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Christchurch Post Earthquake by Janet Hogan

 

 

CHRISTCHURCH POST EARTHQUAKE –

is there a role for Faith Community Nurses?

 

INTRODUCTION

The Universal Declaration of Human Rights, Article 25 states “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security ...”[1] The United Nation’s Millennium Project 2006 obligates world leaders to “improve peoples quality of life by targeting poverty, health, education and the environment”.[2] These two declarations are evident in the Canterbury Earthquake Recovery Authorities (CERA) statement “The social well being of communities and individuals depends on a range of factors, including access to quality housing, transport, education and health systems and inclusive communities, which support people to participate fully in the life of the region”.[3]

 

In 2009 I met Elaine, an Australian Christian Nurse. She had changed her life’s direction after being diagnosed with Breast Cancer. No longer did her management role give her satisfaction. So for thirteen years she worked with the homeless. She said “that each one of them had a story”. This assignment is dedicated to those Christian Nurses working with the forgotten in our cities.

 

The need for Faith Community Nurses / Parish Nurses in Christchurch will be researched. For “parish nursing is a form of ministry which links professional primary healthcare with Christian mission”.[4] Health and social services post Canterbury earthquakes being undertaken by the church will be discussed. The establishment of a Christian based Faith Community Nurse (FCN) Service in Christchurch working with displaced persons (including the homeless) will be considered through a social transformation development process.

 

BACKGROUND

Late morning February 11th 2011, New Zealand’s second largest city Christchurch was struck by a 6.3 magnitude earthquake.[5] In total 185 people with ages across the life span were killed.[6] However, the impact upon the families / whanau and the wider community will never cease.

As a result of the earthquake New Zealand’s Census for 2011 was postponed. Statistics on Census night 2006 for usual resident population in Christchurch was 348,435.[7] The wider Canterbury region showed 521,832 residents.[8] Christchurch cities population is believed to have grown by 7.5% between 2001 and 2006. However, by June 2011 “earthquakes saw the regions population fall by 2.4%” to 367,700.[9]

 

Christchurch is a multicultural city.[10] Like all other regions in New   Zealand there are health problems e.g. Obesity, Cancer, Diabetes, Cardiovascular Disease, Chronic Lung Disease and Mental Illness. Then there is the nation wide increase in persons aged 65 years and over. Adding this aged care burden to the already challenged Canterbury health services (as a result of the earthquake) has resulted in some ongoing resourcing issues. This will continue for the foreseeable future.

 

Christian Doctors and Nurses have never separated physical, mental, emotional or social health from spiritual health. Although a spiritual health assessment aids in case management, we know most health services put little emphasis on spiritual matters. According to the International Parish Nurse Resource Centre, Parish Nursing philosophy is “a recognised specialty practice that combines professional nursing and health ministry”.[11] It “embraces four major concepts: spiritual formation, professionalism, shalom as health and wholeness, and community, incorporating culture and diversity”.[12]

 

Currently there is a small number of FCN / Parish Nurses working throughout New Zealand; including a handful in Christchurch. These Christian nurses are in a mixture of paid and unpaid positions. Most are New Zealand Faith Community Nurses Association members.

 

 

DISCUSSION

Current Situation in Christchurch

 

According to the Population Media website “Only about 20% of the current world’s population has a generally adequate standard of homes. The other 80% live in conditions ranging from mild deprivation to severe deficiency”.[13] In post-earthquake Christchurch, housing standards dropped significantly.

 

Having an understanding of the impact earthquakes have upon people’s lives aids in planning ones response. “Experiencing poverty provoked William Booth and the early Salvationists to urgent action; understanding it equipped them with innovative solutions”. To ‘see” poverty up close and personal and to understand the grinding reality it has on the lives and generations of people is part of the recipe for action”.[14]

 

Immediately following the February 11 earthquake, emergency relief was provided by Red Cross and The Salvation Army. For shelter, Civil Defense Emergency Evacuation Centres, Camper Vans, tents and any form of accommodation still standing was used. In Christchurch today we see thousands of houses being demolished. Subsequently hundreds of people / families have been displaced and some permanently. Those that left the city may or may not return. Even if they do come back their local community / school may not exist. Then there is the increase in rental prices, which is unaffordable to some. So living in inadequate or overcrowded situations is becoming the norm for those on limited incomes. With this comes public health issues e.g. infectious diseases spread more easily.

