USIS Washington File - December 29, 2008
Washington - A groundbreaking program called Nurses Strengthening
Our AIDS Response, or simply Nurses SOAR, is sending nurses
specially trained in HIV/AIDS care from the United States to
hospitals and clinics in Africa to act as mentors for
increasingly burdened nursing staffs.
In 2007, sub-Saharan Africa accounted for 75 percent of AIDS
deaths and 67 percent of people living with HIV, according to the
United Nations' biennial report on HIV/AIDS. Much of the burden
of caring for the stricken has fallen to nurses.
SOAR funding comes largely through the President's Emergency Plan
for AIDS Relief (PEPFAR) and is administered by the Health
Resources and Services Administration, a division of the U.S.
Department of Health and Human Services. Launched in 2003 and
renewed in 2008, PEPFAR is "the largest commitment by any nation
to combat a single disease in history," according to the PEPFAR
Nurses SOAR is a partnership among the Georgetown University
School of Nursing and Health Studies in Washington, the
Association of Nurses in AIDS Care, the Duke University School of
Nursing in North Carolina, the Catholic Medical Mission Board in
New York and health care organizations throughout Lesotho, South
Africa and Swaziland.
The purpose of Nurses SOAR is to strengthen nurses' capacity to
deliver HIV/AIDS services. The program does this by building the
leadership skills of nurses, building communities of self-care,
building HIV/AIDS knowledge and clinical skills, and emphasizing
applying the knowledge in clinical nursing care.
Many of the activities are implemented by expert HIV/AIDS nurse
volunteers from the United States and faculty from Georgetown and
A COMMITTED CREW
All SOAR participants must be certified in HIV care, be members
of the Association of Nurses in AIDS Care and be committed to
improving nursing care, said Kevin Mallinson, an assistant
professor at the School of Nursing and Health Studies at
Georgetown University and the program's principal investigator.
"All members are volunteers," Mallinson said. "They volunteer
their own time," and the program provides funds for travel,
lodging and meals. Since January 2008, the program has sent some
35 nurses to be mentors in Africa, each for three to five weeks.
Each site receives two or more mentors at a time. After one group
goes home, others may come to pick up where they left off.
"The reason I believe in this program is it's not about you. You
can't expect to go over there and be the only person to make a
difference," said Sandy Sheble-Hall, one of the first mentors
deployed. "You have to believe the program will make a
From his 26 years of experience as an HIV/AIDS nurse, Mallinson
says he understands the needs of a nursing staff bombarded by a
deadly epidemic. Many programs that send health care workers to
Africa focus on intensive classroom training on complicated
topics, he said, but SOAR is "teaching people the basics."
In recent years, because of initiatives like PEPFAR,
anti-retroviral therapy has become available in some parts of
sub-Saharan Africa. Anti-retrovirals can boost the immune system
and keep down the level of virus in people with AIDS, a radical
shift from the relentless deterioration faced by people with AIDS
before such therapy became available.
"Nurses there have experience with AIDS, but they don't have
experience in anti-retroviral treatment. It's a big black hole,"
said Sheble-Hall, who along with other SOAR mentors coaches
patients and nurses about side effects of the new drug regimes.
"If they take [anti-retrovirals], they may initially feel sicker.
This side effect will go away, but imagine giving someone
something and they feel worse," Mallinson said. "Mentors can help
with communicating this idea."
A unique facet of the Nurses SOAR program involves grief
"People here are overwhelmed by debilitation and death. Orphan
numbers are beyond belief," Mallinson said. "One in four nurses
where we are now has HIV. They have to deal with their own HIV as
well as family members who die."
Because dealing with HIV/AIDS emotionally burdens the nurses, as
part of the program, Mallinson takes them away for a weekend of
grief counseling and fellowship.
"After a communal intervention to help nurses deal with their
loss and grief, they become bonded," Mallinson said. "One of the
most successful things the program has achieved is this
Initial funding for SOAR will end in May 2009. If funding is
renewed, the program will extend from three to six the number of
countries it serves.
And SOAR organizers are not worried about running out of U.S.
nurses willing to participate - of the 33 SOAR nurses who have
come home, 31 have asked to return, including Sheble-Hall, who
will go back to Africa in March.
"Everyone says it's kind of a life-changing experience. I will
attest to that," Sheble-Hall said. "I can't wait to go back. I
just loved it."
More information on Nurses SOAR is available on the Association
of Nurses in AIDS Care Web site.
More information about PEPFAR is available on the program's Web