Whether your view is that the world is a smaller place than it was 50 years ago, or that our neighborhood has grown larger over the years, globalization is here to stay. As a phenomenon, it is constantly reshaping the world in which we live. With globalization, we have greater travel and cultural interchange, interdependent economies, and dispersal of cultural values. One of the consequences of globalization, though, is that it highlights the world's inequities. Clearly when taking a global view, particularly of health, the playing field is not level.
It has long been known that the social injustices of the world are closely interrelated. More than 1 million people survive on less than a dollar a day; while the same number do not have access to safe drinking water. Surprisingly, more than 40% of the world population does not have access to basic sanitation. (United Nations Millennium Project, n.d.) These impoverished people understandably have the poorest health and highest mortality rates. The mere numbers are mind-boggling, given the strength of the overall world economy-apparently good for some but not for others. Poverty, gender inequality, illiteracy, and poor health are so interconnected that it is impossible to alter one without the others. That is why most public health endeavors require multifactorial approaches. There is much to be done.
"But what can I do?" is a logical question. Becoming familiar with the problem is the first step. It is hard to imagine as you walk into the high-technology environment in which you work that many people in the world do not even have access to a sink or toilet. But the problem does exist. As nurses, we must also realize the part we can play in a global environment. Do any of you remember trick-ortreating for UNICEF as a child? This has become one of the most successful world partnerships for promoting public health. Yet, programs need not be that sophisticated. Nurses can expand their cultural horizons by considering an exchange program for nurses or by sponsoring training for nurses in developing countries. Consider establishing a "pen pal" relationship with a nurse in another country. I have had the opportunity to do this-I can assure you that I learned a lot about mutual respect, and it has transformed my views of what constitutes traditional nursing. Donate nursing educational materials; quickly outdated nursing texts or journal issues may be far less outdated in impoverished areas that have limited access to written learning materials. Look for novel ways of sharing resources. An example would be donating unused materials from an operating room that would otherwise be discarded. There are programs that collect these materials and donate them to countries lacking in medical supplies. Respond to calls for support of global health endeavors. A recent call came out for nurses to write to drug companies in support of providing antiepileptic drugs to countries in Africa where the drugs were not available, or if available, not affordable. If possible, volunteer your time. Nurses were some of the first to respond to the tsunami in Thailand and many have volunteered in traveling surgical clinics in Central America. Time is a very valuable commodity in this context.
There are things each of us can do to address the problem of poverty and human development, but one of them should not be to turn a blind eye to the plight of the world. Florence Nightingale left us a legacy of the importance of a global nursing consciousness. It is a suitable time for us to be reminded of that. If you have had experiences in global healthcare issues that you would like to share with our readers, please write.
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