A Peace Corps volunteer in the early 1980s, Downes lived and worked
in the small of village of Banikoura in the northern part of the west
African nation of Benin.
Shortly after earning a bachelors degree in political science and
economics at Fordham University, not wanting to go to graduate school
and looking to utilize the language skills she acquired as a French minor,
Downes had journeyed to the former French colony to work on a gardening
and wells project.
She was one of only two Peace Corps volunteers within a 100 km radius
of Banikouraand the only one in the village itselfwhich was
located in the Sahel region of Benin (Sahel as applied here
is an Arabic word metaphorically meaning shore of the desert.),
a difficult land where water is scarce.
Benin achieved independence in 1960 and while not the poorest of west
African nations, the countryparticularly its rural northlacked
a great deal of infrastructure and its health care system was threadbare
One day a woman, someone Downes knew, came asking for help. The womans
young daughter was dehydrated and in need of immediate medical care. Downes,
only recently graduated from college and without medical training, did
not know what to do.
I wasnt well-equipped enough to be of help to these people,
who had made me feel so welcome, Downes said. They turned
to me, and I felt I should have been able to [do something].
Self-awareness is the first thing a traveler experiences the first time
she is away from home, said Downes, now an assistant professor of nursing
in the Nell Hodgson Woodruff School of Nursing. Her experience in Benin
gave Downes that self-awareness and with it she embarked on a journey
that has taken her around the world andon occasiongiven her
a chance to stop at Emory.
You think about a woman whose child is ill. How do you get food
on the table? The concerns on a day-to-day basis are all the same,
Downes said. The day your child graduates from school, its
a joy thats universal. Thats always a moment of change that
people see. There really isnt much of a difference between [Americans]
and the rest of the world. Its amazing to a lot of people when they
first experience that.
Upon returning to the U.S. in 1983, Downes enrolled at the University
of Tennessees nursing school. It had a strong program in rural health
care, and that was what Downes was looking for.
Including her time in the Peace Corps, Downes has spent much of the last
20 years in the developing world, working sometimes as a nurse practitioner
and other times training nurses from countries such as Mozambique and
Zimbabwe (two places where she has lived) to take care of their own people.
Most recently, from 1998 until this spring, Downes was stationed with
the World Health Organization in the south Pacific island nation of Fiji,
where she was setting up a nurse practitioners training program at the
Fiji School of Nursing.
The challenges for supporting health clinics in Fiji are different
than Africa, Downes said. In Africa, the roads may be treacherous,
but there is access by land and airalbeit to varying degrees.
As in Africa some villages [in Fiji] are located in the mountains
far from roads, but island nations have the additional issue of remoteness,
with villages on tiny islands 250 miles from the nearest airport,
There are other problems, as well. For instance, in May 2000 the government
was overturned and its leaders taken hostage by a civilian-led coup. After
two months, however, the coups leaders were arrested and are now
awaiting trial. But the unrest has not deterred Downes, who will return
to Fiji in November to check on the nursing programs progress. Its
just all part of the territory.
While Fijis cities are relatively modern, many Fijiansparticularly
those in rural areasdo not have running water or electricity. It
was in this atmosphere in which Downes helped design a new curriculum
at the Fiji School of Nursing, whose reputation is so strong that it draws
students from throughout the south Pacific.
In her nearly three years in Fiji, Downes made quite an impression. The
schools Excellence in Advanced Practice Nursing Award, which is
presented to the outstanding graduate of the nurse practitioner program,
is named for her.
In the four years prior to Downes service in Fiji, she was an assistant
professor in the nursing school, as well as a student in the Rollins School
of Public Health. When she came back this year, she picked up her studies
right where she left off and has only a few core courses and a thesis
remaining to earn her MPH.
Upon her return, assistant Professor Downes collected a second title,
that of academic program coordinator for the new Lillian Carter Center
for International Nursing.
Working to get the Lillian Carter Center off the ground, which was formally
dedicated Oct. 18, as well as planning last weeks center-hosted
global nursing conference has dominated Downes time this summer
and fallbut not monopolized it.
Downes also has helped to develop the curriculum for a new joint international
MSN/MPH degree program with the School of Public Health.
The dual degree aims to prepare nurses to work within the four core functions
of world health systems: service delivery, resource development, financing
and stewardship. In the United States, Downes said, the areas of public
heath and nursing are often separate. Around the world, though, the practices
are much more tightly linked. And it is in view of this changing atmosphere
new degree program will focus.
I dont think public health and nursing can be separated anymore,
Ive just come to realize this recently, but my area is one
of development work, Downes continued. Its just that
it is in the field of health and I use the tools of nursing and public
health. I think my background in political science and economics has served
me phenomenally well. I think it was the best training I could have gotten.
Because of the issues related to policy, Im more adept at that than
if I had not had that type