Global Health Nursing Conference 2016

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On Tuesday, March 15, 2016, I attended the Global Health Nursing Conference held at the University of Toronto, hosted by the Nursing Undergraduate Society at UofT. The purpose and the theme of the conference this year was to shed light on Refugee and Immigrant Health.

This year’s conference is particularly poignant due to the current social climate regarding the war conflicts that have started occurring in 2011 (and are still ongoing) within Syria, and the large influx of Syrian refugees within Canadian borders. Throughout this night, we explored topics related to refugee and immigrant health, and ways in which nurses play a significant role in facilitating access to safe and appropriate for a vulnerable population. The wide variety of panelists, speakers, and session facilitators encompassed a diverse group of registered nurses [RNs] and nurse practitioners [NPs] from a variety of different global health backgrounds. They offered their experiences and perspectives on global health, the impact that nurses can create in health care on a global scale, and the types of work in which nurses can play a part in on an international health care level.

This event garnered significant attention from a variety of different undergraduate nursing students. The evening was comprised of attendees from UofT’s second-entry BScN program, Ryerson’s BScN program, Nippissing, York, etc. It was refreshing to see variety in different nursing backgrounds, making it an optimal night for opportunities to network, meet new people, and make new nursing friends!

The first part of the evening began with a panel of four RN speakers with diverse careers within global health. Some of them worked in various acute care and community health settings in different parts of the world (i.e Sudan, Ethiopa, Sierra Leone), implementing global health initiatives such as surgical programs, vaccination clinics, maternal health education, etc. Some of them worked within the local community (i.e Women’s College Hospital), addressing refugee and immigrant health needs and concerns in the Greater Toronto Area. Having these varied experiences and backgrounds in nursing come to light truly widened perspectives and opened many minds. The nursing students in attendance, a majority of whom have yet to have any solid exposure to global health nursing, were able to think of adequate health care outside of a framework that is well-resourced, highly affluent, and well-supported by a competent government structure. We were forced to think critically about what health care and health care delivery looks like in various populations and cultures, and how we – as Canadian nurses – can use our influence to affect change, in order to improve global health outcomes. Moreover, we also had the opportunity to think critically about how to address global health issues within our own local community. Various speakers spoke about what immigrants – specifically refugees – experience, in terms of health services, once on Canadian soil. We discussed barriers they often face to receiving appropriate care, such as a lack of adequate health care insurance coverage and a lack of unfamiliarity in terms of navigating a new system. The panelists did a fantastic job in articulating that our roles as nurses are to ensure that immigrants and refugees receive a care that is reflective of our health care system’s values and beliefs – that is, a care that is individualized, patient and family-centred, and comprehensive.

 A highlighted global health organization that was brought to attention during this period of the evening was Medicins Sans Frontieres [MSF]/Doctors Without Borders. A number of the RN panelists discussed their own experience in working with this organization and how MSF carries out various global health initiatives in a number of resource deficient countries. The purpose of MSF is to provide medical support and services where it is most needed on a global scale, and to ensure that health care systems and organizations are well-supported and have sufficient resources to deliver adequate care across boarders. More information on MSF and their work, as well as how to get involved, can be found on:

Medicins Sans Frontieres/Doctors Without Borders

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The next portion of the evening was a dinner and Social, where we got to engage with the founders of the company iamsick.ca. iamsick.ca is a company that has created a technology platform in the form of an app and a website, to help facilitate access and equity to adequate health services in your own area. They have developed a system whereby one is able to access the most appropriate health care provider, for their specific needs, online. Furthermore, through this system, they are able to minimize things such as emergency visits, wait times, etc., as it specifically matches the individual’s health need with the specific health service and provider that addresses that need. iamsick.ca is a company that began at UofT and has grown over the last four years, with a large number of consumers that have been helped through its services. They work directly with healthcare providers and organizations to ensure that the link between patient and provider is more effectively established. iamsick.ca ensures that health needs do not go unaddressed and are addressed appropriately. For more information on iamsick.ca, please visit:

iamsick.ca

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The last portion of the evening involved Breakout Sessions, from which students were to choose whichever session they would like to partake in, to develop more knowledge in more specific niches of global health nursing. I chose to take part in the Sick Kids International Paediatric Global Health session, due to my interests in maternal and paediatric health. In this last hour of the evening, the Nursing Manager and the Advanced Nursing Practice Educator from Sick Kids International and Sick Kids Centre for Global Child Health spoke about paediatric health and nursing care on a global scale. They spoke about their past, present, and future projects and global health initiatives to address gaps in international paediatric care. A significant gap that they have found in terms of global child health is that nurses internationally lack the advanced competencies of paediatric nursing care, making it difficult for them to deliver the care that their country’s paediatric population requires. Sick Kids Centre for Global Child Health has taken steps towards developing a project that educates nurses abroad about paediatric nursing and paediatric care, in order to empower that country’s health care providers. This project has been a focus for a large part of their work and they hope to continue educating various nurses in various parts of the world, to ensure they receive adequate paediatric nursing education and training. For more information on Sick Kids Centre for Global Child Health, and to learn more about their work, please visit:

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The Hospital for Sick Children – The Centre for Global Child Health

Needless to say, the night was successful and the nursing students in attendance learned a lot about global health and how nursing plays a pivotal role in global health. With Canadian nursing school curriculums having a strong focus on nursing in the local and national community, there is a significant lack in education about the work nurses do on an international and global scale. This conference has definitely enabled nursing students across GTA to develop their knowledge and awareness in global health nursing, and has inspired us to build careers built on the foundation of community health development alongside with acute care development.

