Program enables professionals to be respiratory care ambassadors.

 Janet Boehm, MS, RRT, far right, joins other delegates with the People to People Ambassador Programs on a safari in South Africa.

When Janet Boehm, MS, RRT, first learned about a trip to South Africa for respiratory care professionals planned by the People to People Ambassador Programs, she knew it would be an opportunity of a lifetime—and it was.

“My goal was to learn about South Africa and the health care system there, and to learn how respiratory therapy fit into the puzzle,” Boehm says. “Respiratory therapy is a [profession almost exclusive] to the United States and Canada, and a few other nations that are starting to develop it, so I wanted to see where they were as far as the development of the profession.”

People to People Ambassador Programs was developed by President Dwight D. Eisenhower to provide professionals with educational experiences abroad. Through meetings, seminars, and cultural activities, participants have the opportunity to meet people in similar professions overseas.

Last March, the group organized a 2-week trip to South Africa for respiratory care professionals led by Boehm, a professor in the Department of Health Professions, and director of clinical education for the respiratory care program at Youngstown State University in Ohio. The 14-member delegation included a combination of RTs and nurses.

The itinerary included tours of private and public hospitals in Johannesburg, Cape Town, and Les Marais, a suburb of Pretoria in the Gauteng Province. The delegation also participated in meetings with the Gauteng Health Department and the Critical Care Society of South Africa, and a roundtable discussion in the Department of Pediatrics at Stellenbosch University and Tygerberg Children’s Hospital in Cape Town.

The trip was designed as an informal, cultural exchange of information.

“We didn’t want to go to South Africa and say, ‘The American way is the best way.’ What works in America might not work in South Africa,” Boehm says. “It was more of a dialogue, a roundtable exchange of information. We got to see what they did, and then we told them what we did.”

“We were going to Africa to share information. They learned from us, and we learned from them. Everyone had positive attitudes,” adds one of the participants, Carrieann Novicky-Averell, CRT, who works in the Cardiothoracic Anesthesia Respiratory Department at the Cleveland Clinic Heart Center in Ohio.

While touring the various hospitals, the participants got an overview of each facility, learned the responsibilities of the respiratory care staff, and had an opportunity to ask questions.

“The procedures and equipment are basically the same as we have in the United States,” Boehm says, “but it’s who does [the respiratory care] that changes.”

For the most part, South Africa does not have respiratory care departments and staff, as such, except at Groote Schuur Hospital in Cape Town, which has a ventilator technician. In the public hospitals, or state hospitals as they are called in South Africa, it is mainly the physicians who are responsible for ventilator care. In the private hospitals, it is mostly the nurses, known as sisters, who are responsible for it.

“We went to different private hospitals that were state-of-the-art and had a small patient-to-doctor ratio. They were the equivalent of our major hospitals,” Novicky-Averell says. “We also went to a huge public hospital, where they had an overwhelming patient-to-doctor ratio. They had up to 250 people in their intensive care unit to care for. They exhibited remarkable teamwork to accomplish this.”

Boehm says that while she views South Africa as being more proactive than the United States in the identification and treatment of individuals with HIV and AIDS through the earmarking of federal funds for such programs, the same cannot be said for South Africa’s work on respiratory health care. Boehm recalls seeing children being paid to burn tires in the shantytowns, which also burn coal.

“All of these people are inhaling this polluted air,” she says, “so there’s a high incidence of pulmonary problems, including COPD and emphysema.

“Because they’re spending so much money on HIV and AIDS, they have no initiative for [identifying and treating] COPD, which is the fourth leading cause of death in the world,” Boehm says, adding that more money and people are needed to screen for and treat respiratory problems.

 Carrieann Novicky-Averell gives a presentation on the Cleveland Clinic Heart Center to a critical care society in South Africa.

As part of the exchange, the delegates gave presentations on various respiratory care topics, and an overview of the facilities where they work.

“They asked us a lot about our profession and what we do in the United States. They were really curious about how we fit into the health care team. We had some nurses with us, and they talked about the value of respiratory [practitioners] in the critical unit, working side-by-side with the nurses and the physicians,” Boehm says.

“They’re experiencing a shortage of physicians and nurses, just like we are,” she says, “so they are completely overwhelmed with these other tasks that respiratory does in the United States.”

The heavy workload has made it next to impossible for the hospitals’ staffs to become educated on all of the available treatments and technologies in respiratory care.

While the profession is more advanced in the United States, Boehm says respiratory care in South Africa is “ready to evolve into a full-blown profession.”

As part of the mission of the People to People program, the delegates each brought something to donate to the hospitals they visited, including academic books, medical journals, and other materials. They also passed out 1-year memberships to the American Association for Respiratory Care to some of the hospitals so that people could go online and conduct research and gather information.

The packed schedule included only one free day, which included a visit to Kruger National Park, as well as a voluntary side trip to Zimbabwe for a safari.

The trip, for which participants could earn continuing education units, also served as a study of the health care system in South Africa that People to People plans to publish as a book. Each participant was responsible for writing a chapter for the book.

People to People Ambassador Programs is planning another trip for respiratory care professionals in March 2007, to either Australia or Russia.

Danielle Cohen is a staff writer for RT.