Imagine there's no countries, it isn't hard to do. Nothing to kill or die for and no religion too. Imagine all the people living life in peace.—John Lennon
Encarta describes the word “global” as relating to or what is happening throughout the entire world.1 The word “poverty” is further defined as not having enough money to take care of basic needs such as food, clothing, and housing or a lack of something.1 These words are important because Journal of Emergency Nursing is participating in a global theme issue on Poverty and Human Development during the months of October and December. The October issue will focus on some of the roles emergency nurses have performed in caring for patients in parts of the world with limited access to health care. The December issue will feature articles that highlight the role of ENA in human development throughout the world through our Trauma Nursing Core Course and Emergency Nursing Pediatric Course.
In many countries across the world, limited contact with basic health care makes it difficult to even consider the need for emergency care. However, the need to focus on immediate and urgent care interventions, particularly in a major crisis such as an earthquake or a flood, have pointed out the necessity for a different view of the role of emergency care in global health care.2 Emergency care systems require 3 components: emergency care at the scene of the illness or injury, care during transport of the patient, and finally, a receiving facility where additional care can be provided.2 A focused effort toward developing minimum guidelines for emergency care globally is needed. This need presents a significant challenge for all emergency nurses to consider.
Emergency nurses have answered the call to provide care throughout the world. In this issue, we have chosen to feature some of their stories. Two medical missions, one to the Honduras and one to Pakistan, taught some emergency nurses about the challenges of culture and work environments very different from the emergency department. A unique story demonstrates how a group of ENA members sponsored a nurse in Bolivia, which has allowed this nurse to remain in her community.
In March of 2005, I was part of a medical mission team that went to Rach Gia, Vietnam, to repair cleft palates, lips, and burn scars. As an emergency nurse for 30 years, I was quite prepared to work with multiple patients and teach nurses, physicians, and families postoperative and basic wound care. We even taught the ED staff cervical spine protection. Figure 1 shows the emergency department at the multi-bed facility, where patients were required to have a family member to cook and care for them and a mosquito net to protect them at night because the only enclosed areas were the critical care units and the operating suites!
Figure 1. Emergency department in Rach Gia, Vietnam.
There are times when the world will bring some of its incredible ugliness to our doorsteps. Richey3 discusses the care of the victims of torture. Unfortunately, as the author notes, torture is common in many parts of the world and its victims, many as refugees, will come to the emergency department seeking care. When I worked in the emergency department at the University of Utah, a Somalian refugee was brought to us for care of her posttraumatic stress related to the sexual assault she had endured by multiple soldiers in a camp.
The responsibility of emergency nurses to the world will only continue to grow. The content of the October issue of the Journal exhibits how some emergency nurses are working throughout the world, caring for others, something we do quite well. We must consider what role we would like to take in making health care, particularly emergency care, available to all.
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