The Secret Life of Milk Bags

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Have you ever wondered what you could do with a milk bag? You know, those multicoloured bags that hold our milk. Well they can also hold a person, that is if you weave above 500 of them together. The School of Early Childhood Studies held an event this past week where I was able to do just that. I came together with other nutrition students and faculty, early childhood education students, and parents and children from the Early Learning Centre to turn old milk bags into mats and mattresses of a different kind.

MILKBAGSunlimited is an organization that works with schools and other institutions and individuals to create bedding and other valuable items out of old milk bags and donates them to people all over the world who need them. Working with donated milk bags that are durable, washable, don’t retain moisture, and will last for up to 25 years is not only economical but it is also environmentally conscious. These milk bags would have regularly ended up in landfills poisoning our earth and now they are providing comfort to someone who may have only a piece of cardboard to sleep on. MILKBAGSunlimited estimates that they have saved 5.7 million milk bags from landfills and created 7200 mats out of them.

MILKBAGSunlimited not only provides mats but they also collect supplies such as wheelchairs, crutches, school materials, toys, and tools and send them all over the world. What I found to be very interesting is that the mats are used as packing material, they serve a dual purpose, to protect and insulate the packing crates and to be used as a mattress at their destination. On top of all this MILKBAGSunlimited provides an opportunity for micro-entrepreneurship. They provide the supplies so that individuals in communities around the world can make their own products and sell them within their countries. This provides an opportunity for people who might otherwise not have the resources or occasion to earn an income. This allows these communities to prosper and the individuals who live there to buy food, clothing, and other necessities.

I was delighted when I heard that there was an opportunity to take some time out of my study schedule to weave together some old milk bags. It sounds strange but it’s actually quite fun and a bit of a workout. What was even more beneficial for me was getting a chance to work with the kids from the Early Learning Centre. I believe that children need a chance to learn new skills and be exposed to different kinds of work. Even though they probably had no idea why we were tying a bunch of milk bags together they got the opportunity to do something new with their hands which is very important. Kids need to see that there are different ways to learn even if they don’t see it that way, these kinds of experiences can be very formative for their brains. Additionally, being able to socialize with people who they don’t know will help them to grow.

After all the mats were finished being woven together I was given one to give away to someone who is experiencing homelessness. I regularly walk home from school and so I was sure I would find someone to give my mat to, but because of the extreme cold I had trouble. However, a few days later I was walking down Yonge Street and saw a man with his dog sitting on the street. Thankfully I had decided to try again to give the mat away that day. When I went up to him, a little nervousness in my step because I know if I were him it would be strange to have some random person come up to me and ask if I wanted some mat they made out of milk bags. After I explained what it was, he decided to keep the mat and he unrolled it and gave it to his dog to sleep on instead of using it for himself.

This whole experience made my heart feel a little lighter, but while I was walking I noticed more and more people experiencing homelessness that could have used my mat which made me sad. I found myself saying “damn I could’ve given it to that person too or that person”. It made me realize just how fortunate I am and it instilled some fear into my heart and mind. I don’t know how people who live on the street handle the stress, I can barely deal with assignments let alone not having a room of my own. I sometimes hear people comment about how disgusting homeless people are and how they are a waste and this rips my heart up because what if that were them? What if they had nowhere to go, would they want to be called disgusting? There are so many factors that lead into homelessness and so many things that come out of it that make it extremely difficult to remove oneself from it. People experiencing homelessness do not deserve to be treated as someone lesser, they are just as important to our world as we are. I feel that sometimes people create a “them and us” attitude when it comes to homelessness when it should really just be us. We are all responsible for homelessness and we can all do something about it. We should not “other” homeless people, they are a part of our society, and they are a part of us.

Sushi & Beer

Every week I ride the Bloor Street Subway out to Scarborough and back into the city. If you have been on the subway before you know what it’s like; people talking, sitting, reading, and minding their own business as the train rumbles beneath the city streets. The subway is a kind of strange place because it’s full of people who we do not know and who we do not always notice or even pay any attention to, we are generally concerned with who is in our immediate surrounding and when our stop is coming. While on my most recent trip home from Scarborough I noticed a man getting on the train at Coxwell Avenue. I was sitting on one of those old stained red and silver seats nearest to the sliding doors with my head leaned up against the glass. I was half asleep, as I often am on the subway, the rocking and warmth having lulled me into a semi-conscious state where the Queen could walk on by and I would still be trying to hold my eye lids open (this is also why I often miss my stop). As I sat there with my head half-tucked into the top of my wool winter coat, my collar popped up around my neck, and my toque low on my face I saw the man enter the train and sit down on the floor. I thought that in my sleepy stupor I was seeing things; why would someone sit on the floor when the train was half empty? This man caught my attention and pulled me back into consciousness as I continued to observe him.

