Eight years ago, Joyce Murray had never been in a developing country. As a professor in the Nell Hodgson Woodruff School of Nursing, however, she became an adviser to three Ethiopian nursing students. She recalls cautioning them, “What I’m telling you may not apply to the circumstances in your country.”

Three years later, she would learn the wisdom of that cautionary note when she traveled to Ethiopia to help improve the country’s nursing programs. Despite learning about the challenges from the three Ethiopian nurses that she advised, Murray said the trip blew her away.

“I’m not sure I was prepared the first time, going to a Third World country,” Murray said. “When you drive through the countryside, there are very few people, and you think back on our expressways and highway systems and wonder how these people get around—how do they get to health care? How do they get the everyday things they need to survive? It was an eye-opening experience.”

Murray’s exposure to this very different medical environment has continued with her involvement during the past three years with the Carter Center’s Ethiopia Public Health Initiative, of which she recently was named director.

Although Murray and other international experts help shape the initiative’s curriculum, they rely on local faculty teams to determine which health problems are most urgent for Ethiopians. The top concerns can differ greatly from those in the United States; infant diarrhea, malnutrition, malaria and HIV/AIDS all are potential killers.

The initiative’s mission is to develop health-training materials for staff in 500 rural health care facilities serving roughly 85 percent of Ethiopia’s population. War with Eritrea disrupted the program at one point, but the ongoing challenges are more basic. Although the program’s students can be taught in English, they must provide health education in a country in which some 87 languages are spoken. Also, poor roads make it time-consuming to bring students into villages for hands-on training.

“One of the unanticipated outcomes of this initiative,” Murray said, “is the stronger relationship built among the scattered college faculties and government health ministry. In our workshops they develop a common focus on their country’s most critical health needs. More important, our program’s graduates report that the work they’re doing is making a real difference in the quality of health care people now receive.”

“We will be evaluating the program’s impact in more detail,” she continued, “but we already know two areas that need more attention: mental health, particularly in families who’ve lost parents or husbands to HIV/AIDS; and a CD-ROM-based means of continuing the education of graduating students, so they can become more effective teachers and keep up with new training materials.”

Three Ethiopians on whom Murray will be counting to play big roles in bringing improved health care to their country include two nursing professors and an official with the nation’s ministry of health—they are the nursing students she advised almost a decade ago at Emory.

“This is really their project,” Murray said. “We’re there to help them in whatever ways we can, with the ultimate goal of improving health care in Ethiopia.”