Bagooaduth Kallooa: “Our health system is dominated by the medical profession”

The International Nurses Day will be observed on Friday 12 May 2017.  In that context, News on Sunday meets Bagooaduth Kallooa who is currently a Nurse Educator at the Central School of Nursing.  He is also the Second Vice-President of the International Council of Nurses (ICN) based in Geneva and member of its Board of Directors, part of its Planning and Finance Committee.  

Could you tell us more about ICN?

ICN is a federation of over 130 national nursing associations and represents over 16 million nurses worldwide. As the global voice of nursing, it enhances and promotes the nursing profession and utilizes the voice of nurses to improve the health of individuals, communities and countries around the world.

What is the role of ICN in the global context?

ICN represents nurses at the World Health Assembly. ICN’s partners with other organisation like the World Health Professional Alliance and the International Confederation of Midwives on common health issues.

ICN is also a member of the steering committee and scientific committee of the International Conference on Violence in the Health Sector. Moreover ICN is a founding member of the Safeguarding Health in Conflict Coalition, which promotes respect for international humanitarian and human rights laws that relate to the safety and security of health facilities, health workers and patients during periods of armed conflict or civil violence.

 In May 2016, ICN signed a joint statement by member of the Health Care in Danger initiative, calling on the United Nations Security Council to adopt a resolution to protect healthcare workers in countries like Syria.

This year, ICN has chosen the theme ‘Nurses: A Voice to Lead, Achieving the Sustainable Development Goals (SDGs) Why? 

To tackle issues that affect people, the planet, prosperity, peace and partnership. 5Ps, the United Nations in 2015 adopted the SDGs. These consists of 17 goals: no poverty, zero hunger, good health and well- being, quality education, gender equality, clean water and sanitation,…. Climate action, etc…..

Nurses are front liners. Nurses are the major health workforce and they work in all settings- general, specialised and psychiatric health services, community based, in conflict zones as well as in major disasters. Nurses recognise the most important social determinants of health which include: poverty, economic inequality, social status, stress, education and care in early life, social exclusion, employment and job security, social support and food security.  Nurses are therefore the most important actors to advance this ambitious UN agenda of Universal Health Coverage and SDGs

You confidently say that Nurses are the most important players, but are they really delivering?

History is testimony that nurses have been at the forefront, caring for the most vulnerable and disempowered and working in incredible and sacrificial ways for the betterment of others health. Nurses caring for prisoners irrespective of what the crimes they may have committed. Nurses are on the roads caring for the homeless, drug addicts and sex workers. They are toiling in areas of conflict, in completely under-resourced, remote locations in the world. Nursing has often had to fill the gap where no other profession is willing or potentially able to work. Nurses see the health needs of the patient beyond the medical diagnosis. Nurses understand the links between wider conditions in which people are born, grow, work, live and age as well as the impact on the health and daily lives of individuals and population in an unequal world.

Unequal world! Anyone can be unhealthy. So how do you relate health to the unequal world? 

There is not only inequality between the rich and poor countries but inequalities within the same countries. The gap between the rich and the poor, the healthy and unhealthy, the educated and uneducated continues to grow. It is now well-recognised that social factors have a direct influence on how healthy a person is. Poverty for example sets in place a cycle that is difficult for anyone to break. Poverty also has immediate impacts on health. There is an obvious correlation to access to food, clothing and shelter. The lower the socio- economic position, the higher the risk of poor health and increased likelihood of premature death. Poor health can be attributed to inequity in the conditions in which people are born, grow, live, work and age. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels. 

Do you really believe that nurses have the level of understanding to correlate all these and to take the challenge to lead on this agenda in this unequal world?

I am more than convinced that nurses can make a difference. 

Nursing worldwide being a female dominated job reflects how women are treated in certain societies. Sadly, in the media, nurses are often portrayed as embodying feminine stereotypes, low-skilled handmaidens.  There is a tendency to value physicians’ work and to discount nurses’, thus reinforcing retrograde misconceptions of nursing in global society.

Moreover there are attitudinal constraints which are often entrenched in the views and policies of some medical professionals who believe that enabling nurses to work to their full scope of practice will adversely affect the quality of care.

Overwhelmingly, this is being disproved by strong evidences which demonstrate that nurses provide cost-effective, accessible quality care with greater or equal clinical outcomes and patient satisfaction to that achieved by medicine. Nurses are now throughout the world well educated, autonomous and practice on evidence gained from rigorous research. The quality of ICN conferences, publications and involvement of Nurses in policy formulation and implementation at local, regional and global levels are all tangible examples. To give you one example among so many is that the  current President of ICN, Judith Shamian was the only representative of health care professional to form part of the high level UN Commission on Health Employment and Economic Growth that was chaired by  former President Francois Hollande and co-chaired by President Zacob Zuma.

Do you evaluate the capacity of Nurses in Mauritius as equally effective to take the challenge?

Certainly they can if they are given all the resources and allowed to practice to their full scope. Sadly, we have constantly been undervalued for our contribution. Investment in the nursing sector has always been regarded as a cost rather than an investment with high return. Our School of Nursing, which exists since 1958, is one of the first training institutions. Run by nurses, our School has trained thousands of nurses who have served the Mauritian population with dedication. However, we are still waiting for our School to be restructured and upgraded. Nurses are autonomously leading units like the renal dialysis and they have even been recognised by the Public Service Excellence Award. Vaccination is another public health nurse-led program which has contributed towards the eradication and control of so many infectious diseases. Such examples abound.

However, our health system is still dominated by the medical profession. Nurses are not empowered. The few who dare to go against the mainstream are oppressed. Policies are tailored to benefit a group with vested interests at the expense of the vast majority. The gap between the rich and the poor is rapidly widening. The disparity in salary is unbelievable. Many families are still lingering in extreme poverty. Drugs, crime, road traffic accidents, suicide, child abuse are all impacting on health. There is an urgent need for strong political will. Nurses are ready to serve and lead.