Académique Documents
Professionnel Documents
Culture Documents
Riley Murphy
March 19 2018
NURS 2020
NURSING IN A DEVELOPING COUNTRY 2
Look Back
In February of 2018, I had the opportunity to travel to Honduras with Trent University on
a nursing brigade to complete my NURS 2020 clinical placement. While in country, I learned a
plethora of new information via first-hand experience. I took this knowledge home with me, and
Elaborate
Being that Honduras is a developing country, the lack of resources is a prominent issue
that my team often faced. Resources that we would expect to find almost anywhere in Canada,
such as the soap needed for my hand-washing project, or toilet paper, are limited, especially in
the rural settings in which we were often working. Running water is considered a luxury in
Honduras. The main water source for many residents is a river. Some residents have a pila in
their homes, which is a concrete cavity in which water from the river is held, connected to the
river through underground hosing. It is not uncommon to see livestock roaming in and around
the homes, in close proximity to their drinking water, and creating a problem for infection
control. Honduras has a different culture than Canada, with its own set of beliefs and values.
Education in Honduras is funded by the government up until grade six. The families of children
who do not have the funding to pay for schooling past grade six do not receive any further
education. While presenting my handwashing project, I realized that some of the children I was
on this nursing brigade, multiple realizations such as this were made, which led me to think
Analyze
One key issue that was prominent during my time in country was the lack of resources. A
rural nurse in the community of El Siriano in Yoro faces this challenge daily. His medication
supply is often empty, as the government does not provide the much needed medication on the
dates that they are supposed to be delivered. When my partner and I went to present our
handwashing station at a rural school in Yoro, we did not think to bring soap. In Canada, almost
every public facility with a bathroom has an abundant supply of soap, including in schools. Upon
arrival, we realized that this school did not have a supply of soap. Thankfully, we were able to
find a bar of soap in one of our donation bags, but this scenario only highlights the issue of the
lack of resources. An article posted in the Journal of Hospital Infection indicates that “Infection
control in developing countries differs substantially from that in the developed world. Limited
resources represent the main challenge for governments in developing countries” (Raka, 2009, p.
293). The limited resources made it difficult to present our handwashing project when we were
made aware that soap was not a supply that was in abundance.
A second challenge that my team and I faced while on this nursing brigade was trying to
perform nursing care in a different culture. It is important to note that just because an
intervention works well in a developed country, does not always mean that it will be just as
effective in a developing country. Santmyire (2009) states that “Even if a plan of care or
treatment is based on EBP [evidence based practice], the NP [nurse practitioner] must consider
the cultural and social consequences of following it” (p. 311). Relating this to my experience in
Honduras, the implementation of menstrual cups as a form of feminine hygiene does not work
for all women in Honduras. They hold the belief that inserting anything into the vagina means
that they lose their virginity. Although this is not a social construct in Canada, it is very relevant
NURSING IN A DEVELOPING COUNTRY 4
to women in Honduras. Even though menstrual cups may be a solution to many of the issues the
women face in Honduras when menstruating, the social backlash they might receive causes them
to be reluctant to use the cups. An article written by Santmyire (2013) tells a story about how
mothers with human immunodeficiency virus (HIV) or acquired immune deficiency syndrome
(AIDS) in Burkina Faso were given infant formula and were told of exclusively formula feed
instead of breast feed for the first six months of their infant’s life, as per the standards of the
World Health Organization. After it was found that the mothers were not formula feeding, it was
discovered from one mother that “The only people who formula fed their children were the very
rich and those with HIV. Understandably, she was not rich and was not ready to announce to
everyone that she had HIV and face the social and cultural consequences” (p. 310). This is just
another example that although evidence based practice interventions may be successful in
developed countries, they may not always be successfully implemented into developing
countries.
was a lower standard of education. In Honduras, education is funded by the government until
grade six. Bajkiewicz (2009) expresses the importance of preparation and research before
departing for a medical/nursing brigade. This preparation includes researching the education
level, predominant health issues in the region, and using education materials that are geared
towards the literacy and cognition processes of the audience. This was something that my partner
and I did do while creating our presentation. We created our presentation at a grade six education
level, and used many images and analogies to help better explain bacteria and the importance of
handwashing. Bajkiewicz (2009) also indicates that leaving behind resources such as
posters and visual aids can be an effective long-term strategy for the retaining of
NURSING IN A DEVELOPING COUNTRY 5
knowledge after the presentation is over. This is a strategy my partner and I also used.
We created posters on how to and when to hand wash, and had them hung on a wall near
our handwashing stations. Our knowledge of the education level in Honduras prior to
departing for the brigade allowed us to create a presentation that would be most effective
Revise
Based on my analysis, preparation and research on the country before entering was a
good strategy that should be continued to be implemented for future brigades. Preparation made
for less of a shock and an easier transition into the culture upon arrival. Additionally, the
bringing of medical supplies and donations such as clothes and toys is a helpful intervention,
since Trent revisits Honduras twice a year. On each brigade, they are able to replenish supplies,
nursing brigade rather than community health and health promotion, I believe that more
extensive knowledge regarding the stigma and beliefs around certain implementations and
procedures would need to be analyzed thoroughly prior to the brigade. This would allow for only
the interventions that work best for the people in the country of study to be implemented,
New Perspective
This nursing brigade has taught me a lot. I learned how to implement a health promotion
strategy, and learned that upstream approaches are just as, if not more important, than the
treatment itself. This brigade has taught me to be more culturally competent, and incredibly more
aware of how impactful the social determinants of health are on someone’s physical health. I will
now ask questions before making assumptions, as you cannot fully understand a person’s
NURSING IN A DEVELOPING COUNTRY 6
situation just by their physical appearance. I learned that everything that I learn in Canada
regarding “the best way” to nurse does not and cannot always be applied in a developing
country. I will apply the experience and the knowledge that I have gained from this brigade to
References
110-114. doi:10.1097/01.cnj.0000348272.27924.24
Raka, L. (2009). Lowbury Lecture 2008: Infection control and limited resources – searching for
doi:10.1016/j.jhin.2009.03.017
doi:10.1016/j.nurpra.2013.04.001