With the appointment of University of Arizona College of Nursing Professor Marylyn Morris McEwen, PhD, RN, FAAN as UArizona Nursing Associate Dean for Global Nursing, the College has begun a major new initiative in global education. Microcampuses are currently being examined for potential partnerships in regional hubs in Africa, the Middle East and Asia, but UArizona Nursing has already been forging bonds in Mexico for some time.
Last summer, students in the Master’s Entry to the Profession of Nursing (MEPN) program participated in a clinical experience in Hermosillo, Mexico. And in November, Clinical Assistant Professor Lisa Kiser, DNP, CNM, WHNP laid the foundation for a new immersion-learning binational experience in Alamos, Mexico geared for UArizona Doctor of Nursing Practice students.
A Tucson native who has spent her career working with Hispanic and Latino communities, Dr. Kiser is intimately acquainted with the need for culturally congruent health care that addresses the needs of native communities both in the U.S. and Mexico.
Rotary International District 5500 invited Dr. Kiser to Clinica Integral Almas in Alamos, Mexico, to help provide training and support for fourteen indigenous health promoters (or promatoras) from the Makurawe communities that surround Alamos, Mexico. Together with Southeast Arizona Area Health Education Center (SEAHEC) border binational coordinator Brenda Sanchez and Rotary Global Grants Coordinator Barbara Kiernan, Dr. Kiser travelled to Alamos on a trip that was part exploratory and part instructive. “We did a few trainings but we also wanted to learn about the community,” she says. “Before we brought students to their communities, we wanted to meet them and become introduced to their culture.”
"Clinica Integral Almas is a bridge between the traditional Mexican health care system and their traditional ways of healing and knowing, and we get to help connect both the clinic and the communities to our wonderful nursing community here at the College of Nursing.” ~ Lisa Kiser, DNP, CNM, WHNP, UArizona Nursing Clinical Assistant Professor
Dr. Kiser explains that, just as in the U.S., outlying rural communities like the Makurawe have access to fewer health services. The Mexican health care system attempts to connect with these populations but resources are scarce and travel times for patients to reach clinics are lengthy. “They encourage people to come in, but it’s a two to 7-hour drive on dirt roads, many of which are impassable in winter,” she says.
The goal of the Alamos binational effort is to provide Makurawe health promoters with training, supplies and technology such as solar-powered computer systems in order to increase their access to health care. Both Dr. Kiser and Brenda Sanchez emphasize, however, that the effort was anything but top-down. Cultural sensitivity and engagement were highest priorities for the team.
“I work with promatoras here in Arizona, so I was trying to find the similarities and the differences between the framework that we use here in the U.S. and the framework that is being used in Alamos,” says Sanchez. “They’re the bridge between the health care system and their community. At the end of the day, promatoras know their community best.”
“One of the things we learned is you’re coming into a system where there’s already traditional health care happening,” echoes Dr. Kiser. “With our current efforts around global health, we’re emphasizing to our students a model of global health where it’s not us coming to help. We’re partnering with these communities.”
During their four-day visit Dr. Kiser and Sanchez listened as much as they spoke. They worked with Clinica Integral Almas to determine next steps for needed trainings, community outreach, and potential community health fairs. They conducted direct engagement around reproductive health, basic anatomy, physical assessments, vital signs, and vector-borne diseases like malaria and dengue fever. They also learned about traditional Makurawe ways of healing. “We realized that they’re already doing health care, traditional health care, but still very important,” says Sanchez. “It’s just as valid as western medicine.”
Dr. Kiser wants to bring that realization to the training UArizona DNP students receive when the first immersion binational borderlands learning experience commences in March, 2020. Receiving a fully-funded student learning opportunity is rare, and we are grateful for our partnership with Rotary International District 5500. This is an important opportunity to demonstrate the valuable contributions of UArizona Global Nursing to support the health of individuals and communities in Alamos, Mexico while focusing on the student educational experience.
Dr. Kiser envisions the seven-day trip as a chance for a fertile border binational exchange. Two faculty—Dr. Kiser, and Martha Lizarraga de Garcia, MSN, RN, CFNP, will travel to Alamos with six DNP students. DNP students will have the opportunity to learn from local health care workers about the needs and strengths of their community health knowledge, practices and infrastructure. They will also help develop community health fairs, observe healthcare provided by the Clinica Almas staff, and possibly source ideas for their required DNP projects.
In the end, the opportunity is a gift for both sides of the border. “We get to be bridges between the two cultures,” says Dr. Kiser. “Clinica Integral Almas is a bridge between the traditional Mexican health care system and their traditional ways of healing and knowing, and we get to help connect both the clinic and the communities to our wonderful nursing community here at the College of Nursing.”