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Asking the Right Questions

“The pungent reality — that I can only help one person while a hundred others suffer and die — led to the profound understanding that we must lift-up one-another, help one-another, strengthen one-another — every nurse and every midwife at every level…. Only time separates us from the next humanitarian emergency – most likely in an impoverished nation.”
Michele Sare, CEO & President,
Nurses for Nurses International

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Michele Sare, MSN, RN, CEO & Founder, Nurses for Nurses InternationalNFNI), Professor, Public Health, Montana State University — with some of the Haitian children she helped during the 2010 earthquake. Used with permission.

Creating Community Health Assessment

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Photo Montage of the team who colllaborated with Michele Sare to achieve NFNI’s 1st Community Health Assessment in Haiti in 2012. Left side down: Junior Beavais, Interpreter; Karrin Sax, MSN, WHCNP; Moise Yraus, Guide; Jesse Conn, IT, Video & Travel Coordinator; Jonas Armand, Transport; Right side down: Ayla Landry, BSN, RN MSN/MPH(C) at the Fondwa Orphanage; Rigan Lewis, BSN; Shana Klinge, LNP, with Haitiian child; Martha Desir, RN, Nursing Standards Advisor, Linda Strenik, NFNI Joint Advisory Board. Photos used with permission by NFNI.

In June of 2012, a team of four US nurses and one Haitian liaison nurse — all from Nurses for Nurses International (NFNI)— joined a Haitian logistics team to establish the first-ever Community Health Assessment in Fondwa, Haiti, an agricultural community, three hours outside of the capital, Port Au Prince. About 8,000 people, mostly farmers, live in this remote region and have no consistent access to even basic health care. Fondwa is part of the region of Léogâne, which was at the epicenter of the January 2010 earthquake.

This first phase of a detailed standard-based Community Health Assessment (CHA) is looking at the needs of a core population of Haitian women 18 to 25 — people of child-bearing age whose need for ante-natal, maternal and post-natal healthcare form the foundation for all of their primary health-care concerns.

This project was developed by Michele Sare, CEO of NFNI, in response to the request of Madame Irma Marie Bois, the Director of Nursing at the Haitian Ministry of Population and Public Health. She said, “Michele, we need help with standards for health care.” Along with Ayla Landry, then a student at the Johns Hopkins University’s MSN/MPH program — and President of the NFNI-Foundation — they designed a survey based on the UN MDGs and the Social Determinants of Health as well as the new US Public Health Accreditation Board’s standards for a CHA (Domain 1).

Michele has traveled to Haiti five times, first to assess Haiti’s needs for public health — but arrived 40 minutes before the January 2010 earthquake there (see more below). According to Michele, this Community Health Assessment is the first piece to getting the right information. “We cannot build standards without solid information. We have to ask better questions to get better answers.” Rather than going to Haiti to tell Haitians what outsiders think they need, instead, Michele says, “we ask what do you need? What’s going on? Then we can build, with the Haitians themselves, the right kinds of skills and ‘walk along side’ to help them.”

This work will take a year to complete with at least four more trips planned. The findings will be shared with Haiti's Ministry of Public Health and Population (MSPP). Michele also notes that, when this Community Health Assessment is completed, “we will help the stakeholders — other NGOs in the area and the leaders within the community, to again ask, ‘what do you need? What do you want to build a community health improvement plan?”

It is anticipated that this assessment will serve as a model for other rural areas of Haiti — and resource poor settings across the globe. This kind of professional Community Health Assessment has never before been performed nor published for this area. It will put into place the building blocks needed to truly build the systems and processes to improve the health and well-being of the people living in Fondwa, Haiti. Watch the video>>

Earthquake! Commitment to Telling the Story of the Power of Care & Haiti’s True Heroes

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Above photos are from Michele Sare’s photo archives of the January 12 2010 7.3 earthquake in Haiti, used with permission.

