CHRISTIAN MEDICAL COLLGE VELLORE Lori Haas RN BSN
CHRISTIAN MEDICAL COLLGE VELLORE Lori Haas, RN, BSN NRSG 839 Global Health Practicum 2017 Masters of Science Nursing: Nurse Leadership specialty Public Health
VELLORE, INDIA § Located 3 hours North West of Chennai in the Southern State of Tamil Nadu § State Language: Tamil § Timeframe: § January 1 st – January 28 th 2017
Pre-Immersion Activities § Attended cultural hours, dinners and meetings § Office of International Affairs § Dr. Mani and Modale Scholars from India § Immunization and infectious disease updates § Read historical content about CMC Vellore, India § Dr. Ida: Passing on the Torch of Life (Wilson, 1959) § Signs of the times: Community health and development program. The community health department of the Christian Medical College, Vellore (Patterson, 2005) § World Health Organization: Burn Prevention Dinner with Modale Fellows Memorial of Dr. Ida Scudder Importance of Dr. Ida Scudder § Dedicated her life work to learning medicine treating women and children in India, and to train Indian women to serve their community 11 § Founded CMC Vellore in 1900
Activities with CMC Vellore College of Nursing § Observed referral system and satellite programs § College of Nursing Community Health (CONCH) § Community Health and Development (CHAD) § Mobile clinic § Rural Unit for Health and Social Affairs (RUHSA) § Care provider to population ratios § 1 nurse for a population of 10, 000 § Community assessment of the village Melminnel § Village Mapping § House Visits § Completed anemia study among childbearing aged women § Taught educational sessions with village in Tamil language § collaborated with nursing students of CMC Checking Hgb in the villages
Interest in Burns § Personal Background: § Burn Nurse for 4 years § Began nursing career in the Burnett-Hurlbut Burn Center at KUMED in 2013 § Accustom to burns in the United States- mostly males admitted for engaging in risky behavior. § Significant Observations at CMC Vellore Burn Unit § Females are the population most frequently admitted from self immolation or suicide § To remove self from relationships § Dowry Deaths § “If the groom’s family does not think the bride’s family offered a large enough dowry, they will set fire to the bride and not attempt to save her”. Fire extinguishers in a rural hospital
Burn Trends Among Women in India § 7 million burn injuries in India annually, 700, 000 require hospital admission and 140, 000 are fatal. 91, 000 of these deaths are women 3 § Females (80. 8%) predominate the males (19. 2%) in all burning deaths in the state Maharashtra 2 § In the state of Tamil Nadu female suicide rates exceeded male suicide rates by 11%4 § Average ratio of fire related deaths of young women to men was 3: 13 § 21% of burn related deaths are due to self immolation 8 CMC Vellore Burn Unit
Theories and Models Leininger’s Sunrise Model Conceptual Model for Partnership and Sustainability § Utilized this model for a culturally appropriate assessment of burn trends against women § Utilized this model as an intervention template to promote self supporting methods addressing burns against women § Starts with worldview and focuses into factors that influence care practices for an individual or groups’ health 10 § Partnership is essential for the ongoing process of sustainability 9 § Factors: § Technology § Religious § Social § Beliefs § Economic § Educational Inputs: 1. Design and implement 2. Resources 3. Community participation 4. Leadership champion
Burns and Cultural History of India has a mixed religious history of Hindu, Muslim, and Christianity. Resulting from this history is a deep rooted culture of tradition and social norms that contribute to high rates of burns among women 1 Cultural Practices § Dowry Demand 1&7 § Arranged Marriages § Brides family pays groom family in marriage § Some families find dowry insufficient and abuse bride § Joint Family 1&7 § Bride moves in with Husbands family § Mother-in-law is head of household § Strained relationships can result in abuse § Education for women is not a priority 8 § Women do not have equal rights 1, 2, 3, 7, 8 § Gender based violence is common and accepted 1, 2, 3, 7, 8
Interventions § Woman Central Response Program planning 5&6 § Bring awareness to community § Large scale public health campaigns about dowry, burns, and women being valuable 3, 5&6 § Engaging Health Care Systems 3, 5&6 § Train health professionals on violence § Offer Support Groups § Policy Development for burns and dowry 3, 5&6 § Better documentation of burns in community 1, 2, 3, 5, 6, 7&8 § Holding community accountable § Reporting system for civilians § Ensure officials follow up on reports § Improving education for women § Incident of self immolation decreased as education increased 8
FUTURE GOALS § Partner with health care systems to develop self sustaining outreach programs and supportive groups. § Incorporate outreach program members to help raise awareness with ongoing domestic violence issues in country. § Connect current programs across India to create a coalition of stronger communities. Sheroe’s Hangout Agra, India Restaurant ran by acid attack victims
REFERENCES 1. 2. 3. 4. 5. Banerjee, P. R. (2014). Dowry in 21 st century India: The sociocultural face of exploitation. Trauma, Violence, & Abuse, 15, 34 -40. http: //dx. doi. org/10. 1177/1524838013496334 Batra, A. K. (2003). Burn mortality: recent trends and sociocultural determinants in rural India. Burns, 29, 270 -275. http: //dx. doi. org/10. 1016/S 03052. 4179(02)00306 -6 Bhate-Deosthali, P. , & Lingam, L. (2016). Gendered pattern of burn injuries in India: a neglected health issue. Reproductive Health Matters, 96 -103. http: //dx. doi. org/10. 1016/j. rhm. 2016. 05. 004 Gajalakshmi, V. , & Peto, R. (2007, February 3. 14). Suicide rates in rural Tamil Nadu, South India: Verbal autopsy of 39 000 deaths in 1997 4. – 98. International Journal of Epidemiology, 36, 203 -207. http: //dx. doi. org/10. 1093/ije/dyl 308 Garcia-Moreno, C. , Hegarty, K. , D’Oliveria, A. F. , Koziol-Mc. Lain, J. , Colombini, M. , & 5. Feder, G. (2015, April 18). Violence against women and girls 2: The health systems response to violence against women. The Lancet, 385, 1567 -1579. 6. http: //dx. doi. org/10. 1016/S 01406736(14)61837 -7 Gehring, A. , Heise, L. , Amin, A. , Abrahams, N. , . . . Watts, C. (2015, April 25). Violence against women and girls 5: Addressing violence against women: a call to action. The Lancet, 385, 1685 -1695. http: //dx. doi. org/10. 1016/S 01406736(14)61830 -4 Jeyaseelan, V. , Kumar, S. , Jeyaseelan, L. , Shankar, V. , Yadav, B. K. , & Bangdiwala, S. I. (2015, Jan 19). Dowry demand harassment: Prevalence and risk factors in India. Journal of Biosocial Science, 45, 727745. http: //dx. doi. org/10. 1017/S 0021932014000571 Kumar, V. (2003). . Burnt wives - a study of suicides, 29, 31 -35. Leffers, J. , & Mitchell, E. (2010). Conceptual model for partners and sustainability in global health. Public Health Nursing, 28, 91 -102. http: //dx. doi. org/10. 1111/j. 15251446. 2010. 00892. x Leininger, M. (2002, July ). Culture care theory: A major contribution to advance transcultural nursing knowledge and practices. Journal of Transcultural Nursing. Wilson, D. C. (1959). Dr. Ida: Passing on the torch of life. USA: DR. IDA.
THANK YOU!!! Burn Unit Staff Ms. Nancy, Mrs. Kalaivani & Mrs. Alice Dr. Mani & immersion Group at the 5 k run College of Nursing Community Health Staff
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