New Haven, Conn.
May 24, -- Nurses in Iraq listed building new
hospitals, English language training and creating
more autonomy and respect for their profession as
priorities in reconstructing a healthcare system in
the war ravaged country, according to a study by
researchers at Yale School of Nursing.
A total of 744 surveys were collected from nurses in
the Dohuk and Erbil regions of northern Iraqi
Kurdistan by field researchers working on the
project with Yale. The region has remained stable
with only sporadic violence because of creation of
the “no-fly” zone in 1991.
“However, a functioning economy does not mean that
the reconstruction is complete,” said Allison
Squires, R.N., doctoral candidate and lead author of
the study in Advances in Nursing Science. “It will
be an ongoing process. Including input from nurses
will be important for ensuring the success of the
policy choices made there.” |
Ali Sindi, M.D. and Allison Squires, R.N. |
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Squires and co-author Ali Sindi, M.D., who is in
Iraq, developed the survey. After the survey was
translated into Arabic and Kurdish field
coordinators distributed it to nurse participants at
their place of work and the data was emailed to
Squires.
In addition to new hospitals, language training and
leadership development, nurses reported the need for
new equipment and furniture for patient care,
financial support for student nurses, more access to
nursing and medical journals and improved laboratory
services.
“Nurses repeatedly wrote down that they wanted more
respect, not only in the workplace, but in society
as a whole. They suggested that this could be
accomplished through recognition for quality of
performance,” Squires said. “They also wanted
respect from physicians, administrators and the
public but did not offer solutions in this area.”
The nurses also called for assistance with housing,
child care and transportation to and from work and
risk allowances to cover health benefits such as
vaccinations. “We might assume from this that many
nurses have not been properly vaccinated against
infectious diseases, which increases their risk of
contracting easily preventable illnesses on the
job,” Squires said.
The nurses’ comments reflect the low public status
of nursing and the lack of consistent authority. “We
have more than one manager.” “We are insulted and
every guilt of the hospital eventually comes upon
nurses.” “We should be paid more than police and
teachers because teachers have four days off each
month and they are not tired like us.” Currently
nurses in Iraq earn an average of US$150 per month.
Diseases nurses listed as priority concerns were
childhood illnesses, cancer and sexually transmitted
diseases other than HIV/AIDS, of which the incidence
rate remains low. Squires said cancer rates are high
in the region due to a variety of factors including
chemical warfare used by the previous authoritarian
regime for ethnic suppression. Malnutrition was also
a serious concern. It stems from both prolonged
political sanctions in the region and mismanagement
that impeded the success of the United Nations’
oil-for-food program in the country during the
1990s.
“The feedback provided by the nurses in this study
demonstrates clear priorities that can facilitate
both the short-term working conditions of Iraqi
nurses and the long-term plans for the development
of the profession,” Squires said.
The study was made possible by a collaboration
facilitated by the Yale World Fellows program along
with Internet access. This non-governmental
collaboration added to the credibility of the study,
although the study did have the support of the
regional government. The authors believe the
non-governmental collaboration increased the
willingness of the nurses to participate.
The Internet provided a consistent means of reliable
communication in a place where electricity and phone
service are sporadic at best. And, although managing
a research study without local site visits did
require relinquishing a certain amount of control,
“credible and useful results can still be generated
with thoughtful, careful planning in the overall
research design,” Squires said.
yale.edu
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