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July, 2019

A World Traveler Settles Down at CUA

By Anne Cassidy

Assistant Dean of Nursing Mary Paterson.

If it’s Tuesday, it must be Uzbekistan. That’s not exactly what Associate Professor of Nursing Mary Paterson felt during her years of health care consulting around the globe. But at times it came close, as Paterson worked for weeks, months or even years in such countries as Egypt, Iraq, Kyrgyzstan, Macedonia, Malawi, Russia and, yes, Uzbekistan.
“The first trip I made for the American International Health Alliance (AIHA) they said, ‘Do you want to go to Uzbekistan and teach a health care financial management class?’ and I said, ‘Sure, but where is Uzbekistan?’ ” Paterson recalls. This was in 1992, and Uzbekistan had only declared independence from the U.S.S.R. in 1991. 

But once she learned where it was, Paterson was off to this central Asian republic for a few weeks to teach the class. 

With a Ph.D. in health care policy (and a concentration in finance) from the School of Public Health at the University of California at Berkeley, Paterson found tremendous opportunities to help health care professionals following the breakup of the Soviet Union in 1991. 

But she also realized she had much to learn. On her first day in Uzbekistan, a woman in the apartment where she was living kept gesturing at the bathtub. “I couldn’t figure out what she was trying to tell me,” Paterson says. “Was I dirty? Then I figured out that the water was turned off every night. People filled up their bathtubs with water during the day so they’d have enough to wash and to flush the toilet in the evening and the next morning. Otherwise, you were stuck until they turned the water on again in the afternoon for two hours.” 

Paterson, B.S.N. 1980, became assistant dean of undergraduate programs at CUA's School of Nursing last summer and is responsible for admissions, academics and other matters relating to the school’s undergraduate program. She says she was attracted to CUA because she is an alumna of the school and also “because of its values based approach. I wouldn’t work in a place that didn’t have that emphasis.”

Lab Coats, Stethoscopes and Social Workers

Paterson’s experiences in Uzbekistan were just the beginning of her education in cultural diversity. Once she walked into a new medical clinic in Egypt only moments after the end of a fist fight. “We’d just equipped the doctor with a new stethoscope and a lab coat and here he was all disheveled, the nurses were crying and so I asked, ‘What on earth happened here?’ What happened was that a man had come in with vague symptoms and the doctor had asked the man in a polite way to please take off his jacket so he could take his blood pressure. The man got upset and started fighting with the doctor, saying, ‘You’re just trying to get more money from me,’ ” Paterson recounts.

“In Egypt there was no primary care to speak of. If a person got sick in Egypt their first thought was to go to the hospital,” says Paterson, who spent two years on a pilot project sponsored by the World Bank, the European Union and the U. S. Agency for International Development (USAID) to help open nine primary health care clinics in the Egyptian port city of Alexandria. There she came face to face with the reality of a country with little to no primary medical care.

“Many of the nurses had never seen a stethoscope,” she explains. There were no charts or records. Patients expected doctors to sit behind a desk and write prescriptions — not to examine people. After the fist fight, “that’s when we realized we had to bring social workers into the waiting room to sit with patients and say, ‘This is a different kind of health care, this is what happens when you go to see the doctor.’ ”

From 1992 to 2003, Paterson visited more than a dozen countries, some of these trips as a consultant for AIHA and others as a principal associate of Abt Associates, a government and business research and consulting firm. While her specific projects varied, she was usually either teaching classes on the financial aspects of health care, managing projects or training doctors, nurses and other medical professionals. Each country was an adventure: She built up her classical CD collection in the Czech Republic, went grocery shopping in Skopje, Macedonia, and got scurvy in Moscow. She says she knows a little bit of a lot of languages.

From May to August of 2003 Paterson went to Iraq to help rebuild its health care system. It was an impossible job, she says. “The design of the project was based on a vision that we’d have a conflict and the conflict would be settled, everything would be secure and we could go in with teams of people and rehabilitate clinics and reconstruct hospitals and bring in medications. What we didn’t think well enough about was the whole security problem.”

Paterson says she spent a lot of her time in Iraq “hiring security guards and staying alive.” Before the conflict, Iraq had “one of the most advanced health care systems in the Middle East,” she says, but afterwards the infrastructure was “just gone.”

Paterson’s experiences in developing countries has left her with a deep gratitude for her good fortune. “Once you’ve done this kind of work you begin to realize that what we think are problems, challenges and crises here are not the order of magnitude that many people face,” she says. She also became convinced that the way to help the world is through education — and that led her to academia, and, fortunately, to CUA. 

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Last Revised 25-Jan-06 10:10 AM.