James Cook University named a WHO centre

Australian academics are making progress training Fijian nurses to be confident and competent in the area of disaster relief and emergency response, writes Kate Leaver.

Under the leadership of Professor Kim Usher, the School of Nursing and Midwifery at James Cook University has become a World Health Organisation Collaborative Centre (WHOCC) - only the second in Australia to win such an accolade. For Usher, it's a long-awaited and well-deserved title that indicates her research is world-class but she's too pragmatic to overestimate its significance.
"Being a WHOCC doesn't bring any money along with the designation, it's really just a figurehead. I've been working towards this for many years and it does mean we'll be able to expand our research, but it's not so much exciting as it is lucky. I feel very lucky."

The team at JCU, lead by Professor Usher, has been training nurses in Fiji for more than six years, and have begun crucial work in Palau, Micronesia, the Marshall Islands and Papua New Guinea.

The school is also secretariat for the Asia Pacific Emergency Disaster Nursing Network (APEDNN), joined by the Universities of Hawaii and China. The objective is to standardise nursing education in the region through research, exchange programs, and training.

"At the moment we're doing research around the psycho-social impacts of disaster, and post-disaster. We're developing targeted research on the outcomes of Cyclone Yasi here in Queensland, and to do the same sort of work throughout Indonesia. We'll look at the impact of volcano eruption there and possibly roll-out research with tsunami victims in Japan."

Usher brings formidable expertise to the project, in mental health management in Aboriginal communities in Australia, and in Fiji. In a 2005 research paper called 'Developing the Future Nurse Leaders of Fiji' she and JCU colleague Lee Stewart argue that developing countries like Fiji are dealing with many of the same problems as us - a shortage of healthcare professionals, an alarming increase in chronic and degenerative diseases like diabetes, heart disease and cancer, as well as substance abuse, domestic violence and poor nutrition.

While Fiji is known for its golden sand and cocktails-in-coconuts, it's also known for its lax, casual concept of time - "Fiji time" - which has presented problems for Australian teachers expecting punctuality from their students. Away from the beach, beyond the bargain-hunting tourists, Fiji is a republic rocked by persistent political unrest. Across its 18,000 square metres, 300 islands and 814,000 people, there are 17 hospitals, 1,750 nurses and just 300 doctors. With insufficient training, nurses in the Pacific Islands are not only short-staffed but ill-prepared for natural disasters - which is especially dangerous given that the region is particularly prone to earthquakes and tsunamis.

Nurses and academics from JCU intervene in the provision of health services in Fiji with as much cultural sensitivity as possible. Far from imposing Western ideology, nurses from JCU have diligently worked with nurses in Fiji to accommodate their values. The JCU team is vigilant about discussing the relevance of their programs with Fijian students, and they typically co-facilitate learning with local tutors.

One fine Fijian afternoon, a nursing student snuck into a classroom, grabbed a piece of chalk and scrawled on the blackboard: "We're going to be transformative nurses!"

This joyous, chalky declaration is proof that Australian academics are making progress training Fijian nurses to be confident and competent in the delivery of health services. Representatives from JCU run courses as part of an AusAID-assisted initiative called the Fiji Health Services Improvement Sector Program, which promotes emotional intelligence and self-awareness in addition to practical training in disaster relief and emergency response.

Professor Ian Wronski, Pro Vice-Chancellor of the Faculty of Medicine, Health and Molecular Sciences at JCU, is an avid supporter of the program. He's excited when he speaks about the WHO development and clearly very proud of his staff.

"The WHO generally opens doors. Doesn't give you much money! But it provides a fantastic network in a region that really needs it. Nursing is the backbone of the world's health systems and it's so important to have leadership and solid relationships with countries in the West Pacific and South East Asia."

James Cook University is also home to a WHO research centre for tropical diseases and medicine. "Of course we have to go for grants to facilitate our research in both schools, but that's the game."

The WHO accreditation is an honour, and an asset to any university conducting international research, but it's clear that improving the standard of nursing in the region is Usher's main priority- the work her team did before becoming a WHOCC has been remarkably successful, but it's far from over.

"Nurses are the biggest part of the health workforce, in all countries. They're on the frontline of disaster relief, and we've got a long way to go but we can really make a difference in a country, and we've learned a lot along the way ourselves."

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