On Tuesday afternoon, January 12th 2010, Michele Sare had just landed at the Port au Prince International Airport in Haiti. She was there to “see what it would take to teach a public health nursing course” and to learn more about public health needs of Haiti — the poorest nation in the Americas. Just while she was leaving the airport with her bags, the now-infamous 7.3 earthquake struck and she immediately began her fateful adventure to serve the immediate health care needs of people in Léogâne, injured and displaced from this catastrophe. She recalls, “its kind of like being tossed in the middle of a snow globe and having my life shaken real hard [but with] a more beautiful view of what my life can be — because of Haiti…. They are the poorest people on the Western Hemisphere, but Haitians are remarkable human beings and have taught me a great deal.” To commemorate the third anniversary of this earthquake, watch this video>>

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Watch the video >>  Cover graphic for ‘Today, Léogâne,’ used with permission.

On Sunday January 17 — five days after the quake claimed over 350,000 lives, leaving a million homeless and injured hundreds of thousands in just seven seconds — Michele listened to CNN, ABC and Sky News reporters talking about Léogâne —the earthquake epicenter — as a 'village.’ She knew — from her own immediate on-the-ground experience — that Léogâne was instead a region of 300,000 people where the UN declared that 80-90% of ‘everything’ had been destroyed.

From this, Michele also knew that Léogâne, Haiti was a place that the world forgot for six terrible long days. The stories of what happened in Léogâne — before the influx of international aid on Monday January 18 and the days following — had not been told. Thus she knew that she must tell her own story and the story of the people who helped her to help so many more during those unforgettable days. Her story — dramatically recalled in her book — Today Léogâne is available as a paperback here>>   e-book here >>

“Nurses have a long history of stepping in to a crisis and making things right. Today, Léogâne is an amazing story, written by a nurse, with incredible passion for the job she loves and honoring the beautiful people of Haiti, she came to help….From the minute I picked it up, I couldn't stop until the end.”
Kathryn Price RN BSN MSN FNP Family Practice & OB-GYN

JOIN! —An Online Journal for Nurses & Midwives Worldwide

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Connecting the stories of nurses and midwives from around the globe! Sharing issues that affect the world of nursing and midwifery! The first issue of the inno- vative online journal — JOIN — was launched in January, 2013.

A long-held dream of Michele Sare’s, this journal is where the world’s nurses and midwives are to be given a voice to share common problems and offer solutions — and to share uplifting and inspiring stories. It has been created to learn more about challenges and best and innovative practices from fellow nurses and midwives across the globe. Its overarching purpose is to endow and empower nurses and mid-wives to lead — because together — we can reverse injustice in healthcare. Graphic introduction (left) to this journal is used with permission. Read more >>

“By Uplifting A Nurse or A Midwife,
We Uplift An Entire Community”

Nurses for Nurses International (NFNI) reaches across borders, to some of the world’s most disparate regions, to support, uplift and inspire nurses and midwives — nurses and midwives whose lives mirror the disparity of those they serve.

Since 2005, NFNI has advanced successful legislation to support rural and frontier public health, innovated, designed and implemented a landmark rural nursing education program, provided nurses in Haiti with personal protective equipment [PPE] and nursing supplies, worked to get student nurses basic immunizations after the Haitian quake, provided direct aid in the heart of the Haitian earthquake, provided maternal–child health in Nicaragua, worked with Ministries of Health to develop standards for practice, authored two books to strengthen the role and perceptions of nurses and many other initiatives to strengthen nursing and midwifery in areas where our peers face the greatest challenges.

NFNI’s purpose and methods are to uplift, inspire and connect nurses and midwives — to help each claim their powerful voice of care. “By uplifting a nurse or a midwife, we uplift an entire community.” Together, 17 million nurses and 18 million midwives can turn the tides of healthcare injustice. NFNI offers a suite of products that deliver on this commitment to inspire and uplift the professions of care. Watch the Nurses for Nurses International video>>

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Logo of Nurses for Nurses International, used with permission

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Visitors at the Mapparium in the Mary Baker Eddy Library in Boston, Massachusetts. This was the site to launch Dr. Jean Watson's Million Nurse Project—during the 2010 International Year of the Nurse—to radiate heart-centered Love, Caring and Compassion through individual and collective global meditations. Photo Courtesy of the Mary Baker Eddy Library.