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Deployed Air Force nurse aims to change Afghanistan med culture

  • Published
  • By Airman 1st Class Candy Miller
  • 82nd Training Wing Public Affairs
Working in conditions described as "1940's-style nursing," an Air Force nurse deployed to Kandahar, Afghanistan, is helping to bring western medicine to an underdeveloped city.

Lt. Col. Susan Bassett, assigned to the 205th Afghan Regional Security Integration Command, is learning the stark reality that items such as sterile equipment, IV tubing, alcohol wipes and other common nursing necessities are not a staple here nor is having a trained staff the norm.

"Change in Afghanistan, just like in America, is an art that takes skill, planning and lots of patience," said Colonel Bassett, who is on a 365-day deployment from the 882nd Training Group, Sheppard Air Force Base, Texas.

Colonel Bassett's mission, although daunting, is to train and mentor nurses of the Afghan National Army. The heart of the challenge, she said, is the different resources - or lack thereof - and procedures. 

The ANA's nursing school is only about nine months long compared to the four years of education required for U.S. military nurses. Afghan nurses learn how to do basic procedures such as starting IVs, administering an EKG or taking care of wounds, but are not taught subjects such as anatomy, physiology or about diseases, said Colonel Bassett.

"When do we ever get put in a position to help change the course of life for literally millions of people?" she asked. "When are we ever given the opportunity to be the point person in dispersing hundreds of pounds of donations to destitute people?"

Colonel Basset sees her deployment as an opportunity to help change some of the basic nuances of life to improve the Afghan medical culture. The U.S. military provided the beginnings of change with a new facility and modern equipment.

A new facility alone doesn't change the culture. It also requires an understanding of the differences in the training that the all-male nursing corps gets, and the level of care they have provided for decades, if not centuries. One example of these differences is a fundamental practice among nurses in the United States -- documentation.

"Not one word (was) being written down by the nurses," Colonel Bassett said. "In fact, the only thing the doctor wrote was a set of orders. The nurses couldn't understand why they should write anything. It was obvious if the doctor had written it once, then that was what the nurse had given."

Through time and patience, she said the ANA nurses have grown to understand the importance of recording vital signs on a regular basis and documenting the type, amount and frequency of medications given to patients.

Training takes patience, whether it's training Airmen at Sheppard or a staff of ANA nurses in Kandahar, said Colonel Bassett. Throw in barriers such as language and procedures into that mix and patience will be put to the test.

Even so, Colonel Bassett said it is a blessing to be part of this mission. She studied Dari, the official language in Afghanistan, and has learned more than 2,000 words to better communicate with her Afghan counterparts. In turn, the ANA nurses are learning some basic English.

"So now we deal with one or two words and lots of sign language," she said. "It actually can be very effective ... just because nurses sort of know what is most needed and then what to do next."

During the Ramadan holiday, strict guidelines were in place controlling the work schedule in order for nurses to participate in early morning prayers and breakfast to honor required daytime fasting.

On one such day, a wounded Afghan soldier came into the emergency room seeking medical care. That wouldn't have been a problem if it hadn't been at 7 p.m., the time when Ramadan participants can eat their evening meal.

"The patient quietly laid there on a stretcher waiting until the surgeons and operating room crew ate their dinner so they wouldn't be too tired to complete his surgery," she said.

The relationship cultivated between Colonel Bassett and the ANA nurses has been a success story that transcends any cultural or language barriers. She said her relationship with the nurses is "quite unique and special."

"Being over 50 years and still 'active without a cane' is awe inspiring to them," she said, explaining the life expectancy in Afghanistan is in the mid-40s. "They call me Mama Bassett, except I insisted the 50-year-old chief of staff simply could not call me mama, so he calls me sister."

Colonel Bassett said they always make sure she has chai tea four times a day and gets adequate rest. Before the daily grind of patient care begins, they insist on exchanging pleasantries.

"They simply will not talk to me until we have shaken hands, customarily kissed on both cheeks, asked about my past night's rest and reviewed the health and well being of my family members back home," she said.

The colonel said she's been fortunate to see the fruits of her labor as she trained and mentored the fledgling nursing corps, from documenting medications to taking vital signs. It is that impact she'll remember from her deployment.

"I have found it to be 100 percent more interesting than I ever could have imagined," she said. "It is far more dangerous than any assignment I ever thought I would have with the Air Force. This has to top my list as the number one rewarding assignment in my 33 years as a nurse."