06/30/08 — Cherry nurse gets international view of health care after trip to South Africa

View Archive

Cherry nurse gets international view of health care after trip to South Africa

By Phyllis Moore
Published in News on June 30, 2008 1:46 PM

Cherry Hospital nurse Shryl Uzzell's recent nine-day visit to study health care in South Africa made such an impression she hopes to share the experience and return with a group of her own in the future.

Ms. Uzzell, 52, a nurse preceptor at Cherry for 29 years, was selected as part of an 80-member nursing delegation to learn more about the prevalence of the HIV/AIDS pandemic and its impact on nursing and the health care system.

She witnessed much in her travels -- poverty, the racial divide and the widespread ravages of a disease that is killing off the population and filling orphanages there.

Ms. Uzzell recalls seeing children playing in mud puddles, people standing outside waiting for work each day and an obvious economic division.

"The highways divide them -- shanties on one side while across the street, there are nicer houses for those with more money," she said.

And yet by contrast, it is a country that values education and seeks a better future for its children.

"We would see children walking to school early in the morning, wearing uniforms," she said.

But it was the health care system and the stark statistics that were especially alarming.

"Seventy to 80 percent of the people who live there are HIV-positive," she said. "There's still a big stigma behind it."

The problem spills over into other areas, she said. Because of weakened immunity, tuberculosis is a big killer. And, she learned, every 23 seconds a woman in South Africa is raped, beaten or abused.

"A lot of it has to do with the HIV-AIDS epidemic," she said.

The American nurses visited clinics, an infectious disease ward at a hospital and orphanages, gaining exposure to as much and as many of the government and non-government efforts in the country.

Health care is bursting at the seams, Ms. Uzzell said. The ratio of doctors to patients is 1 to 200,000. Nurses may see between 200 and 500 patients a day.

Nurses are highly respected in South Africa, she said, with government assistance offered for housing. Still, she noted, migration is a large concern, mostly caused by the salary disparity.

Many, she said, seek work as nursing aides in other countries because oftentimes they can make up to three times as much as they do as a nurse in their own country.

"A lot of people don't have transportation, so the elderly will walk to the clinics at 4:30 in the morning and sit until 4:30 or 5 at night in order to be seen," she said. "They're trying to make improvements in the system, but I didn't see any public transportation."

Orphanages are also at capacity, she said, but have been "forgotten" by the government so other agencies have had to step in and assist.

"It was a heartwarming but a heart-wrenching experience -- if you could put them in a bag and bring them home you would," she said.

Recalling the array of ages and situations represented -- a 3-day-old baby with AIDs, for example -- there and at a hospital's infectious disease ward affected her the most as a nurse, she said.

And yet by contrast, those she encountered taught her a thing or two about attitude.

"Having lived in America, though you may not have access to everything, most of us don't know that level of poverty," she said. "I think I would have had great sorrow and seen nothing to smile about, but they were a very embracing people, smiling and trying to put their children in a position that they could obtain more."

Nursing is about caring, she said, and the cultural opportunity proved beneficial in its reminder of that.

"For me, to see people coming to work every day, we complain if they give us eight patients instead of six -- 'I can't possibly care for all these people,'" she said she will hear. "You see people (there) caring for 200, 300 people today and coming back day after day.

"They were tired and yet they keep giving."

The opportunity restored her belief in the importance of the role nurses play as the patient's "first line of advocacy," she said.

"I had the feeling when I walked into those clinics, even though I think I'm a pretty good nurse, when I saw what was expected of them, I don't know if I could go over there and work," she said.

The images she saw remain with her -- 16 beds lined up with sick people, racial disparities even years since apartheid.

"You have to say, 'What can I do?'" she said. "Some might think if it's not in our backyard, it's not our problem. But it is in our backyard and if we don't do something, it's going to be our problem."

In the aftermath of her visit, she has planned several presentations to share with others.

Her greatest hope is that it will generate interest from others willing to play a role in change.

"I want to pull together a delegation and go back next summer, maybe spend a week or two, work in the townships where a lot of things are needed," she said.