When nursing lecturer, Fathimath Hussain, returned from her studies in Australia under an Australia Awards Scholarship she was instrumental in launching the Maldives’ first Bachelor of Nursing course, the graduates of which are now poised to improve health care on some of the country’s far-flung islands.
Watching her grandfather die painfully was a turning point in nursing student, Huna Ismail’s, life. It was then that the young Maldivian decided to become a nurse. “He was bedridden for two years,” she recalls. “I always wondered, what would be the care given by professionals in other places. I wanted to know how to give care to the bedridden patients; how to give care to the geriatric patients. That was my inspiration for becoming a nurse,” she explains.
A few years ago, it would have been difficult for Huna to follow her passion. She would have needed substantial funds or a scholarship to travel abroad from her outlying island home – eight hours by ferry from the Maldivian capital, Male – to gain a bachelor degree in nursing. Today, thanks to another nurse’s passion, Huna is among the scores of young nurses about to graduate from the Maldives’ first Bachelor of Nursing course. That other nurse is Huna’s lecturer, Fathimath Hussain, who was instrumental in setting up the new course.
“Through the bachelor of nursing programme we are hoping that we can provide a higher quality of nursing care throughout the different areas in the Maldives, not only here in Male, but in the Atolls also,” explains Fathimath, Lecturer at the Maldives National University and Australia Awards Alumnus.
Through her Australia Awards Scholarship, Fathimath studied a Master’s of Nursing at Monash University. She focused on nursing education and, upon her return to the Maldives, drew on her former lecturers’ and Monash’s own bachelor of nursing curriculum to draft with her colleagues the first-ever such course for the Maldives.
“While studying in Australia, I gained knowledge about how to build that relationship between my students and me. In our culture that relationship can be distant … so from there I learnt how important it is to have a good friendly relationship with the students,” Fathimath says. “I love nursing and I love knowledge and I want to develop that in my students.”Fathimath has passed her passion onto her students. Once she graduates, Huna hopes to find a position at the health centre on her home island, Hinnavaru. Like most health facilities sprinkled across the 198 inhabited islands of the Maldives, this small white building, within eyesight of the sea, provides only basic health care, such as vaccinations and first aid, to the 4,000 or so people who live on Hinnavaru.
“If an emergency case comes, for example a person with shortness of breath or with pain in the chest … they [the Hinnavaru health centre] can take an ECG or they can provide oxygen supplies and they refer the patient immediately to the nearest hospital,” explains Huna. The nearest hospital is a 30-minute ferry or costly 15-minute speed boat ride away.
Sometimes, access only to basic care can have devastating consequences as Ibrahim Qasim discovered when his diabetic mother-in-law developed an ulcer on her foot. Three months passed before she got the needed treatment after finally traveling to Male. Unfortunately, by that point the foot could not be saved and had to be amputated. “We want to stay in Male now,” he says. “We don’t want to risk the other foot.” So, Ibrahim is looking for work in the already overcrowded capital and hopes to move the rest of the family to Male as soon as possible.
To avoid health complications, many Maldivians travel to Male for health care, if they can afford it. As a result, the capital’s health services are under pressure. Fathimath believes that the new degree-trained nurses will be able to help ease this pressure and, even with only the basic facilities in place on the islands, they will be able to improve health services to some extent.
“The role of bachelor nurses in improving health care will be, I believe, mainly in the health promotion and health prevention areas,” Fathimath says. “For example, in cases of lifestyle diseases such as hypertension and diabetes, if these are not treated adequately they can lead to disability through the loss of limbs,” she explains. “We believe that after finishing their studies the bachelor nurses will have the capacity to identify these issues earlier, and also by giving health education and providing health education among the rural communities, they will be able to prevent many lifestyle illnesses and even communicable diseases,” she says.
Huna echoes her teacher’s words, explaining that: “I know there are few [health] facilities in our island, but I can apply the knowledge I have gained here and raise awareness among the relatives of geriatric patients, so that they can stay at home and give the right care to the patients,” she says.
Scores of students like Huna will soon graduate as the Maldives’ first home-trained bachelor-level nurses. Meanwhile, many more are enrolling and the numbers of students taking the course are increasing. “I think the biggest reward is yet to come, to see better nursing care all over the country,” Fathimath says. Thanks in part to her Australia Awards Scholarship, Fathimath and her colleagues are now working on a national Masters course to help improve health services even further.