“I just don't understand how you could be a nurse if you don't know the Lord,” says Dorothy Chirindo, acting director of the nursing school at Karanda Mission Hospital in Zimbabwe. “I see a lot of fear of the death, death and dying, and I see a difference in a nurse from elsewhere who does not know the Lord or is not even exposed to Scriptures. They’re also afraid of death and dying.”
While death is a daily reality in a remote country with an HIV/AIDS pandemic and the highest rates of cervical cancer in the world, Chirindo takes comfort in knowing she’s not just training the next generation of healthcare providers in her country; she’s also paving the way for the spiritual renewal of future generations.
“I’ve realized that for [these] nurses, who have done their best to take care of a very sick patient when there’s no other hope ... if they know the Lord, [it means] going to everlasting life, and the suffering is gone,” Chirindo says. “This is why I really have liked participating in this program – because it gives that hope.”
Giving physical and spiritual hope has been the mission of the staff at Karanda Mission Hospital since it opened in 1961. It includes a three-year nursing school, a one-year midwifery program and a primary school for children of the hospital staff. The hospital also offers a home-based care program that ministers to the needs of widows, orphans and those with HIV. Five chaplains on staff help meet the spiritual needs of patients through daily devotions and grief counseling services. Doctors perform 3,500 surgeries and 2,000 deliveries a year, as well as treat HIV/AIDS, tuberculosis, obstetrics and hydrocephalus patients. The hospital has 130 beds and sees 200 to 300 outpatients come through the doors each day.
The hospital is not only successful in its treatment of patients, but also in its training of future healthcare workers. Their reputation for excellence is known across the country. “When I travel to different cities of Zimbabwe, everywhere I meet nursing graduates from this school and [hear] how they’ve worked hard, they’ve been promoted,” Chirindo says. “They’re in key positions in the ministry of health. It makes me feel good to see how much we have contributed to the ministry of health in Zimbabwe.”
The nursing school opened at Karanda in 1962. Over the years, the school has trained an estimated 400 to 500 nurses. The three-year, state-accredited program for registered general nurses began in 2001 and currently enrolls 45 students. The school receives well over 1,000 applications for the coveted 15 to 20 spots open to first-year students.
THE HIGH PRICE OF EDUCATION
Higher education is highly valued because the opportunities are so rare. With so many applicants, the students take their acceptance and enrollment very seriously and at the expense of personal sacrifice. The first year proves to be especially grueling.
Cheryl Jereb, a TEAM missionary and nursing instructor, explains, “Many of them struggle with the English language, so the schooling in itself can be quite challenging. As well, they’re leaving their family for a three-year program,” she says. “Most of them come from at least an hour away. With transportation barriers in this country, it might as well be five or six hours. And they’re leaving spouses; they’re leaving their young children for other people to raise. So it’s really a sacrifice to be here. Emotionally, it can be quite a toll on them. My door is open for academic stuff, but I find them in my office more often for emotional support and spiritual support.”
That social, emotional and spiritual connection is what drives Jereb as a teacher. “That’s why I’m here and not in the States. I tell my students, ‘I don’t want you just to be a good nurse. I want you to be a Christian nurse. I want you to be a nurse with integrity and morals. I want you to have compassion for your patients,’” she says.
Quite often, Jereb sits at her desk across from a student with a Bible open and tissues in hand, praying. “We go through the Scriptures together, and we pray over their family and pray that they can take what they’ve learned medically to be a good nurse, but then to bring the gospel with them back to their community,” Jereb says.
Kiersten Hutchinson, who has worked as a physician assistant at Karanda since 2000, has seen students overcome the difficulties of their situations.
“It can be quite stressful for the students. And yet, we see that being also a wonderful opportunity to show the power of Christ in their lives, and that Christ is capable of meeting those needs in their lives,” she says. “By the time we get to the third year, the students are looking back and saying wow, look at the hand of God.”
Judy Parker, a nurse and educator who has served at Karanda for 25 years, believes the integration of the gospel into the students’ training is key.
“A good nursing student for Karanda is one who has an interest in people, is caring and compassionate, has good academic passes in high school subjects and has an ability to learn how to think. They also must be willing to work hard,” she says. “We don’t expect every student to be a Christian when they come to us, but we pray that by the end of their three years, they will know the Lord and will have grown as a Christian. It is only with God in their lives that they can have that caring and compassion needed for nursing.”
Patricia Chishiri, the director of nursing at Karanda Mission Hospital, says that one way to become a good nurse is to love the work, and it’s hard to separate that from the love of Jesus and his compassionate example toward those in need. “We are trying to train the best nurses in the country, because we teach them about the love of Jesus, and it is only Jesus who can give us strength and can give us motivation,” she says. “Other than just doing a dressing, taking blood pressure, giving drugs, they have to show love.”
Mr. Mahoko is in his final year of nursing school. He’s married to a nurse aide at the hospital and they have a 2-month-old son. Juggling family life, work and school is understandably difficult. He wasn’t sure he could make it, but other students encouraged him to stick with it. “It’s a demanding course,” he says, which is why it’s important to focus on spiritual life as well as schooling.
“If you look at the definition of nursing, it doesn’t really necessarily mean the administration of medicine to the sick, but it also focuses on the spiritual life of the patient,” Mahoko says. “Sometimes the illness might be spiritual, so you need also to address the spiritual part. We as student nurses at this hospital also need to revive our spirits so we can deal with the patients. That’s why every day you can see us going to the morning devotions before we start work.”
