Nursing Visionary

Afaf Meleis, dean of the School of Nursing since January, cannot be pinned down. Born in Alexandria, Egypt, the scholar has made her mark all over the world—from the Middle East to Latin America to Southeast Asia—and rightly earned the title of citizen of the world.

For more than 30 years, she has been at the forefront of women’s health issues, championing causes like gender equity and the redefinition of women’s work. She is currently the council general of the International Council for Women’s Health Issues, an international consortium of nurses who seek global solutions to health care.

Formerly a professor at the University of California at San Francisco, Meleis now leads the School of Nursing during a time when nations worldwide are battling a shortage of nurses. With the issue taking on global proportions, Afaf talked about the role of nurses in the world and how Penn Nursing is making an impact far beyond the boundaries of the campus.

Q. What is on your list of priorities for Penn Nursing?
A.
To prepare students who are citizens of the world.

Q. How do you do that?
A.
You do that by having international traffic, by providing opportunities for students [through] exchange programs, by having international students in the school, by [giving students] the opportunity to see nursing in the context of world affairs. I think nursing has the potential of being the vehicle for international peace.

Everybody needs a qualified nurse in the world. If we play a role in preparing the best nurses and the best leaders of nursing in the world, we [will] have the core group who can be our ambassadors for enhancing peace.

Q. Do you think society values nurses in this way?
A.
Everybody is beginning to realize how important nursing is and how vital it is for patient care. We really can’t think of a healthy healthcare system without having a healthy group of nurses and a healthy environment for nurses to work in. I really think the public right now should be enraged with some of the new research that is coming out about how the [nursing] shortage is risky to their health. The public should be demanding…not only adequate number of nurses but nurses who are allowed to do what they do best, which is provide care for patients rather than provide care for papers and taking care of other things that people less qualified could do and could do really well.

But there’s another reason why I think it’s an exciting time for nurses. For the first time in the history of the World Health Organization a strategic plan has just been developed for nursing and for nurses. In the strategic plan there is a request that all the [administrators] of health in the world be accountable for the shortage of nurses….

In this school, we have a role in helping develop policies for quality care. I believe we have a role in also preparing the leaders in different parts of the world that would lead to development of knowledge but also would lead to the development of better models of health care.

Q. What attracted you to the School of Nursing?
A.
The reason I made the move was because I was really impressed with the distinguished faculty. This is a school of nursing that is part of a campus that is interdisciplinary. I came with the idea that this is going to be so exciting because the students here are able to be a part of a whole campus and to take courses in different schools and the faculty are partnering with other members of the faculty. Our schools are very well-connected, and we call on each other to provide programs that are very rich and interdisciplinary.

Q. Such as?
A.
With the School of Medicine we have developed a master’s program in public health that [includes] nursing and medical students and other students on campus. Another joint program is with Wharton…and there [are other] programs with the School of Engineering, Law and Annenberg.

[But] it’s not only that formal programs are there. It’s working on new initiatives that always brings people together on this campus. A couple of things have happened since I came. The deans got together and decided to do something on bioterrorism. ISTAR (Institute for Strategic Threat Analysis and Response) was created from those initial meetings when the deans got together and said, We have a role to play, a role that’s joint. It’s those things that have been extremely rewarding to me. There is a joint mission rather than a fragmented mission.

…Another initiative that the dean of the School of Medicine and myself created is our mission and goal for making our schools even more prominent internationally. We decided we would create an initiative related to global issues in women’s health.

Now what are we going to do with that? We are going think about training that’s joint training. We are thinking of joint research projects. We are positioning ourselves to be able to attract scholars from different parts of the world.

Q. And what are some of those issues in women’s health?
A.
There are two important conferences that happened that placed women’s health internationally in a completely different context. The Beijing Conference [on] Women’s Health and the Cairo Conference, both of which have made the point loud and clear that we need to think about women development if we want to work on anything related to their health. If we want to prevent HIV infection in low-income women in the world we cannot work on the disease and the prevention without looking at women’s situation—how oppressed they are, how they are living in inequitable situations.

[We have to look at] early detection of diseases, prevention of illnesses, dealing with aggression against women and violence against women within a development context. None of those we could work on without working on women’s education and increasing their equity and their voice.

Q. How does Penn Nursing integrate these two approaches—the medical and the sociological?
A.
Nursing science is about responses of human beings to illness situations. It’s not about the disease. It’s about how people experience the disease, live with the disease, deal with the disease, and develop strategies to prevent it and to treat it. Penn Nursing looks at nursing science from that perspective. That means that there are some biological basis to it, socio-cultural basis to it and psycho-behavioral basis to it. The research [conducted here] includes all those in trying to frame the care that’s provided.

Q. You are a known international scholar. What do you bring to Penn Nursing with such an international background?
A.
I bring the experience of [having been] an international student to the United States [Meleis pursued graduate degrees at UCLA] first of all, having come here and experienced the amazing generosity of professors and colleagues who have helped me in learning about this country and learning about nursing here. I think I’m a far better mentor of students in general because of that experience and having seen what worked and what didn’t work for me personally. I also bring the perspective that there is another side to every issue.

 Afaf Meleis