In Myanmar, oncology expertise travels from nurse to nurse

Image of global health team with nurses in Myanmar Through the Dana-Farber/Boston Children’s Global Health Initiative and World Child Cancer, oncology nurse Amy Federico, RN, CPNP, had the opportunity to travel to Yangon, Myanmar, to share her oncology expertise with the staff at Yangon Children’s Hospital. Amy’s interest in global health began eight years ago, but the trip to Myanmar in October 2017 strengthened her commitment to share her knowledge across borders. Amy, who is a nurse practitioner specializing in care of patients with solid tumors at the Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, reflects on her experience abroad:

My interest in global health care has developed over the past eight years since I started attending the Society of International Oncology Pediatric annual conferences. So when Lisa Morrissey, MPH, MSN, RN, CPHON, asked me to join her and Kathryn Barrandon, MPH, BSN, CPN, on an educational trip to Myanmar, I enthusiastically accepted.

One of the pediatric oncologists at Yangon Children’s Hospital requested solid tumor nursing education so I knew this would be a wonderful opportunity to share my years of oncology experience, especially my expertise in caring for patients with solid tumors. The experience would also give me a better global perspective of health care delivery in another part of the world.

On October 27, we set off on our 22-hour, three-leg, 8,300-mile journey from Boston to Yangon. I realize now, more than ever, that access to health care depends upon where you are born and where you live.

The day after our arrival, Lisa, Katie and I toured the oncology ward. I was astounded by the overly crowded — yet oddly quiet — patient bays, ill-looking children and desperate-yet-hopeful parents. Occasionally, a parent or patient would poke his or her head out a door or up to a window, curious about the three of us visitors. Admittedly, I was saddened by the environment.

The next day, I was relieved when we returned and were greeted by 32 energetic and excited nurses from nine hospitals across four Myanmar states. In addition to providing oncology education, our goals were to advocate for specialty nursing practice and to provide collegial support to conference attendees.

Over the next three days, Lisa and Katie taught about a variety of topics including fluid and electrolyte management, infection control and general nutrition assessment. I presented on various solid tumor diagnoses, treatment options and nursing care. I also taught educational modules on how to interpret complete blood count tests and understanding the implications of bone marrow suppression. We also provided “hands on” time covering best practices for handwashing, skin and ostomy care, wound assessment and growth chart plotting.

A network of support, regardless of geographical distance

There were many highlights of this trip, but I was particularly inspired by the networking, relationship building and mentoring between the nurses from Yangon Children’s Hospital and the visiting nurses. Everyone was so encouraging to each other in spite of having just met. It was so inspirational to see nurses teaching nurses!

Amy Federico, RN, CPNP of Dana-Farber/Boston Children's was part of a global health trip to Myanmar
Amy Federico, RN, CPNP of Dana-Farber/Boston Children’s

I was also impressed by the attitude of the oncologists, who were exceptionally supportive of the nursing staff by promoting nursing education, camaraderie and friendship, both inside and outside of the hospital.

This experience was more rewarding than I had ever imagined. I returned home humbled by the excellent — and oftentimes creative — care that the team at Yangon Children’s Hospital provided in spite of their limited resources and challenging staffing ratios. While I knew Yangon is a city of little means, I was shocked by the degree of poverty. At the same time, I was inspired by the fearless spirit of the staff, patients, families, and community members.

While we sometimes take our own access to superior health care and resources for granted, it is important to recognize our ability and duty to share our wisdom with others who are less fortunate. I realize now, more than ever, that access to health care depends upon where you are born and where you live. I am grateful for this unique opportunity to share my education, my expertise, and myself with those who need it most.

Going forward, I am committed to providing moral support and a mentoring presence to the nurses in Yangon via online networking formats. It’s important that they know how much we care about them and their work, and that we support them, in spite of our geographical distance.

Learn more about our Global Health Program.