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When Simin Marefat, RN, noticed a gaunt man covered in lesions lying alone under a bench in a hospital, she felt deeply disturbed. The man was an AIDS patient in a Zambian hospital. No one had touched him for a month, and he was startled when she reached out to hold his hand.

Marefat, a cardiac intensive care nurse at University of California, San Francisco (UCSF) Medical Center, was in Zambia as a nurse volunteer. The man, in his late 30s, had been shunned by the people in his village when he started to show symptoms of AIDS. Now he was in a room overcrowded with patients dying of the same disease.

He asked Marefat why she wasn't afraid to touch him. She explained how HIV is transmitted and the progression of the disease — things the man had never heard before. He struggled to breathe as he shared about the three children and wife he was leaving behind. After more than an hour with Marefat, the man stopped talking. Marefat knew he had died.

This experience was one of many that sealed Marefat's resolve to use her nursing skills to help people in countries where vaccinations, medication, and even an embrace from another human being can be a luxury.

“No human being should spend the last hour of life under a bench being ignored by people,” says Marefat, 34. “The only way my conscience could be calmed was when I decided I would do something about this.”

Early travels

Marefat experienced her first taste of living in a foreign country when she moved to the United States at age 11. She had grown up in Iran, but her parents decided to leave the country when the political regime changed.

The family moved to a small town in Kansas where they were the only Iranians, and Marefat enrolled in an ESL program to learn English. As she considered career options for the future, Marefat was drawn to nursing. Her father spoke highly of the demand for medical professionals globally, and she was fascinated by the biology of the human body.

After completing nursing school in Kansas, Marefat traveled to Thailand for vacation. On this trip, she was exposed to Third World conditions she had never seen.

“I saw things like children drinking from dirty river water, and someone else bathing in that same water,” she says. “You can come home from a trip like that and say the people are happy the way they are, or you can come back and feel bothered by it. I was haunted by what I saw.”

Marefat decided to become a travel nurse because this would give her the freedom to volunteer abroad between assignments. When she wasn't working in Seattle, San Diego, Hawaii, or San Francisco, Marefat was in places such as South America, India, and Africa. Rather than volunteering through organizations, Marefat opted to travel independently because it was cheaper.

To find places to volunteer, Marefat would search online for orphanages or health clinics in the countries she wanted to visit. When she would arrive, she would ask workers if they needed help, and they always did. She has assisted with everything from vaccinations to HIV education to delivering babies.

And although she cannot help everyone she encounters, there are times she feels drawn to spending her money to help particular people. For example, she heard about a 2-year-old who was having seizures. The doctor had told the girl's parents she was mentally retarded, and as a result, they were seriously considering sending her to an orphanage. Marefat suspected the girl might have epilepsy, and spent $10 to take her to a larger city where she could be seen by a specialist. The child was diagnosed with epilepsy, and Marefat paid for the proper medication. The girl is thriving, and Marefat continues to send the family money so the child can continue to receive her medication.

New horizons

Although Marefat has been to 62 countries, she has felt particularly drawn to Africa and the devastation caused by the AIDS epidemic. Two years ago, she started pursuing a master's degree in health policy at UCSF's nursing school. She has focused her studies on the U.S. policy on AIDS.

Although Marefat has yet to decide how she will combine her experience abroad with her master's degree training, she cannot forget what she has seen overseas. The interactions she has had with people in other countries have changed the way she views patients in the United States.

“I realize how lucky patients are to have what they have here,” she says. “And I work in the ICU at UCSF, where things are very technically driven, and it's easy to forget I am taking care of a human being. I can take 5 minutes to find out what patients were like before they ended up in the hospital, and that can make people feel really good.”

Marefat has recently focused on raising money to send orphans to college in Rwanda. Anyone interested in making a donation can visit www.orphansofrwanda.org.

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Heather Stringer is a freelance writer. To comment, e-mail editorCA@nurseweek.com.