1. Wytenbroek, Lydia
  2. Grypma, Sonya

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I[Lydia] embarked on my first international nursing experience in 2006, 4 years after graduating with my bachelor's in nursing. A professor encouraged me to volunteer as a nurse in Africa, so I contacted a Christian organization in Tanzania and a few months later was working alongside a handful of Tanzanian-trained nurses at a mission clinic. The patients at the clinic only spoke Swahili. To help me learn the language, the clinical staff spoke to me only in Swahili; initially I felt overwhelmed and alone. I had few connections to home with no access to Internet or telephone, but when my time was up, I was sad to leave. I had managed to learn enough Swahili to communicate with patients and had formed wonderful friendships with the Tanzanian nurses.

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I wrote my master's thesis about the international experience of a Canadian nurse, Margaret Campbell Jackson, who was employed by the World Health Organization (WHO) from 1954 to 1956 and stationed in Tehran, Iran, where she participated in the establishment of a maternal and child health (MCH) center (Wytenbroek, 2012). I was fascinated by her story; we had both worked as international nurses. While Jackson was in Iran, she wrote 180 letters to her family. Seventeen months into her contract with WHO, Jackson informed her family that she was "heartily fed up" with her work in Iran and was "finding the mental strain more than one person should be asked to carry" (Wytenbroek, p. 25). The difficulties she encountered were plentiful. Her placement in a distant, unfamiliar country precipitated culture shock and loneliness. The locale presented unique challenges, such as a shortage of supplies, equipment, resources, and staff. She was unable to communicate with her Iranian patients in the local language. Recognizing she was unable to "get anywhere with the work" (p. 35) unless she learned Farsi, she arranged to take two weekly hour-long language lessons. She eventually abandoned the lessons as she found the language too difficult, but her Iranian-nurse counterpart spoke English well and was able to translate.


Within months of Jackson's arrival, a new MCH center was established. Over the next two years her tireless efforts to initiate a field-training program for healthcare providers included cultivating relationships within Iran's Ministry of Health. Although she was discouraged at the lack of progress, by the time she left Iran, Jackson had secured two students from a midwifery school to come to the clinic to receive hands-on training.


Reflecting on my work in Tanzania, I wonder if I would have been better prepared for the challenges had I first read Jackson's letters. As I've since learned, North American nurses have been working internationally since the late 19th century (Grypma, 2011). As a nurse and aspiring historian, I believe there is value in learning from the trials and successes of our forebears like Margaret Jackson. Not only does learning about nursing in 1950s Iran help us anticipate and identify contemporary challenges, it also provides insight into broader social and political influences that shape international nursing, and puts contemporary Iranian news into a new perspective.


Nurses have long taken encouragement from Galatians 3:28 to adopt a view of others-as-ourselves: "There is neither Jew nor Greek, slave nor free, male nor female, for you are all one in Christ Jesus" (NIV). Living in a globalized society where Iran and Tanzania seem like just a computer click away, we may forget the effort it takes to work across lines of difference related to language and culture in our pursuit of health for all. But, as the work of Margaret Jackson attests, it remains a worthwhile pursuit.


Grypma, S. (2011). Missionary nursing: Internationalizing religious ideals. In M. Fowler, S. Reimer-Kirkham, R. Sawatzky, & E. J. Taylor (Eds.). Religion, religious ethics, and nursing (pp. 129-150). New York, NY: Springer. [Context Link]


Wytenbroek, L. (2012). "I don't think I want a career with this WHO": The challenges of international nursing as experienced by WHO nurse Margaret Campbell Jackson in Iran, 1954-1956. Unpublished Master's Thesis. Master of Arts in Interdisciplinary Humanities, Trinity Western University, Langley, British Columbia. [Context Link]