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Sheppard nurse trains, changes culture with peers in Afghanistan

  • Published
  • By Airman 1st Class Candy Miller
  • 82nd Training Wing Public Affairs
Some things are taken for granted in American hospitals, emergency rooms, operating rooms and clinics such as sterile equipment, well-trained staff and support.

Very seldom do medical facilities in the United States run out of basic supplies like IV tubing and alcohol wipes- common, but essential tools in the medical community.

Lt. Col. Susan Bassett, the chief nurse at the 882nd Training Group, is learning the stark reality that these items are taken for granted while assigned to the 205th Afghan Regional Security Integration Command in Kandahar, Afghanistan. Working in conditions described as "1940's-style of nursing," the colonel is working to change the medical culture at her current assignment, bringing western medicine to a underdeveloped city.

"Change in Afghanistan, just like in America," she said, "is an art that takes skill, planning and lots of patience."

Changing the course of life

Afghanistan is an extremely poor country, according to the CIA's "World Factbook," highly dependent on foreign aid to meet basic needs of food, drinkable water, housing and medical care. Since 1747, when the country was founded, it's been the location of civil wars and invasions, debilitating the country's ability to grow and prosper.

But Colonel Bassett said she sees her 365-day deployment as an opportunity to help change some of the basic nuances of life to improve the Afghan medical culture.

"When do we ever get put in a position to help change the course of life for literally millions of people?" she asked. "When are we ever given the opportunity to be the point person in dispersing hundreds of pounds of donations to destitute people?"

Colonel Bassett's mission, although daunting, is to train and mentor nurses of the Afghan National Army. The heart of the challenge, she said, is the different resources - or lack thereof - and procedures. The U.S. military provided the beginnings of change with a new facility and modern equipment.

A new facility alone doesn't change the culture. It also requires an understanding of the differences in training the all-male nursing corps receives and the level of care they have provided for decades, if not centuries. One example of these differences is a fundamental practice among nurses in the United States - documentation.

"Not one word (was) being written down by the nurses," Colonel Bassett explained. "In fact, the only thing the doctor wrote was a set of orders. The nurses couldn't understand why they should write anything. It was obvious if the doctor had written it once, then that was what the nurse had given."

Through time and patience, she said the ANA nurses have grown to understand the importance of recording vital signs on a regular basis and documenting the type, amount and frequency of medications given to patients.

Lots of patience

Training takes patience, whether its training Airmen at Sheppard or a staff of ANA nurses in Kandahar. Throw in barriers such as language and procedures into that mix, and that patience can be put to the test.

Even so, Colonel Bassett said it's a blessing to be part of this mission.
She's done her part, including studying Dari, the official language in Afghanistan. She said she's learned more than 2,000 words to better communicate with her Afghan counterparts. And the ANA nurses are learning some basic English.

"So now we deal with one or two words and lots of sign language," she said. "It actually can be very effective... just because nurses sort of know what is most needed and then what to do next."

ANA nurses don't complete the four years of education required for U.S. military nurses. Colonel Bassett said their school is about nine months long and doesn't include courses like anatomy and physiology or diseases.

She said they learn how to do basic procedures such as starting IVs, doing an EKG or taking care of wounds.

Another example of how the culture can affect every day operations was the Muslim holiday of Ramadan. Because of the strict guidelines, the duty hours were changed to 8 a.m. to 1 p.m. to allow the nurses to participate in the early morning prayers and breakfast. They are required to fast during the day.

On one such day, a wounded Afghan soldier came into the emergency room seeking medical care. That wouldn't have been a problem if it hadn't been at 7 p.m., the time when Ramadan participants can eat their evening meal.

"The patient quietly laid there on a stretcher waiting until the surgeons and operating room crew ate their dinner so they wouldn't be too tired to complete his surgery," she said.

Mama Bassett

The relationship cultivated between Colonel Bassett and the ANA nurses has been a success story that transcends any cultural or language barriers. She said her relationship with the nurses is "quite unique and special."

"Being over 50 years and still 'active without a cane' is awe inspiring to them," she said, explaining the life expectancy in Afghanistan is in the mid-40s. "They call me Mama Bassett, except I insisted the 50-year-old chief of staff simply could not call me mama, so he calls me sister."

Colonel Bassett said they always make sure she has chai tea four times a day and gets adequate rest. Before the daily grind of patient care begins, they insist on exchanging pleasantries.

"They simply will not talk to me until we have shaken hands, buzz-kissed on the cheeks, asked about my past night's rest and reviewed the health and well being of my family members back home," she said.

The colonel said she's been fortunate to see the fruits of her labor as she trained and mentored the fledgling nursing corps, from documenting medications to taking vital signs. Its that impact she'll remember from her 365-day deployment.

"I have found it to be even 100 percent more interesting than I ever could have imagined," she said. "It is far more dangerous than any assignment I ever thought I would have with the Air Force. This has to top my list as the number one rewarding assignment n my 33 years as a nurse."