HOPE, EVEN IN DEATH
Mildred Mumanye graduated this year from the nursing school and now works as a nurse full-time in the hospital. Her prayer for patients is that they would “know God first and have hope in their life” — that they would have hope in life, even as they face death. It’s a critical reality for not just the nurses, but also for the students. Chirindo recounts the story of a student who had failed one of her exercises. She wanted the opportunity to practice before she retook the exam, and so she was given a patient who was dying. It was a cold morning and the doctor on duty wanted her to give the patient blood. When the student realized the patient was not going to live, she invited his wife to come and be with him. “She wanted to tell the patient about Jesus,” Chirindo says.
As the student was preparing the tubes and equipment to give blood, she removed the blood bag she had been carrying inside her uniform to warm it before it entered the veins of the dying man. She held his hand and told him that Jesus loves him and asked to pray with him and his wife. The patient died soon after.
“I’ve never been able to forget that girl on that cold morning with the ice cold blood on her chest to try to warm it up for the patient,” Chirindo says. “[It was like she was thinking], ‘This patient must live, but if [he dies] it is fine because I’ve talked to him about Jesus.’ That has been very meaningful to me, and it was a student whom I didn’t even know how much she had grown in her faith because I thought that student didn’t know the Lord.”
EXCELLENCE THROUGH PARTNERSHIP
Friday Chimukangara, known affectionately as Mr. Chim, is the acting hospital administrator and says there is a good relationship between the hospital staff and the nursing school — mainly because the need for help is as great as the need for experience. “Without the students, we wouldn’t be able to manage,” he says. “The training school is quite helpful in providing manpower for the hospital, as well as the hospital then provides the skills for the nurses, so when they qualify, they are better skilled as nurses.”
“They play a vital role in the performance of the hospital because they work and learn at the same time,” Hutchinson says. “They’re the ones who are actually implementing that work, and they’re also doing all the documentation that goes with that. But most important is the actual face-to-face patient care. Our goal, at least from my perspective, is not just to have good nurses. We also want to train godly nurses.”
The reputation of Karanda’s nursing school is unparalleled, thanks to their hands-on training and high pass rate for the state final examinations.
“Our graduates can be found all over the country of Zimbabwe at hospitals and clinics, often in leadership roles,” Parker says. “Karanda graduates have a good reputation and are shaping nursing in Zimbabwe in various capacities.”
Karanda’s one-year, state-certified midwifery school, which opened in 2005, received the Gold Medal on Midwifery in the country due to graduating the highest-scoring students.
“We have an impact not just on society around Karanda, but in the country as a whole and maybe the world also,” says Pedrinah Thistle, the nurse educator for midwifery. “Most of our midwives actually go out of the country once they qualify [because] any country will take them.”
Pedrinah Thistle says most nurses prefer to come to a mission hospital so they can benefit academically but also practically, because the mission hospitals tend to be given governmental status. Students receive a stipend from the government for attending.
REACHING INTO THE COMMUNITY
During their schooling, students spent 40 weeks as class time and the rest working at the hospital getting practical experience. Part of their journey includes an 18-week community health nursing program, where they spend time working in the rural villages and urban environments close to the capital city.
The needs are inexhaustible in a country of nearly 14 million. The World Health Organization (WHO) reports that there were fewer than two doctors for every 10,000 people in Zimbabwe from 2000 to 2010, and 80 percent of posts for midwives remain vacant.
When Karanda Hospital was established 53 years ago, it met the needs of mission outposts and then expanded into a larger facility where people travel great distances to receive treatment. But there is still a need to reach out into the countryside. Currently, Red Cross-trained volunteers go out from the hospital to work among local villages and communities.
Dr. Paul Thistle, a specialist in obstetrics and gynecology who came to Karanda in late 2012, pioneered a program to help equip those volunteers by giving them bicycles for transportation. “For our village health workers, our community volunteers, who are often unemployed, don’t have full-time jobs, and are rural subsistent farmers, having a brand new bicycle is like a kid getting a Lego set under the Christmas tree,” he says. “So it’s an excellent way to give them a sense of purpose and let them do their work better.”
The network of caregivers working together at the hospital and out in the villages brings hope to people of Zimbabwe. Mentoring and passing along knowledge from generation to generation helps extend that hope. And as this hope blooms in Zimbabwe through Karanda, Thistle says it reaches out and into the communities. “You realize that the eyes and the ears of the community are out there,” he says. “You can use people and help people help others. That provides a sense of community ownership that we’re here together for a common purpose to serve God and to serve the people.”
In order to serve even more people in the future, Karanda is expanding. They have three building projects planned for 2014. Having completed the new male ward, they seek to renovate and move pediatrics to the former male ward and then renovate the operating rooms, which will double the size of their operating theater. They’re also planning to build additional staff housing. As they expand, more national workers are getting involved with the ministry. The administration of the nursing school was recently turned over to a very capable national nurse.
“She will be the one to lead the school into the future,” Parker says. “God willing, it will continue for another 50 years in the training of nurses for Zimbabwe that incorporates both good physical and spiritual care.”
-Written by Cara Davis
-Photographs by Robert Johnson