Some international aspects of nursing.

Abstract

The spread of countries and diverse subject matter in this issue, together with evidence of increasing collaboration between authors, is encouraging for INR's international objectives. The guest editorial by Lis Wagner, an INR editorial board member, reports on Denmark's 20 years’ experience of providing an integrated health care model for older persons. It is rare to read of such long-term follow up, and encouraging to see the success of this project with international dissemination and take up of the policy objectives elsewhere. Older people and their individual needs for water is the subject of a paper from USA. The article references recent international activity on the right to universal access to clean water. In 2003 (the UN International Year of Fresh Water), ICN celebrated World Health Day by highlighting the critical importance of safe water in the health of children and issued a revised position statement (http://www.icn.ch/pswater.htm). ICN also became a founding member of the International Network to Promote Safe Household Water Treatment and Storage, led by the World Health Organization. A year is a long time in politics, and it is ironic that in May 2003 Linda Thomas, Editor in Chief, RCN Publishing, could write that ‘some of the most poignant images from Iraq are those of children pleading for water from journalists and the military’1. How quickly our concerns can change! A recent article in a British broad sheet newspaper showed how developed world governments frequently renege on their commitments to water aid because it is not as newsworthy as assistance in other areas. Yet, in focusing on poverty for this year's International Nurses Day theme on 12 May, the lack of clean water and sanitation is listed by ICN as the second major problem related to poverty, preceded only by malnutrition2. 6000 children a day die from infections caused by poor sanitation. Because poverty and health are interlinked, actions for nurses to take include applying pressure to local, national and regional governments. The USA article in this issue shows that whilst many nurses need to function professionally with individual patients, there also is a crucial need to remain aware of broader needs and to take action at many different levels. Other articles in this issue include nurses’ perspectives on care of the dying, and symptom management for HIV/AIDS patients. Each is written from local perspectives in Brazil and Norway, respectively, and the authors do not claim wider generalization from their findings. The international implications of these papers may nevertheless stimulate nurses who wish to reflect on their own practice in the light of the experience of others. Local accounts can foster understanding between nurses working in very different situations. This may lead to closer working relationships and appreciation of mutual problems, as in the article on collaborative research on leg ulcers between Swedish and UK researchers, or in the evaluation of training courses in Ethiopia carried out collaboratively with researchers in the Netherlands and Denmark.