The chance to compare experiences in caring for HIV/AIDS patients brought four nurses from Nigeria to Baltimore for a recent two-week visit sponsored by the Global Health Office in the School of Nursing.
The nurses are program officers at the Institute of Human Virology, Nigeria (IHVN), where they oversee key areas of HIV care and support under the leadership of Emilia Iwu, RN, MS, senior nursing advisor for IHVN and a School of Nursing assistant professor. The goal of the Baltimore visit was to help the nurses develop strategies to carry out what is feasible in Nigeria despite differences between clinical settings in the U.S. and those in sub-Saharan Africa.
The program was part of a collaboration among IHVN, the University of Maryland School of Medicine, the School's Institute of Human Virology (IHV), and the University of Maryland School of Nursing. A group of Nigerian nurses also visited the School of Nursing last November, and the School sent six students to Nigeria in the summer.
A shortage of human resources is a "critical roadblock" in delivering HIV/AIDS care in Nigeria, says Jeffrey Johnson, PhD, professor at the School of Nursing and director of the Global Health Office, which seeks to build nursing capacity through its international exchange program. "We hope to strengthen the role of nurses and the respect they are given," Johnson says.
The four Nigerian nurses who visited Baltimore from Feb. 22 to March 8 noted low U.S. ratios of patients to caregivers compared with the ratios in places such as the Nigerian capital of Abuja, where one nurse may be expected to care for as many as 20 babies.
They also talked about differences between the role of nurses in their nation and in the U.S. "The [U.S.] nurse practitioner sees patients, assesses them, and diagnoses them," said Asabe Gomwalk, RN/RM, DIP NURSING EDUC, Bsc. "Only physicians do this in Nigeria."
Janet D. Allan, PhD, RN, FAAN, School of Nursing dean, spoke with the Nigerian nurses, as did William Blattner, MD, professor in the School of Medicine and director of the IHV's Epidemiology and Prevention Division. Experts on subjects such as palliative care also met with the nurses.
The Nigerians also observed infectious disease and pediatric care at the University of Maryland Medical Center, conferred with nurses at the Baltimore Veterans Affairs Medical Center, and visited a Johns Hopkins University clinic.
At the VA's outpatient infectious disease clinic, they met with Karen Cervino, RN, MS, ACRN, to discuss ways to help HIV/AIDS patients adhere to their medications.
Halima Ibrahim, RN/RM/PHN/CHO, said that HIV/AIDS patients in Baltimore, some of whom keep a diary on their experience, generally "take much more responsibility for their own health" than do Nigerian patients.
Edwina Mang, RM/RN, RN (Pead.), ADHSSM, BSc NAdmin, concluded that Baltimore residents get less help at home. "In the area of family engagement, we're actually doing better in that regard," she said.
While sitting in on a support session for patients, offered by the IHV's JACQUES Initiative, Emily Umaru, RN/RM, PHN, Bsc Social Work and Administration, observed the positive group dynamics created when people with HIV/AIDS accept their status and mix with others. "Coming together gives them hope," she said.