Atlanta Certified Nurse-Midwife Studies Maternal/Infant Risk Internationally
Monday November 10, 2008
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Kristin VanderEnde, RN, in Kenya
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Ten years ago she lived in a Bangladesh orphanage as a summer volunteer. After earning her undergraduate and master's degrees in nursing, she worked in the Northern Mariana Islands and volunteered in Kenya. And when she returned to the states, she discovered a local connection to Bangladesh through Emory University's Nell Hodgson Woodruff School of Nursing.
"From the time I was young, I heard stories about problems in Bangladesh," says VanderEnde. "When my college offered summer trips, no group wanted to go there, so I went by myself. I was the first foreigner to live in the orphanage with the workers and 50 orphans. I taught English and hung out with the children, but I learned and received so much more."
She switched her major to nursing while a pre-med student at Vanderbilt University in Nashville. "I chose to be a nurse-midwife when I realized the importance of the relational aspect of hands-on care and being with the patient, sharing that time through the pregnancy," she says. "That holistic view informs my research and is the lens through which I view the world."
As a condition of her National Health Corps Service scholarship, she was required to work two years for an approved employer in an underserved area of the U.S. She chose a clinic and 175-bed hospital at the Commonwealth Health Center, Saipan, one of the Northern Mariana Islands (and a U.S. Commonwealth). She took her husband Dan, an internist she met in college.
The staff and patients fulfilled her desire for international work. In one day, she'd typically see patients who were Chamarro (native to the Islands and Guam), South Korean, Chinese, Micronesian, and Filipino.
"If we had any OB complications, the nearest referral center was a four-hour flight to the Philippines or an eight-hour flight to Hawaii," she says. "I had one woman who needed to give birth to her fifth child elsewhere, so I flew with her during labor. It impacted a lot of care and choices."
When her commitment was complete, she accompanied Dan and the first of their two children, then an infant, to the city hospital in Kijabe, Kenya, for 11 months. "I didn't have time to take the six months of courses required to convert to a Kenyan license, so I did work on protocols for labor and delivery, and assisted with patient transport," she says.
After a three-month education stop in London, they moved to Atlanta. "It was for [my husband[']s] job as a hospitalist, but I couldn't have picked a better place for a PhD," she says. "My interest is international work and intimate partner violence, particularly how it impacts the health of pregnant women and child care, and my advisor, Lynn Sibley [RN, PhD], studies maternal and infant mortality in Bangladesh, including causes of delayed treatment and injury."
Through Sibley, VanderEnde connected with researchers who conducted World Health Organization studies of women's health and domestic violence in 10 countries, including two sites in Bangladesh.
Instead of focusing on individual factors, such as age and education, VanderEnde looks at the community. "I'm looking at women's status, poverty, residential stability, community norms, and examing whether [the community] intervenes or considers violence a private or family matter," she says. "There are higher rates of violence in rural than urban communities, and I'm trying to tease out the differences within the same country.
"Once we better understand the causes, my goal is to be able to target interventions that can be done at a community level. And my hope is that they're not all specific to Bangladesh but that some will hold true across cultures, including the U.S."
Wendy Bonifazi, RN, CLS, APR, is a senior staff writer for Nursing Spectrum.
To comment, e-mail editorSE@nursingspectrum.com.
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