On this month's cover, a community nurse practices health education with residents of a small fishing village in rural Uganda. I took this photo on the day I accompanied two nurses on a two-hour drive into the bush to observe this session, which took place in a small community center made of dried mud bricks, wood, and straw. The nurses wrote the lessons out on poster-sized sheets of white paper and tacked them to the mud wall as they addressed topics like personal hygiene, sanitation, food safety, communication, and prevention of infectious diseases.
The hardship of the villagers' lives was evident, yet they spoke matter-of-factly about conditions most of us would find intolerable. When the nurse talked about food storage, they told her the topic wasn't relevant to them. "We are too poor," they said. "We don't have food to store because we eat it all." They said their animals slept with them in their homes so they wouldn't get stolen. When talking about sanitation, they described how they always brought a stick when they went outside to use the toilets to keep the snakes away.
I was struck by the similarities and differences between these nurses' day and mine when I practiced community health nursing in rural New York. Among the differences was the setting, of course, but also the lack of resources and technology (other than the ubiquitous cell phones), and the unhurried way the nurses went about their day. But the education strategies were much the same: the use of small group work, how the information was presented (the large sheets of paper substituting for PowerPoint slides), even using the telephone game-whispering a message to one person who passes it along to the next-to teach communication.
The reality of nursing in Africa is also explored this month in "'I Am a Nurse': Oral Histories of African Nurses"-original research that shares African nurse leaders' stories so we may better understand nursing from their perspective.-Karen Roush, PhD, RN, FNP; member, AJN editorial board