Making a Difference: Peace Corps Nursing

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By Debra Wood, RN, NurseZone contributor

Ensuring that more than 7,000 volunteers in 70 countries return home healthy, Peace Corps nurses bolster the agency’s goal of achieving world harmony and mutual understanding. The work performed by the nurses helps Americans assist a global populace learn how to break the cycle of poverty.

"I know I’m making a difference," said Paula Dolan, RN, an international health coordinator. "We’re committed to the philosophy and goals of Peace Corps. It’s probably the best diplomacy we have overseas."

During the early 1980s, before graduating from nursing school, Dolan spent two years as a Peace Corps volunteer, living in a remote Jamaican village with no running water or electricity. Health crises were a component of everyday life, with the nearest clinic a three hour walk away. One of the things she learned was that people didn’t care what she knew until they knew she cared. She explained, "It means a lot to people just to know Americans are willing to spend a day in their shoes."

But before Americans can show their commitment, a Peace Corps nurse screens them. Nurses review health-history forms and, if indicated, prepare additional questions for the volunteer’s physician. They try to accommodate volunteers with chronic medical conditions, such as diabetes mellitus, asthma or heart disease.

"We work at screening people in—not out—of Peace Corps," said Mary Grace Brennan, RN, clinical manager for screening. "We want to be sure we will not put them in additional risk with their medical condition and that they will be able to complete their tour of duty."

Brennan began working for the Peace Corps two years ago, after a career in college health nursing. She said that challenging cases make her job more interesting.

Overseas, about 141 Peace Corps medical officers (PCMOs) assume responsibility for volunteers’ health needs. They try to prevent communicable diseases, as well as handle emergencies. About half of the medical officers are nurses. Rebecca Ehrich, MN, RN, CS, FNP, served as a PCMO in four different countries. While in Mongolia from 1995-1998, she introduced local practitioners to modern nursing theory and scientific methods. Although now working in private practice in Missouri, Ehrich recalls warmly her Peace Corps years.

"There’s no other job like it," she said. "I not only felt gratified myself, but by keeping volunteers healthy and reasonably happy, they were able to function efficiently doing wonderful things."

Peace Corps Medical Officers develop a network of health providers to facilitate care in the assigned country. If a volunteer requires medical evacuation, the PCMO calls one of eight international health coordinators, like Dolan, who collaborate and make arrangements for stateside care. A serious accident may call for stabilization at a foreign facility before transferring to a Washington, D.C., hospital. Other times, an MRI, unavailable in the host country, may be all that’s needed.

"We want to treat them, hopefully get them better and send them back to the country, so they can keep doing their work," said Catherine Bruder, RN, another coordinator. Before becoming a nurse, Bruder signed on as a Peace Corps agricultural extension agent in Mauritania, Africa.

Her co-worker Tea Hess, RN, BSN, MPH, also understands the volunteer experience. The former pediatric oncology nurse joined as a community health nurse in Guatemala, where she taught basic principles of health, nutrition and sanitation, and walked from village to village vaccinating children.

"I’d do it again in a heartbeat," she said.

Last year, during a leave of absence, she participated in an international polio eradication project in Nepal, going house to house immunizing children, marking the houses and monitoring the effort to make sure no youngsters were missed.

While not all Peace Corps nurses have been volunteers, most have international experience. In addition, many make field support visits to learn how volunteers in their region live and work.

Every day about 60 or 70 volunteers receive care in Washington for a variety of medical and mental health conditions. Once stable, if the supervisor overseas agrees, volunteers may return with temporary restrictions. When medical or mental health conditions preclude going back, service terminates.

Anne Casey Mills, RN, MSN, manager post services, processes and manages health benefits for former volunteers. She arranges evaluations to determine if lingering medical problems are Corps related and, if so, prepares worker’s compensation claims.

"We have one central goal—taking care of them and giving them the benefits they deserve," said the former occupational health nurse. "Because of that, everything else follows. It allows you to practice in a way that’s exceptional."

President George Bush hopes to double the number of volunteers during the next five years. By then, a new set of nurses will be screening and caring for volunteers, because Corps employees can stay only five years, a rule designed to encourage fresh thinking. While most regret the forced separation, all feel privileged to have helped bring citizens of the world a bit closer.

"I’m supportive of the volunteers and Peace Corps effort, so I’m very happy to work at headquarters," Bruder concluded. "We can get Americans out living with different peoples all over the world."

March 22, 2002. © 2002. NurseZone.com. All Rights Reserved.