 
He sat on the floor with his back leaned up against the red doors opposite me, these doors wouldn’t open again till Yonge Street So he had time to make himself comfortable. As the train pulled us farther into town I saw more and more of this man; his grey hair sticking out from under his tattered blue and white Maple Leafs toque and the dark creases and dry pale skin that enveloped his hands and face. His acid wash baggy blue jeans were torn up at the bottom showing off his beat down formerly white sneakers and he wore an old Maple Leafs jersey which matched his hat. The man was carrying a reusable shopping bag with him that looked like it only had one tug left in it before it feel completely apart. I found out later that in this bag he was carrying his dinner, a small take-out box with a few maki rolls in it and a pitcher of light beer wearing its own toque to minimize spillage. After the man removed the contents of his bag with extreme care so as to protect them from the unstable and unpredictable movements of the train he did something that in the moment surprised me. He put his hands together in prayer, closed his eyes, and began whispering something I was too far to hear. He then took a single maki roll and a sip of beer and cautiously returned his meal to his dilapidated sack. As I watched him eat I thought about how I never thank anyone for my food other than the waiter who brings it to me. This man was thanking his Lord for the pitiable amount of food he had and yet I take a full cupboard and fridge for granted.

 
Our journey continued across the Bloor Street Viaduct and I noted the darkened sky lit up with the luminous glow of downtown business towers and condos reflecting off the clouds. Our train stopped on the bridge and I could feel the wind brushing against the sides of the train, the doors rattling in and out, and the screech of the wheels as we slowed to a halt. Looking out the train window I felt the whole city get cold even though this is an unusually warm December. I wondered to myself where this man would go, what would he do when he reached his stop and was faced with a still harsh December? In the time that I was distracted by the city skyline and my thoughts I hadn’t noticed that my traveling companion had slipped into his own state of half-consciousness. He stretched his legs out along the doorway and his head and back were upheld by the glass separating the seats from the doors. His left hand and arm were hugging his shopping bag and in his right hand he had a lighter. It was at this point that I saw the cigarette sticking out from under his toque amongst his scraggly hair. He was playing with the lighter, rubbing it with his fingers and tapping it on the train floor. At one point he threw his arms up into the air and as they crashed back down to the floor I could see his face drop into sadness, as though he were giving up and submitting to the thoughts that were running around in his mind. Maybe he was expressing frustration, depression, despair, desolation, or hopelessness, I don’t know what he was thinking but he did not seem happy, he looked tired; exhausted in a way that I hope I will never have to feel.

 
Our train picked up and we started into the tunnel, eventually reaching Sherbourne Street where the man rose to his feet and switched over to the opposite doors now lying directly beside me. As the doors slid open at Yonge Street I watched the changing faces of the new passengers. Men and women went from smiling and laughing to disturbed and disgusted. People scoffed and turned up their lips in a grimace, passing judgment over someone they didn’t know and had no contact with. Some people didn’t even notice him as he lay at their feet. Every person with the exception of one man parted at the doorway moving further into the train and filling it. The man who remained bent down and pinched the arm of my now sleeping traveling companion waking him up. The new man dressed in a dark woolen coat and boots asked the laying man to get up as he was in the way, even though he was not bothering anyone. It’s not as though people were stepping over him to get to closed doors that would not open again until Spadina Avenue which I later learned was this man’s stop. A heated conversation ensued with yelling and swearing resulting in a now irate and fatigued man being forced up and out of his resting position and off the train. This entire exchange was pointless and unnecessary and only resulted in anger and the perpetuation of stereotypes. After the altercation the atmosphere on the train changed, for a moment there was a noticeable dip in the collective mood. The woman across from me said “what can you do?” and shrugged off the whole event, the man next to me said to his friend “they’re all the same” and continued their conversation as though nothing had occurred.

 
Why was this happening? Why did this whole show come about? Why did this man feel it was his right to upset and force someone off the train who was doing nothing wrong? Was he assuming that because of the way this man looked or was acting he shouldn’t be on the train with us? Or perhaps he went into the situation with good intentions, but we all know where that road leads. I don’t know why this happened but all I can say is that my traveling companion deserved the same peace and respect that I receive. I am often asleep on the train and while I may not be lying on the floor no one bothers to wake me. Being in a seat puts me in no one’s way but this man was in no one’s way either. He knew the door schedule and would have gotten up the same way he did the last time. This man never even said anything to anyone, he was minding his own business the same as everyone else and yet society decided it was their right to intervene and not to help but to make things worse. It’s been my experience that assumptions do not lead to good solutions and going into a situation with stereotypes in the back of your mind will not help but hinder. People experiencing homelessness aren’t stupid or worth less than anyone else. This man simply wanted a warm place to eat his sushi and beer and to take a nap, he was not impeding the travel of or bothering anyone else and yet he was interrupted and attacked. Why?