Training for nurses in Dahuk well received

It's turning into a busy month for Mudrika Abdulselim, an instructor at Dahuk's nursing school in northern Iraq. Usually, she works only afternoons and evenings. For the past two weeks her mornings have been full too, not with teaching this time, but learning. "For 20 years we've been cut off from the world, nobody more so than the nurses," she told IRIN in Dahuk's central Azadi hospital. "When I heard nurses were coming here from outside to work with some of my colleagues, I realised it was an opportunity I couldn't miss." Most of the 26 women currently being trained by three nurses from the NGO Northwestern Medical Teams (NWMT) were handpicked. Abdulselim volunteered, along with two other teachers from the nursing school. "We're here for a month," Melody Simmons, a specialist labour and delivery nurse from Fairbanks, Alaska, told IRIN. "We're teaching paediatrics, maternity and intensive care." Though she and her two colleagues had never been to northern Iraq before, NWMT has. Relays of nursing teams have been in Dahuk and Erbil since last November, teaching everything from burns treatment to intensive care. The task the teams face is daunting. Not only do Iraqi hospitals often tend to be high on high-tech equipment like MRI and CAT scans at the expense of essentials like surgical gloves and bandages, the medical profession itself is seriously top-heavy. With 240 doctors to 160 nurses, Azadi hospital is no exception. Nursing shortages are particularly glaring in the burns and intensive care units. For Lisa Connell, an Australian intensive care nurse, the disparity in numbers is telling. "In the West, nursing is a profession," she told IRIN. "Here, you get the feeling it's only a job, and not a particularly respectable job at that." Azadi's director of nursing, Safiya Sabri, concurred. "You only have to look at the fact that, while Iraqi doctors eat in the canteen, nurses eat with the patients," she said. The problem, she added, is as much an issue of education as of status. "While Iraqi doctors have always been highly trained, nurses often have not," she explained. "So you often find doctors doing tasks that really should be a nurse's job - taking a patient's temperature or blood pressure." As a result, the NWMT nurses have concentrated their attentions on attempting to broaden the responsibilities of their charges. "We arrived to find nurses doing little but following written instructions left by doctors," Simmons said. "We've explained that they too should be leaving written records of what they are doing, but we've also been teaching them, for example, how to assess a patient's condition." Local nurses said they welcomed this approach. "It's a vicious circle," Jemila Bahatin, told IRIN. "You do nothing so you are not respected. We want more responsibility." Like the NWMT members, though, she and her colleagues doubted whether a month's training would be enough to bring about permanent change. "There's a difference between theory and practice, unfortunately," explained Abdulselim. "We agree with what the NWMT nurses have been saying about nursing practice, but neither we nor they have the authority to bring about structural change. There is no follow-up to these month-long training sessions." Like the nurses, Azadi hospital director, Dr Arif Younis Balatay, believes the NWMT training sessions should be extended. "What would be ideal would be to have Western trainers working with our nurses for periods of at least six months, particularly in the units where nursing care is most vital, like burns or maternity wards," he said. "It is impossible to exaggerate how much we have learned from working with NWMT," Abdulselim added. "If only they could stay on a while to help us modernise the teaching at our nursing school."