Spring 2018 updates

Spring 2018 updates

How politics, economics intersect with global health interventions

Dr. Nora Kenworthy first became interested in public health while working as an EMT rural Massachusetts in college. As an EMT, she observed the vast social inequalities of the region. Many of the people that she interacted with were not being supported by the social systems that had been put in place for them. Observing these social and health disparities led her to peruse a career in global health.

Kenworthy, now an assistant professor at the UW Bothell School of Nursing & Health Studies, recently published a book, Mistreated: The Political Consequences of the fight against AIDS in Lesotho. It examines how politics and economics intersect with global health interventions and the resulting consequences.

The book focuses on the HIV crisis in Lesotho, a country where the HIV prevalence rate is greater than 40 percent. She spotlights several heavily impacted HIV+ communities, including garment workers in one of Lesotho’s largest export industries.

“The very rapid ‘scale-up’ of HIV treatment in Lesotho had these striking social and political consequences – people lost faith in the government, they lost trust in each other, they felt that all these other social and health needs were being ignored,” she said, adding that the loss of faith in the government has led to political instability in Lesotho.

Global health interventions would have a more profound effect on citizens and their government if social, political, and economic consequences were discussed and taken into consideration, Kenworthy said.

“I hope that this book will push us to think about global health interventions not just in terms of their clinical or health impacts, but in terms of their social and political impacts,” she said. “We need to ask ourselves, ‘how can we not only treat and cure diseases, but also address and alleviate social and political ills?’”

Kenworthy teaches several courses at UW, including the social dimensions of health (BHS 302), critical perspectives on global health (BHLTH 423), and narratives of health and illness (BHLTH 497 E). She is currently developing a global health minor with other UW Bothell faculty that they hope to begin offering next year.

Promoting health through cross-cultural exchanges

In 2015, countries across the world adopted the United Nations Sustainable Development Goals, a set of 17 goals to end poverty, protect the planet and ensure prosperity for all.

UW Nursing students are learning to address and make progress on Goal 3 – ensuring healthy lives and promoting the well-being for all at all ages – thanks to opportunities for cross-cultural immersive experiences in international healthcare settings.

Undergraduate students Ann Nguyen and Brennan Jones traveled recently to Tokyo to participate in Keio University’s Short-Term Nursing and Medical Care Studies program, which allows students to study the roles of nurses in Japan for one week. The program emphasizes the need for global collaboration to advance the United Nation’s Sustainable Development Goals and Universal Health Coverage. It includes students from the United Kingdom, Japan, South Korea and China.

“International exchanges provide students with a meaningful experience where they can step outside their life and work in the U.S. and understand nursing and their role on a global scale,” said Dr. Sarah Gimbel, co-Director of the Center for Global Health Nursing. “Facilitating international exchanges allows students to grow as individuals, students and future practitioners and researchers.”

On the first day, students observed several units in Keio University’s Hospital, such as the intensive care unit, gynecology and outpatient surgery. Then, they visited home nurses, a rapidly growing sector of healthcare in Japan due to growth of the aging population. Each student was assigned a Japanese student who acted as guide and translator throughout the week, allowing the students to have meaningful conversations with Japanese-speaking healthcare providers and patients.

Nguyen said she enjoyed learning first-hand the impact of the Japanese culture and investments has had on their health system.

“Investment in public transportation and education, healthy diet, social connection, and universal insurance coverage — through no coincidence, produce positive health outcomes and longevity only experienced by a few other countries in the world,” said Nguyen, a BSN student. “This experience has reminded me of how culture and policies influence health on both a national and global level. It highlights the need for global leaders to communicate and collaborate in order to overcome global health challenges.”

Students also had the opportunity to participate in cultural activities, including visiting a famous Shinto shrine, participating in a tea ceremony, and trying kaiten (conveyor belt) sushi.

“I felt privileged to participate in these interactions and to observe Japanese lifestyle and culture in such an intimate setting,” said Jones, an ABSN student. “I was able to make international friendships and appreciate the strengths and weaknesses of our respective health care systems. I hope to apply this insight to my future nursing practice and to continue the dialogue with international nursing peers.”

DNP-Population Health student embarks on fellowship in Ethiopia

Rebekah Maldonado-Nofziger

Rebekah Maldonado-Nofziger

Rebekah Maldonado-Nofziger chose to study public health nursing because it combines her passion for peace and justice with the force nursing.

As a second year DNP-Population Health Nursing student, she is preparing to combat systems of injustice alongside partnerships within the community.

Maldonado-Nofziger recently received a six-month SCOPE fellowship in Gondar, Ethiopia, where she will pursue her interest in global maternal and child health. While in Ethiopia, Rebekah will work on the Faith Leaders Advocating for Maternal Empowerment (FLAME) study.

FLAME aims to reduce maternal mortality by pairing Orthodox priests with community health workers. Maldonado-Nofziger will assist in incorporating results from surveys, focus groups, interviews, and assessments into FLAME interventional trainings and materials.

Maldonado-Nofziger grew up in Pettisville, Ohio, a small rural farming community. Her faith, background, culture, and experience all contributed to her passion for global health. Maldonado-Nofziger’ mother is from Bolivia and her father worked as a volunteer in Bolivia in rural areas. Her Latin American roots played a formative influence on her upbringing. She grew up traveling to Latin American countries with her family and many of the workers on her family’s farm were from South America.

Since leaving home, Maldonado-Nofziger has furthered her passion for global health. She spent time in Bolivia as a nursing student and the Middle East conducting research. While in Palestine, she worked on a project that aimed to understand why a small community chose to use nonviolent resistance. This gave her a better understanding of competing political contexts and varying ideas and perspectives.

Once Maldonado-Nofziger returns from Ethiopia, she will complete her final two quarters of the DNP program. She plans to continue working in the area of maternal and child health while she completes her degree. Maldonado-Nofziger hopes to work abroad upon graduation.

Featured publications

Simulated patient encounters to improve adolescent retention in HIV care in Kenya: study protocol of a stepped-wedge randomized controlled trial.
Wilson KS, Mugo C, Bukusi D, Inwani I, Wagner AD, Moraa H, Owens T, Babigumira JB, Richardson BA, John-Stewart GC, Slyker JA, Wamalwa DC, Kohler PK.

Improving data quality across three sub-Saharan African Countries Using the Consolidated Framework for Implementation Research (CFIR): Results from the African Health Initiative
Gimbel S, Mwanza M, Nisingizwe MP, Michel C, Hirschorn L, et al.

Self-Management Strategies for Coping with Adverse Symptoms in Persons Living with HIV with HIV Associated Non-AIDS Conditions.
Iribarren S, Siegel K, Hirshfield S, Olender S, Voss J, Krongold J, Luft H, Schnall R