1. Alexander, Greeda RN, RM, MSc(N)

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5:00 a.m.: Greeda Alexander wakes before the cock crows. After spending quiet time in prayer and meditation she moves on to her kitchen to prepare food for the family. As a faculty member at the Christian Medical College, College of Nursing's Community Health (CONCH) Interior Department, she has a joint appointment with the community health nursing department as case manager and supervisor serving the rural villages near the city of Vellore in the state of Tamil Nadu located in southern India. Sipping the hot brewing coffee, Greeda plans for her day.

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7:30 a.m.: "Sing unto the Lord a new song," nightingales of the college sing as Greeda enters her office. Loads of work ahead ... "I can do all things through Christ who strengthens me," reads the tabletop verse on her table. Staff and supervisors come in, one after the other, to Greeda's room to discuss the schedule for the day.


8:00 a.m.: On the bus that takes all of them to the rural village area, Greeda, with her black bag and umbrella, gazes out the window at the bypassers in the road. People of different color and creed, vendors selling flowers and vegetables, honking cars behind the bus, cart and bull trying to compete with the bus, slowing everyone down. "Ah," says Greeda. "Everyone in their own world."


8:30 a.m.: Beautiful flowers of the field, coconut leaves swaying in the breeze, the smell of the morning lilies, and the sunshine over the golden green paddy fields all together remind Greeda that they have arrived at the village.


8:45 a.m.: After stopping at the clinic, Greeda arrives on foot at the home of Mr. and Mrs. J. Greeda's memory reaches 10 years back when she met this family. That was the time when Mrs. J. learned that she was HIV positive during routine antenatal checking. She pleaded with Greeda not to reveal her status to anyone. During one of the home visits, Greeda found Mr. J. suffering from severe breathlessness, productive cough, and mouth sores. Greeda used this opportunity to refer him to the infectious diseases clinic where he was found to be HIV positive. The World Health Organization estimates that the prevalence of HIV in India to be 2-3 million people (World Health Organization, 2007) India hosts the second largest population of HIV-infected people in the world, second only to South Africa (World Health Organization, 2007). Over the years, Greeda has counseled the couple, identified health needs, made appropriate referrals, and facilitated the antiretroviral medicine regime that prevents opportunistic infections and controls their HIV infections. Greeda's thoughts are interrupted by the arrival of Mrs. J. with a big broad smile. After exchanging well wishes, Greeda spends time with Mrs. J getting to know about her condition and current treatment. She provides teaching on nutrition that will improve the health of Mrs. J. and her family.


10:00 a.m.: Greeda arrives at the home of her next patient. A beautiful young lady, tears rolling down her rosy cheek, narrates her family problems to this trusted nurse. She listens to the 23-year-old woman as she describes a multitude of problems. To Greeda's surprise the husband of the young lady is lying on the bed fast asleep and snoring. Sobbing, she tells Greeda that he was on psychiatric drugs that he stopped taking, and is having a lot of suspicious grandeous ideas and is not willing to go for work. She verbalized in between her sobs that they never followed up in the outpatient department due to financial problems. The husband awakens and rises from his bed. He wishes Greeda good morning and continues to say that he is not able to be out of this medication and he needs help. After counseling him Greeda gives a referral for the psychiatrist and arranges for an appointment for the husband. Greeda also assesses the young man's mother who had a recent hysterectomy, and after reassuring the family, she sets off to walk to the clinic.


12:00 p.m.: Greeda returns to the center, tired of walking in the scorching sun with an outdoor temperature of 39[degrees]C (102[degrees]F). Closing her eyes, she offers a prayer in her heart for the young lady's soul to be at peace and her husband to be healed. She hears Muniyamma, the helper and the member of the geriatric club, screaming at the top of her voice. Greeda peers in the center and sees all the geriatric club members getting ready to do exercise, with Muniyamma leading them, shouting "1 ... 2 ... 3." Smiling to herself, Greeda joins in the fun and teaches them a new exercise. Later, as Greeda assesses an infant with a cold and fever clinging tightly to his mother, she sees the members of the geriatric club go away with thankful hearts, bidding goodbye to the staff nurse who gave away the refreshments.


1:30 p.m.: After a short, refreshing lunch break, Greeda attends the leaders' meeting with the local leaders of the village to discuss a new health education project on environmental sanitation followed by a mass health education program to be carried out by the master's level students in the village. The leaders appreciate Greeda and Christian Medical College for their work in the village and agree that they will extend their full support.


3:00 p.m.: Junior staff nurses and the fourth year graduate nursing student walk beside Greeda as they get ready for a group health education program near the banyan tree in the end of a big street. Stiff and smart, the student delivers a health education session on the importance of a well-balanced diet. Greeda helps the student to demonstrate high-fiber and high-protein recipes.


4:30 p.m.: Back to the office after another bus ride and a busy, tiring day. The other staff drop into Greeda's room to report on the day's activities in their own assigned villages. Greeda locks her office and heads home.


6:00 p.m.: After a refreshing bath Greeda writes in her daily journal, "Thank you Lord for a fruitful day. I pray for all the lovely people whom you put in my hands today." She gets off her couch to her kitchen to prepare supper for her family.




World Health Organization. (2007). 2.5 million people in India living with HIV according to new estimates. Retreived from[Context Link]