Nurse practitioner student serves the underserved in India

Soon to be a nurse practitioner, Robin Herb conducts a physical assessment on an elderly Indian woman complaining of stomach pain. “They have it right. They take care of each other.”

"Life transforming” is how Robin Herb, B.S.N., R.N. describes a 14-day trip to Puttur, India. From December 27, 2009 to January 9, 2010, the graduate student from Villanova University College of Nursing used her winter break to serve the underserved with a Christian church group based in Mohnton, Pa. to assist the Good Shepherd Mission in Puttur. Puttur is in the southeast area of the peninsula about 2 hours inland from the Bay of Bengal, in the state of Andhra Pradesh. As Herb triaged local residents to be seen by physicians, handed blankets to grateful members of a leper colony who traveled long distances, and helped dedicate a new HIV/AIDS center, she saw the impact on this agricultural community.

Herb is wife and mother from Reading, Pa. where she is also a nurse in a cardiology practice. She is earning her master of science in nursing degree as an adult nurse practitioner (NP). In 2009, friends connected her to the Calvary United Methodist Church which organized the trip with 10 volunteers from all walks of life. She was later struck by how each member of the team was critical to the effort in aiding the Indian population.

Since mission work has been of interest to Herb, she soon began her immunizations against typhoid and hepatitis A, in addition to preventative malaria medication, for the experience. She packed her stethoscope, a blood pressure cuff and an intrinsic sense of cultural acceptance that served her as well as the nursing tools. Herb says one of the reasons she came to Villanova and the College of Nursing was the overall sense of acceptance she felt on campus. “I took that with me,” she says, along with knowledge gained from a recent lecture on cultural sensitivity to NPs by Elise Pizzi, M.S.N., CRNP, assistant professor. Herb said it helped her comfort level while interacting with a community dealing with serious health and poverty issues. “I was not going to try to change hundreds of years of culture,” she explains. She appreciated the balance the people achieved between the Hindu and Indian traditions. “It reminded me of what the College does. No matter what someone’s background, we accept them,” she offers.

One of three nurses in the group, Herb was in constant motion. The Mission has established a hospital with just over a dozen beds. Herb triaged patients there and visited with those who calmly and pleasantly waiting for extended periods of time while sitting on the lobby floor. Women would watch each other’s babies without fear of strangers. “No baby was crying” remembers Herb, as each child was attended by another woman if the mother was unavailable. She also gathered with children from the orphanage on the grounds. Fifty girls sleep on the floor, keeping all of their belongings in a tiny footlocker. As they and their male counterparts get older, they are encouraged to assist the Mission. Many of the staff members there were supported by the Mission earlier in life and stay to give back to the community.

Herb and the group moved out of the compound to make and lay bricks for the Mission’s HIV/AIDS Support Center on the outskirts of town, the closet parcel of land that the community would offer for these stigmatized patients. At the same site, they celebrated the dedication of the facility with music, prayer and colorful decorations provided by area residents.

Herb traveled with others to three remote villages to triage patients for five Indian physicians. One day there were 800 patients who had waited in line. Each was seen. “There were all types of physical complaints,” notes Herb, though many were musculoskeletal problems related to their life of hard labor in the local rice paddies or peanut fields. Many walked for miles when they heard of the scheduled arrival of the medical team. Because of language and resource barriers, Herb was especially grateful for her NP physical assessment skills and the ability to listen (via a translator who spoke the native Telugu) as she obtained a patient’s medical history. Patients were also able to get a few simple medications such as mild analgesics, antibiotics, antacids and skin creams.

“I had not a clue what life was like for them,” states Herb of the Puttur residents who now have a hold on her heart. “They are the most gracious, appreciative people and they have nothing.” After meeting the people with leprosy (a bacterial disease causing, ulcerations, severe infections and deformities) who are considered to be the lowest caste or level in the society, she recalls “They were so thankful for a $2.00 blanket.” What was her key lesson from the people of India? “They have it right. They take care of each other.”