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Advancing Nursing Practice in Africa

Ever since I was an exchange student in high school, I have been drawn to the idea of living and working in other cultures. That dream got put on pause until my children graduated high school and I retired from my public health job. With over 40 years of experience as a nurse and midwife in clinical, academic, and administrative positions, I applied to Peace Corps Response. I recognized that Peace Corps provided a vehicle for me to make a difference in global health by helping train the next generation of nurses.

Two women stand in front of an obstetrics office
Nursing director, Anna Agnes, stands in front of the hospital with Rebecca.

To reduce high infant and maternal mortality rates, many countries in sub-Saharan Africa train all nurses as midwives. My journey as a Peace Corps Response Volunteer (PCRV) first took me to Tanzania in 2014, where I served for twelve months teaching midwifery in a diploma nursing program. I continued my mission as a nurse educator during my second Peace Corps Response service in 2016, where I traveled to Uganda for six months and worked in a newly established bachelor of science in midwifery program.

In 2019, I decided to serve again with the Advancing Health Professionals (AHP) program. AHP aims to improve healthcare education and strengthen health systems on a societal level in resource-limited areas. While I expected to serve for 12 months in Eswatini, I was evacuated in March 2020 with other Volunteers due to the COVID-19 pandemic. I hoped to return and finish my service, and in October 2022 I did! I went back to the clinic where I had been in Mbabane and completed the remaining eight months of my service. My assignment was to build capacity among nursing staff who cared for children and adolescents living with HIV and TB at Baylor College of Medicine Children’s Clinical Center of Excellence and its two satellite clinics.

A women hugs a young girl in Africa
Mary John, who now works as a registered nurse in Tanzania, serves as a positive role model for her sister.

The clinic is a not-for-profit health center that provides comprehensive care to over 5,000 people. My role was to help the nurses acquire new skills in quality improvement and evidence-based care. I provided didactic teaching, and I mentored nurses on how to develop nursing standard operating procedures, design health education materials, and implement quality improvement (QI) projects. One area of focus for our work was the clinic’s adolescent health program. We adapted an evidence-based screening questionnaire to identify and initiate early intervention with youth at risk for depression, alcohol and drug use, and teen pregnancy. Nurses also asked for help strengthening their emergency response skills. With two of the clinic’s pediatricians, I developed tools and implemented a hands-on simulation program to help the clinical team deal with clinical emergencies.

Retaining professional nurses is a challenge for Eswatini and the other countries where I’ve worked. Most African countries face brain drain—with skilled professionals leaving to find work elsewhere—and critical health workforce shortages. I assisted Baylor’s administrative team in improving job descriptions and onboarding processes for new staff, and for ongoing professional development opportunities. Our goal was to increase job satisfaction and retention.

I continue to stay in touch with the nurses I’ve met in Tanzania, Uganda, and Eswatini. Learning about their work volunteering at refugee camps, staffing clinics, and hospital wards during the pandemic, and working towards advanced degrees in nursing makes me feel proud. I feel very privileged to have participated in their education and grateful for my time volunteering with Peace Corps Response.

A group of Peace Corps Volunteers in Eswatini wear colorful clothes and stand in a group in front of a set of windows outside of a building.
Peace Corps Volunteers in Eswatini following their swearing in ceremony in 2019