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Africa

Dr. Carol Pavlish in Rwanda

UCLA School of Nursing: UCLA Nurses in the world.Prior to joining the UCLA School of Nursing faculty in 2006, Dr. Carol Pavlish spent nearly three decades teaching at College of St. Catherine in St. Paul, MN, a women's college. There, she learned of the importance of viewing women's health in the context of women's political and socioeconomic wellbeing. Pavlish became acutely aware of the close link between education and women's ability to exercise options - and saw that when given the opportunity, women tended to make decisions that improved the lives of their families and communities.

Much of this thinking has developed in the decade that Pavlish has been working with the nonprofit American Refugee Committee (ARC), which has provided humanitarian assistance and training to millions of beneficiaries in its 30-year history, working with refugee communities in seven countries. Since 2000, Pavlish has made regular visits to the African countries of Rwanda, Uganda, and Sudan in conjunction with the ARC, contributing her research and academic expertise.

What started as a health focus has evolved. "The women in these areas told us their health is much bigger than a physical experience - that it has to do with things like political autonomy and cultural traditions as well," Pavlish says. "They kept talking about gender-based violence and not having opportunities for education. We realized we couldn't address health without addressing these other issues."

The community-based research of Pavlish and her ARC collaborators aims to deepen understanding about the social context that influences human rights experiences and gender relationships in post-conflict settings. Working most recently in southern Sudan, they have teamed with community-based groups in an effort to explore perspectives on human rights barriers women encounter. "In postconflict settings human rights violations persist, and women and girls are especially vulnerable to discrimination and violence," says Pavlish.

Pavlish was most recently in southern Sudan in August and September, fieldtesting and refining activities created by the community organizations before they are disseminated. Among the strategies are the use of drama and storytelling in an effort to develop and integrate a human rights framework that will be effective in the small villages.

"The stories we hear about human rights violations and gender-based violence are just heartbreaking," says Pavlish. "But there are many people in the country who are committed to doing somethingabout it and improving the health and well-being of women and their families."

Dr. Sally Maliski in Kenya

When Dr. Sally Maliski visited the Presbyterian University of East Africa School of Nursing in Kikuyu, Kenya late last year, she was taken aback at the school's dearth of resources. "They had none of the things that we take for granted at UCLA - including no library with nursing journals and books," Maliski says.

The School of Nursing assistant professor's visit to Kenya occurred via her involvement with Thousand Oaks, CA-based Care Now Foundation, which supports clinics in remote areas of Africa. As part of the trip, Maliski was able to visit Presbyterian University of East Africa and its connected hospital, where the school of nursing was being established. She taught at the school and conversed with the nurses at the hospital to learn more about their needs. Maliski also met with the director of the new nursing school, Mary Kamu. "She is so energetic and visionary," Maliski says.

"She is working hard to move from a diploma program to a baccalaureate program, with the dream of eventually developing an advancedpractice nursing program focused on the needs of the African people. Both steps are critical to the growth of professional nursing in Africa, where clinicians and educators are desperately needed."

Maliski was also impressed by the school's students. "They are eager, bright, and really understand what nursing is and how it can transform the health of their country - and, indeed, the continent," she says.

Since her visit to Kenya, Maliski has been in frequent email contact with Kamu and her leadership team as they develop a baccalureatelevel curriculum. At some point, Maliski hopes to be able to collaborate with the Kenyan nursing school on research in Maliski's focus area, prostate cancer symptom management in underserved populations. Research on prostate cancer in Africa would have implications not only for that continent, but also for the United States, Maliski explains, given that African-American men have nearly twice the prostate cancer risk as U.S. men of other ethnicities. Maliski has been in contact with a school of nursing in Nigeria to discuss the possibility of a research collaboration exploring issues related to prostate cancer risk there.

But at the nursing school in Kenya, as in most of Africa, any discussion about such a research collaboration is at this point theoretical. "The capacity isn't there," Maliski says. "They don't have cancer registries to even get a sense of what the situation looks like, and they can't even obtain basic treatment that we have here. Cancer care is basically palliative care."

For now, then, Maliski is focused on building the school's capacity. After her return from Kenya, she put out a call to her faculty colleagues asking for nursing journals and books that could be donated to help the Kenyan school start a library. The response, she says, was overwhelming, requiring multiple shipments.

"I came back from Kenya firmly convinced that if we want to help promote health in Africa and other parts of the developing world, the way to do it is to support in-country nursing education, because their context is so different from the context in which we educate nurses here. Research is critical, but the first step in these developing countries is helping them build their capacity, in part through a curriculum that meets their needs."

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