Professor, student team up to study impact of foreign medical missions

Lindsay Jarman started volunteering on mission trips shortly after graduation as a nurse from Georgia Southern University - in Kenya, Honduras, Ecuador and Zimbabwe - to help provide a range of primary, preventative and community-based care solutions in developing countries across the world. She also participated in a global medical partnership with Emory University that took her to Vietnam.

"I worked in an emergency room in downtown Atlanta at the Level 1 trauma center. It was dynamic and challenging, and I always felt like that was my domestic service, but I've always had an interest in global health, and volunteering abroad was my passion," Jarman said.

Having kids and moving to Charlotte from Atlanta in 2023 put the brakes on Jarman's overseas volunteering, but she still harbored a desire to help others. Her sister-in-law will graduate from East Carolina University's BSN program this academic year and recommended that Jarman explore the options that the College of Nursing offers.

Jarman had previously enrolled in a Georgia university's graduate nursing program in 2022, but after a semester, things just didn't feel right. ECU's online BSN to Ph.D. program offered something different, something closer to the direct impact she had while on health promotion trips overseas. She could learn from home while caring for a newborn and conduct research that promises to impact the lives of exponentially more people by shaping the way that members of other medical missions engage with in-need populations across the globe.

"I originally came into this program wanting to correlate social responsibility and nursing fulfillment," Jarman said, and fate - in the form of her instructor, Dr. Bege Dauda - led to the nursing education career and research she wanted to pursue.

The class

Jarman was in a class that Dauda, an assistant professor of bioethics and global health ethics at the Brody School of Medicine, taught this summer. During perfunctory introductions the first week, Jarman discussed her interest in global health and experiences impacting health systems in developing countries.

"I was like, 'Wow, this is really good, you've been to Kenya and all those places. I think we have something in common - I'm originally from Nigeria,'" Dauda said. "She told me about her work in those countries and I told her it would be interesting for us to develop something together."

The course was an introduction to basic research ethics, Dauda said, which is beneficial for all students from ECU's health sciences disciplines to be exposed to. Part of Dauda's intentions with the class is to have his students explore what happens when Western health care professionals have fleeting interactions, and limited long-term commitment, to communities they parachute into for short duration missions - however well intentioned.

"When it comes to providing services or doing research in developing countries, we try to have a set of ethical guidelines because people in developing countries are vulnerable; they are disadvantaged in terms of health and infrastructure," Dauda said. "We need good, ethical frameworks so we are not just providing beneficial services, but we are also respecting them and their culture."

Dauda stressed the importance of having Jarman in his class because nurses have unique perspectives they can bring to the classroom.

"Ethics of care is important in nursing because nurses are experts in taking care of patients, so there is a lot of emphasis in the care for the patient," Dauda said.

The research

Jarman is interested in how short-term medical mission trips impact nurses, what tools their experiences give them, and how those experiences broaden their horizons.

"I want to relate social responsibility and global health to nursing. If a nurse participates in social responsibility, volunteers and is active in their community will that make them happier? Will that keep them at the bedside longer? Will that increase their satisfaction?" Jarman said.

There is some evidence, Jarman said, that short-term medical missions, often under the auspices of churches, can do more harm than good if not planned and executed through the lens of ethical responsibility.

Medical professionals who participate in mission trips need to know the people in the communities they serve and the ethical rules that dictate supporting those communities in need, both abroad and those in their own backyards. Efforts that don't support sustainability and capacity building once Western mission trip members return home will ultimately fail to bring lasting change, Jarman said.

"Something that I've learned is that when you move out of your comfort zone and put yourself in a new experience, those experiences help you understand different cultures and ways of life here at home too," Jarman said.

While she is still working to refine her specific research focus, Jarman is hopeful that she can leverage the experiences of College of Nursing faculty and students who have participated in the college's long-running mission partnership with communities in Guatemala and other overseas service-learning opportunities.

Jarman sees the value of a longitudinal study of ECU faculty and student experiences in Central America to learn how nursing professionals appreciate their ethical responsibilities to developing world communities and whether their experiences translate to more empathetic and socially conscious care for patients at home.

"What's it going to do if we bring a limited supply of hand soap and then it's gone? It's better to do some education and preventative measures like teaching caregivers how to identify signs of infection," Jarman said of the thought process that frames more ethical care.

Jarman's partnership with Dauda is culminating in a commentary article to submit to academic journals that blends Jarman's experiences and education with the ethical research that Dauda taught in the class she attended. They also hope to share their findings at the Consortium of Universities for Global Health meeting in Atlanta in February.

"I'm thankful for the time that he's put into our experience. He doesn't have to do this and he's met with me every couple weeks to talk and encourage my writing," Jarman said.

Dauda is equally complimentary of Jarman for her energy, enthusiasm and commitment to learning, and the diverse experiences that breathe life into her research narratives.

"She has an enthusiasm that I've never seen before; she drives me to work even harder. She comes with questions that are insightful and valuable to the project, so I enjoy working with her," Dauda said.