of this, nurses lack the essential authority in their profession.
Theoretically it has been called an independent profession but practically it is not yet. This is not only my individual standpoint but is the fundamental issue from nursing committees of Nepal. This is the first place I feel the need of help from nurses in the United States where nurses have more autonomy. Another is the scope of nursing as a Nurse Practitioner. At present, when nurses are studying medical surgical or pediatric nursing in their masters’ degree so as to prepare themselves to be a nurse practitioner, there is no such area of practice. This certainly will lead them to disappointment. If the nurses from the United States help us to identify the need and define the role of Nurse practitioner in Nepal, then probably the nursing board committee would think further in this issue.
What does Global Health Mean to you?
Talking about global health, I define it as a health of the largest community we live in. The rapid movements of people and technologies throughout the world have demand for ultimate notion of “Global Health”. The policy and health status of one country affects the people of other country and global health gives the answer on “How”. Despite the declaration of health as a fundamental human right, there is still disparity among countries and even among individuals leaving many people with poor quality of life and global health focuses on such kind of health equity for all people worldwide. These are the basic reasons for my inclination towards global health so as to locate and identify the inequities and work for it. Personally, I would be very glad to communicate, share experiences and even work with the nurses of United States on global health or on global health nursing.