Solidarity and sustainability: ICN Wellness Centres for Health Care Workers®


We gathered in the calm environs of the ICN Wellness Centres for Health Care Workers® in Swaziland, overlooking the garden with its generosity of fruit, vegetables and flowers. Grete Christensen, President of the Danish Nurses Organisation (DNO) and I listened carefully to Muzi Dlamini, Director of the Centre, speaking of the achievements and challenges during the Centre's six years of service to health care workers. We listened carefully because Muzi speaks softly like most Swazis, but also because the story is fascinating and we wanted to understand the critical elements of the Centre's success.

An early success was a country-wide Hepatitis B immunisation campaign that saw every one of Swaziland's health workers protected against this serious workplace infection. The Centre's holistic services for health care workers include home-based care that brings food sustainability along with medicines; HIV/AIDS testing, counselling and treatment in a secure and caring environment; wellness days for HIV positive mothers-to-be; access to stress management seminars and specialist staff; workshops to help cope with grief and loss; and more.

At Wellness Centres in Lesotho, Uganda, Malawi, Zambia, and soon Ethiopia, similar and other services are on stream or in the pipeline. Additional ones are resilience workshops for the adolescent children of health care workers; support groups for spouses; treatment management for HIV positive children of health care workers; and healthy lifestyle counselling for prevention and control of non-communicable diseases (NCDs).

For all the Wellness Centres, this range of care defines their solidarity with their colleagues. It supports the wellbeing, motivation and capacity of health care workers so they can care for others and underpins solidarity with their communities.

And what are the challenges? For Dlamini and the other Wellness Centre directors, the large challenges are clear: responding appropriately to an ever-increasing demand and ensuring sufficient resources to do this.

Sustainability is derived, created and recreated from the solidarity and resources delivered to the Wellness Centres from a variety of sources including ministries of health, the Stephen Lewis Foundation, BD Corporation, PEPFAR and locally based NGOs and international agencies.

But none is more significant or constant than the solidarity of national nurses associations (NNAs) in other parts of the world, namely Denmark, Ireland, Norway and Sweden. The NNAs in these countries have supported and collaborated with the Wellness Centres from the beginning.

‘They are our source of strength’, said Yayneabeba Tadesse, Director of the Wellness Centre in Ethiopia. ‘The international nursing solidarity expressed by their caring ways, technical collaboration, advocacy with key policy figures nationally and internationally and financial support is simply precious’.

The Swedish NNA (Vårdförbundet), a professional organisation and trade union, is concerned about the health effects on populations of an overworked, stressed and shrinking health care workforce. ‘These are some of the reasons why we are intensively trying to give the best support for our colleagues in Lesotho’, explained International Secretary Eva Szutkowska. ‘Also, our statutes guide all our activities. They include the UN Declaration on Human Rights and the principle that in all our affairs we must see to the international field and align our activities and strategic planning abroad and in Sweden. Our solidarity is built on our strong conviction that helping others is also to sustain oneself’.

For the Irish Nurses and Midwives Organisation (INMO), a basic organisational value drives their solidarity with the Ethiopian Nurses Association – in unity there is strength.

‘I know that our collaboration with Ethiopian colleagues for the Wellness Centre will unite and sustain both our organisations’, said INMO Past President Sheila Dickson. ‘We are excited about the fact that the Wellness Centres are nurse-led and tackling health and wellness issues that health workers face everywhere, including Ireland. We are learning too about strengthening the healthcare workforce so they are better able to meet the health needs of societies’.

The Norwegian Nurses Organisation (NNO) supports Wellness Centres in Malawi, Uganda and Zambia, believing that solidarity is critical in supporting nurses in Africa to remain at their workplaces and thereby contributes to sustaining health care systems on the continent. ‘However, for continued success and sustainability the Wellness Centres must also be supported by national authorities’, stated Michael Vitols, Special Advisor to the NNO. ‘Secondment of government personnel, provision of medicines, consultative arrangements with medical specialists and free access to treatment facilities in nearby hospitals form part of this important collaboration. The Wellness Centres are owned and run by NNAs. Partnership with government, as well as international partners, allows for a sustainable health care initiative addressing core issues regarding health and well-being of nurses and other health care workers’.

The DNO believes that their organisation gains strength and solidarity, new visions and results for all nurses by cooperating across borders. Grete Christensen explained, ‘We started our engagement with the Swaziland Nurses Association in 2006. The lack of health care workers, including nurses, due to poor working conditions, migration and diseases such as TB and HIV, was a serious threat to both Swaziland's health care and socioeconomic development. We believed that by supporting the SNA through the establishment of the Wellness Centre, we could contribute positively to change this downward spiral. And indeed we have’.

She continued: ‘Moral support, financial resources and organizational development back-up have defined the solidarity and close cooperation between the Swaziland Nurses Association and the DNO. We are proud to follow the sustainable development of the Centre closely and to see how the Centre's capacity has increased during the last six years, together with the staffs' professional commitment and the organisation's progress. Close ties and contacts link us together across countries and continents with mutual benefits’.

This international nursing solidarity that sustains and enriches the Wellness Centres is also at the very heart of the International Council of Nurses, sustaining, guiding and enhancing its work for over a century.

Linda Carrier-Walker retired in 2011 as the Director of Development and External Relations for ICN. She continues to work as a consultant for the ICN Wellness Centres for Health Care Workers® program, is a member of the Editorial Board of the International Nursing Review and a Board member of the Florence Nightingale International Foundation.

Helen Kathleen Mussalem, who served on the Board of the International Council of Nurses (ICN) from 1981 to 1985, died at the age of 97 in Ottawa, Canada. A graduate of the Vancouver General Hospital School of Nursing, she served as a surgical nurse and lieutenant in World War II. She obtained her baccalaureate in nursing from McGill University, Montreal, and her masters degree from Columbia University, New York, where she was also the first Canadian nurse to earn a doctoral degree. Dr Mussalem was a member of the federal government's first Royal Commission on Health Services, and executive director of the Canadian Nurses Association from 1963 to 1981. She served as President of the Victorian Order of Nurses from 1989 to 1991. She received many national and international awards, including Fellow of the Royal College of Nursing, the Florence Nightingale Medal, and Companion of the Order of Canada.