Building capacity in Afghanistan

November 2013   Comments

A Canadian Armed Forces nursing officer trains and mentors Afghan nursing instructors as part of Operation Attention

My first deployments to Afghanistan were as a critical care nursing officer in Kabul (2004-2005) and in Kandahar (2007), providing care to coalition forces. When the Canadian Armed Forces (CAF) ceased combat operations in this country in the summer of 2011, itsHealth Services professionals shifted their focus from caring for sick and injured coalition personnel to mentoring and capacity-building within the Afghan National Security Forces (ANSF). We work shoulder to shoulder, or shohna ba shohna, with the people of Afghanistan, as part of the mission code-named Operation Attention.

LCdr Joni Forsyth at work with nursing instructors at the Armed Forces Academy of Medical Sciences in Kabul.
MCpl Frieda VanPutten

Since July 2013, I have been a member of the Armed Forces Academy of Medical Sciences (AFAMS) advisory team, a cross-section of 26 health-care professionals, administrators and training development experts. We are continuing the work of others who were involved in rebuilding the Afghan National Army medical training system and mentoring the academy’s senior leadership. We have been working closely with our Afghan counterparts to create appropriate programs of instruction for 14 health-care occupations, which include pharmacy technician, dental therapist and combat physician assistant. Our focus is curriculum development and training the trainer — to ensure that once coalition personnel depart, a solid system for instruction is in place.

The instruction program for nursing students is well established and has had more than 100 graduates over a five-year period. A recent expansion of the curriculum from one year to two years allows for increased time spent in skills labs and greater clinical exposure. Although the program length is a positive step for the profession, the result is that the severe nursing shortage in the ANSF will be further exacerbated. For that reason, one of my current tasks is to finalize instructional material for an eight-month nursing assistant course, aimed at increasing the numbers of front-line caregivers in a short period of time and removing the burden of much of the day-to-day care from family members and fellow patients.

Nursing in Afghanistan has seen growth and change over the past decade since the arrival of coalition forces within the country, with knowledge, skills, concepts and technology introduced at an unimaginable rate. Today, nurses attend advanced cardiac life support courses, present at hospital grand rounds and have access to the same equipment the CAF uses to care for critically ill patients. In 2007, a patient bed with a mercury sphygmomanometer mounted on the wall was considered an ICU bed, and nursing practice in what we would understand to be a critical care context was non-existent.

Operation Attention ends in March 2014, with the conclusion of the fourth rotation of personnel. As the final nursing officer to be working on the AFAMS advisory team, I have the privilege of being the “last out” and sharing this story as a chapter of our military and nursing history comes to a close. It is my hope that nursing students completing the courses we have developed, learning from instructors we have mentored, will become the backbone of the ANSF health-care system. I wish for the peace that Afghanistan so deserves and so desperately requires to sustain the progress that has been achieved in the very recent and tumultuous past of this ancient country.

LCDR Joni Forsyth

LCDR Joni Forsyth, is a Critical Care Nursing Officer in the Canadian Armed Forces. She is mentor to the Chief of Nursing Services for Canadian Contribution Training Mission - Afghanistan. In previous deployments, she has served in Afghanistan and Bosnia-Herzegovina. She is currently posted to Edmonton.

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