I was recently asked this question by a group of oncology nurses, each of them eager to engage and contribute on a global scale, but frustrated by not knowing how to begin. My own foray into global oncology work was actually quite serendipitous—largely a matter of being in the right place at the right time. When a physician from the International Network for Cancer Treatment and Research came to visit the cancer center where I was practicing as a palliative care nurse practitioner, a colleague introduced us. As luck would have it, there was a need for a palliative care nurse to travel to Nepal to help with a collaborative training project; I leapt at the chance. That first trip was transformational, personally and professionally, and set me on my current path.
The recent UICC World Cancer Congress reminds us of the urgent need to address the exploding global cancer burden (which disproportionately impacts low and middle income countries) and the vital role oncology nurses play in this work. In this post, I outline my top suggestions for oncology nurses who are interested in global health work, and recommendations for how to get started. Many of these are rooted in personal lessons learned, and things I wished I’d done differently myself. Global health work isn’t for everyone; it’s tough and challenging, and isn’t particularly conducive to family life. But it is also immensely rewarding and interesting, and provides an unparalleled opportunity to gain a broader perspective of how health issues impact people around the world. Committed oncology nurses are well poised, and needed, to make a difference!
- Get relevant experience and develop a meaningful skillset: It may seem obvious, but your ability to contribute, and your marketability to global health organizations, will be substantially greater if you bring solid oncology experience to the table. This experience may be as a clinician, educator or researcher, depending on the needs and focus of the global health project. Clinically, experience in chemotherapy administration, radiotherapy, palliative care and symptom management (especially pain management and wound and ostomy care), and cancer screening and early detection are all particularly valuable skills. A huge need in many low-and-middle income countries is workforce capacity building and training, so garnering experience not only in oncology knowledge and skills—but also in how to teach and evaluate them—will help make a positive difference. In addition to oncology nursing knowledge and experience, it is important to be informed about delivering culturally sensitive care and global health issues in general. I highly recommend medical anthropology and public health coursework in preparation for global health work, and this doesn’t require shelling out big bucks for University classes. Coursera offers many good free on-line courses related to these subjects; for example, Introduction to Global Health, is currently being offered by the University of Copenhagen. Books such as Improvising Medicine can provide insights as to the realities and challenges of cancer care in a low-income country.
Network, network, network: Someone once said luck is what happens when preparation meets opportunity. In the previous bullet point I talked about the importance of preparation. Helping preparation meet opportunity is all about networking. It really is true that experiences and opportunities often boil down to who you know. I got my life-changing global oncology opportunity because I told my physician mentor I was interested in global health work, and then one day she connected me with the right person to make it happen. Spread the word to colleagues and friends that you are interested in global health work. You just never know who may be the critical link.
A crucial, and efficient, way to network is to put yourself in situations where you are interacting with lots of global health practitioners. A great way to do this is by attending conferences. But conferences (especially international ones) are a big time and financial commitment, so it is important to choose wisely. Personally, I have had the most networking success at the International Union for Cancer Control World Congress and the International Conference on Cancer Nursing. Other key conferences worth checking out include the Global Nurses Caucus and the Oncology Nursing Society Congress.
- Join the conversation: A terrific and helpful virtual global health community is GHDOnLine. A diverse group of global health practitioners from all over the world contribute to this forum and job openings and volunteer experiences are commonly posted. Lancet Global Health, Lancet Oncology, CancerWorld and our very own OncLive are other on-line opportunities to learn about global health topics, get ideas, and dialogue with others.
- Research organizations where you can volunteer or become employed: It is important to find the 'right fit' between the organization/project or group you will be working with and your personal goals, values and life circumstances. For example, working with a faith-based global health organization (such as Mercy Ships) was not a good match for me, but it may be for others. I also didn’t feel my skillset and general personality was right for Doctors Without Borders, and due to job and financial considerations at the time I could not commit to a period of prolonged fieldwork. Instead, I sought an organization committed to collaborative, longitudinal projects related to oncology palliative care that involved 2-3 weeks in the field per visit. It took a while, but I eventually found the right match through the International Network for Cancer Treatment and Research Palliative Access Program. Depending on your flexibility, SEED Global Health, Partners in Health, the World Health Organization, the Center for Disease Control and Prevention, the American Society of Clinical Oncologists International Cancer Corps Volunteers, the Oncology Nurses Society and Global Oncology all offer programs that may work for you. If you are a student, many Universities and Schools of Nursing have international initiatives or Centers for Global Health; the experiences offered may not be oncology-specific, but can provide a good way to get a flavor for global work and see if it’s for you. You may also want to explore opportunities through the Fulbright Program or NIH Fogarty Fellowship, especially if you are a faculty member or nurse scholar. There are some other good lists of global health nursing organizations here, here and here. Again, they are not all oncology-focused, but it's a way to get started.
- Harness the power of social media: FaceBook and Twitter make connecting easier than ever before, and offer a unique opportunity to learn what is currently trending and getting global attention. It’s also an efficient and inexpensive way to get the highlights from global health forums and conferences you may not be able to attend in person, and learn about key papers and publications related to oncology global health issues. Open a Twitter account and follow leaders in the field, such as Jim Cleary, Stephen Connor, Julia Downing, Betty Ferrell, and Felicia Knaul as well as key organizations such as UICC, NCIGlobalhealth, ACSGlobal, and GlobalNursingCaucas.
What have I forgotten? What else should be recommended to oncology nurses who wish to start engaging in global health? I’d love to hear! You can send me a tweet at @virginialebaron