nursing outreach

Return to the Kingdom of Swaziland

New Perspectives on the AIDS Pandemic

In late May, Crue and the 13 other Carroll students who participated in this year’s Swaziland Study Abroad trip, entitled “Exploring Compassionate AIDS Care in Southern Africa,” returned with new perspectives and greater appreciation for the nursing profession. On May 9-26, 2006, Aubrey and her fellow Saints journeyed to the southern African kingdom to witness the work of Swazi parish nurses, the fi rst of their kind on the continent. This was the largest Carroll student group ever to enroll in the Swazi study abroad course, now in its third year. Led by Carroll Nursing Department Chair Dr. Cynthia Gustafson, who helped establish parish nursing in Africa, the students saw the horrors of the disease and the sorrows of the survivors. They also found hope.

Swaziland and Montana have approximately the same population, less than a million people each. While a total of 353 Montanans have contracted the disease since the outbreak began 25 years ago, Swaziland by contrast now has a quarter of a million people infected, according to UNICEF. According to Derek Von Wissell, national director of Swaziland’s National Emergency Response Council on HIV/AIDS (NERCHA), over 56 percent of Swazi citizens ages 25 to 29 are infected with the virus, and studies have shown that almost 40 percent of women giving birth in Swaziland test positive for HIV. The average life expectancy in Swaziland has declined from 55 years in the late 1980s to age 39 today. By the end of the decade, 200,000 people will die of AIDS in Swaziland. UNICEF estimates the number of Swazi children orphaned by HIV/AIDS at over 70,000. Experts project that by 2010 orphans will number 120,000, or 12 percent of Swaziland’s entire population.

For Gustafson, this was a fi fth trip to Swaziland, and she noted marked progress in the fi ght against AIDS there. On her first voyage to Swaziland in 2003, NERCHA had developed only a skeletal plan of programs they wanted to implement. Now, clinics are established in rural areas, more people are being tested, the World Bank has given NERCHA money to purchase medicines, and 13,000 patients are now taking antiretrovirals, which were not even available in Swaziland just a few years ago. Antiretrovirals suppress HIV infection and can considerably lengthen an infected person’s lifespan. Swaziland’s parish nursing program, called A New Robe, is based on the philosophy of viewing AIDS patients not as victims deserving scorn and ostracism but as human beings worthy of dignity and respect. Parish nurses in Swaziland devote most of their time to AIDS patients, including many situated in villages only accessible by foot.

On their journey, Carroll students saw the Swazi parish nurses in action visiting their patients. They toured clinics with no electricity or running water. They visited care facilities for orphans whose parents had died of AIDS. And, they helped transport blood drawn for HIV testing.

The trip also offered an immersion experience for the 13 nursing majors and one chemistry major participating. Half of the study abroad students stayed with Swazi parish nurses — this is the first time students have been given this opportunity. Meanwhile, the other seven visited 2004 Carroll graduate Kate Menninger, a Peace Corps volunteer in the Swazi village where she works for the Community Development: HIV/AIDS Education Program.

Menninger led her fellow Saints on clinic tours and talks with health care providers who perform AIDS testing and counseling.

Carroll’s study abroad students came bearing gifts. They presented the Swazi parish nurses with a $2,000 check to support their work. Erika Phillips, a Carroll nursing senior, spearheaded the fund-raising effort with the Carroll Student Nurses Association, which raises money throughout the year to send students to the national convention. This year, no one went to the convention, Phillips says, so the association decided to donate the money to the parish nurses.

“A few of the students had gone on the prior Swazi study abroad trip and met Thandiwe Dlamini (the coordinator of the Swazi parish nurses),” Phillips says. “She’s the most inspiring woman I’ve ever met. I can’t think of any other better way for the club to spend its money.”

While the $2,000 will purchase medications for AIDS patients — everything from antiretrovirals to tuberculosis treatments and pain relievers — the Carroll students also brought other treasures. Senior nursing major Caroline Proue, a veteran of Carroll’s previous Swazi study abroad, gathered two hockey bags full of latex gloves during spring semester for the parish
nurses. All of these donations were more than just friendly gestures, Gustafson says, since funding for A New Robe is drying up, as are its resources.

The Carroll students also delivered toys and treats to Swazi children, who retaliated with smiles, songs and proud recitations of their alphabets. Linda Darelius, a Carroll nursing senior, presented one of the parish nurses a pocket New Testament. “She cried when she got it,” Darelius recalls. “She said her Bible is so heavy to carry over long distances to read to her patients.”

Darelius stayed at the home of parish nurse Edith Ntiwane and accompanied her on morning rounds.

They starting off on foot at 8:30 a.m. and visited seven patients, to whom they administered medicines for symptoms ranging from pain to nausea and diarrhea. With many miles of walking between huts, they didn’t return until that afternoon. For Linda, the experience allowed her a glimpse into her own future.

“I went because I’m hoping to do medical mission work in Africa. This gave me an idea of what I can do,” she explains.

For Aubrey Crue, the journey opened her eyes to the privations that underlie the prevalence of AIDS in Swaziland.

“The majority of the people with AIDS wanted antiretrovirals, but had no transportation, and they need a healthy diet but can’t afford food,” she says.

These epiphanies are the reason Gustafson plans to keep shepherding Carroll students to Swaziland.

“Students right now are interested in making a difference,” Gustafson says. “They are really interested in how they can serve and be the change in the world. They explored this through the study abroad trip.”

“No matter who you are, you have the opportunity to change the world. Maybe it’s the world for one person, or maybe it’s hundreds of people. This trip was my opportunity to do that, to help make the world a better place,” Phillips says.