Those we lean on most

AMERICAN-EGYPTIAN Professor Emeritus Dr Afaf Ibrahim Meleis has won this year’s Princess Srinagarindra Award for her contribution to nursing, healthcare and public health. 
Her Royal Highness Princess Maha Chakri Sirindhorn presided at the October 17 award ceremony at the Grand Palace.
Throughout her career, Dr Meleis, 76, has advocated for vulnerable women and promoted nursing to address their and their families’ and communities’ needs. 
Her passion for nursing and women’s health came from her mother, who was the first nurse from the Middle East to study in the United States. 
Seeing her commitment to the development of nurses and strengthening of their impact on society, the young Afaf realised that nursing could make a significant difference.
The World Health Organisation says nurses and midwives account for nearly half of the global health workforce and play a critical role in health promotion, disease prevention and primary and community care. 

“Ninety per cent of the nurses in the world are women,” Dr Meleis told The Nation. “If you empower nurses, you empower women. And we should be educating women anyway. 
“Most recent research shows that, if you have nurses who graduated in a baccalaureate programme or were educated in the hospital sector, you decrease the hospitalisation period overall – you send patients home earlier. It also enhances team spirit when people have equal knowledge and abilities, and it affects the outcomes. Patients get better faster and they stay well longer.”
Nursing education is crucial for a healthy society. A UN High-Level Commission on Health Employment and Economic Growth concluded that investments in education in the health and social sectors tripled the success of medical outcomes, global health security and economic growth.
“What we care about and develop knowledge about is different from other fields,” Meleis said. “Nursing is about the human being, not about illness. Nursing is about the human being’s experience and their responses to the illness. It’s the profession that focuses on the people, on the family and the community. 
“The phenomena about which we want to develop knowledge are very particular to human beings’ reaction and relationship to the environment and how the environment influences how they cope and deal with the situation. Many communicable diseases have been conquered, so life expectancy is much longer, but lifestyles have changed, with less walking and fewer activities, leading to chronic illnesses. Nursing is not about curing disease – it’s about living in spite of disease.”
Since nurses do most of the work at a health clinic, they know the clinic best. They provide and manage personal care and treatment and, most importantly, they are part of their local community, sharing its strengths and vulnerabilities, making them key persons to meet the needs of the ill and their families. 
Yet for all this, nurses are often treated as inferiors to doctors and those in other medical professions. They’re paid less, work more inflexible hours and enjoy fewer benefits.
“The gender difference is there because originally most physicians were men and most nurses were women,” Dr Meleis said. “But you can’t separate the oppression of the nurse from the oppression of women in general. They are very much interrelated. 
“Nursing began with Florence Nightingale, and in the Islamic world with Rufayda al-Aslamiyyah. There was no education for nurses – they learned through apprenticeship. The gender gap comes from legend, from culture, from history – the same reasons nurses are in this position.”
She cited an international government commission that sought methods to improve the health of women around the world. 
“The commission came up with a plan, saying, ‘If you improve nurse education, you improve women’s health and you improve the economy.’ 
“I see the changing face of nursing today. We will see nurses in parliament. We will see nurses sitting on hospital boards. We will see a nurse become minister of health. Nurses are making an impact.”
As she coaches future researchers, educators and clinicians, Meleis acknowledges that teaching and mentoring are both important – but believes mentoring is more sustainable.
“Mentoring involves really knowing the capacity of the person and how you can help them function up to the full capacity,” she said. “My mentoring goals are facilitating them, connecting them, continuing to the full support and really knowing them as an individual.” 
Healthy, give-and-take mentor-mentee relationships have enabled her to steer Thais into the nursing doctoral programmes at Mahidol and Chiang Mai universities and the four-university curricular consortium programme. 
That experience led Dr Meleis to co-found the International Network for Doctoral Education in Nursing, a non-profit professional association whose mission is to advance quality doctoral nursing education globally. 

 n The Princess Srinagarindra Award Foundation was established on October 21, 2000, in commemoration of the centenary of the birth of Her Royal Highness the late Princess Mother Srinagarindra Mahidol.
n The foundation enjoys royal patronage, with Her Royal Highness the late Princess Galyani Vadhana serving as president from 2000-2007 and Princess Maha Chakri Sirindhorn since 2008.
n The Princess Srinagarindra Award is conferred annually on a registered nurse, registered midwife or groups of either who have made significant contributions, through direct care, research, education or management, within or to their professions and contributed to the health and wellbeing of people around the world.