 

Adding to the displaced persons are the homeless. Those sleeping rough are both men and women. This is not a new issue and it is not unique to Christchurch. It is a nation-wide problem. They can be found on Auckland’s Queen Street and under the Grey River Bridge. Recently I commented to a niece “if I could not find a place to stay on my trip to Gisborne I would sleep under the William Petty Bridge”. Her reply “you will be lucky to find a place there; it is already taken by many”.

 

Homeless and / or displaced persons continue to be found in a variety of settings. These include parks, railways platforms, cars, caravans as well as crisis accommodation centres, supported residential, boarding and temporary housing. Often higher numbers of such people are found in the inner city. The men’s overnight shelter has 27 beds.[15] Women often couch-surf or use women’s refuge safe house.[16] However late November 2012 a women shelter is is being opened on a year’s trial.[17]

 

To address some of the housing issues in Christchurch district, aid came in the form of three temporary accommodation villages being built - two in the eastern suburbs of Christchurch and one in Kaiapoi.[18] These are being used for families displaced whilst repairs are being done on their homes.

 

An innovative social transformation project to get people back into their permanent housing and reconnect them with their community and social networks is being done by Habitat for Humanity. For 50 households where for one reason or another insurance assistance had been declined; a team of volunteers are undertaking repairs free of charge. Hope is returning to these people. This type of initiative supports the United Nation’s Millennium Goals i.e. improves the lives of the worlds poor.[19]

 

A comparative study in the 1990’s into the causes of new episodes of homelessness for persons over the age of 50 years[20] indentified communication breakdowns as the main issue. This was either with the partner, parent, family, a service provider or landlord. When this issue was drilled down further no one root cause was found. Issues like heavy drinking and poor health, including mental health e.g. depression, deteriorating relationships, death of a spouse / parent, too embarrassed to discuss debt situation, benefit and literacy were all contributing factors. A contributing factor to why these issues are being seen with the vulnerable in Christchurch relates to poor communication. Interestingly in those surveyed, half believed their homelessness could have been prevented.[21]

 

According to Narelle Everard, Southern Region Team Co-ordinator Royal District Nursing Service Homeless Person’s Project; 100,000 homeless persons in Australia in 2006 “experience severely compromised health”.[22] One needs to ask if compromised health is an added issue for those displaced and homeless in Christchurch.

SOLUTION

 

To Myers, transformational development is “seeking positive change in the whole human life materially, socially and spiritually”.[23] Social transformation begins with a communities’ acknowledgement of their issues. A statement of the problem is needed. In Christchurch’s case I would suggest:

 

The heart of Christchurch’s post earthquake population is
broken, physically, mentally, emotionally, socially and spiritually.

 

To assist with the transition into a new life for the people of Christchurch, restoring one’s wellness, a holistic and collaborative model is required. There are a number of organisations already providing earthquake related welfare support to address the population’s hurts; some done in partnership arrangements. These services include social workers and school supporter workers; however no Faith Community Nurses have been employed as a result of the earthquake. Church and community organisations working in Christchurch with the displaced include:

 

  • The Salvation Army Earthquake Recovery Team / Community Ministries Service
  • Red Cross
  • Presbyterian Support Services
  • Faith Community Nurses
  • Canterbury Charity Hospital
  • Habitat for Humanity
  • Other church and community organisations / groups that care.

 

According to Elaine Tyrrell, New Zealand’s first Anglican Parish Nurse “In the wider community Parish Nurses demonsate that the church has a hand in response to the health of New Zealand”.[24]

 

A Faith Community Nurse-led project working with the displaced in Christchurch would “integrate faith and healing to bring about harmony of body, mind and spirit in the individual and / or the faith community as a whole and empower the individual, groups, and / or communities to achieve healing, health and wellness”.[25] If the community was empowered and support was given by a development facilitator, they could start to address the identified problem in a fresh and innovative way. Such as a Faith Community Nurse. A community profile and needs analysis is required to confirm that a Faith Community Nursing service is needed and that it would address the identified needs of the community. As the nurse would be looking after health needs that include the spiritual needs of her client base; this transformational development project could see people being re introduced to their faith and integrated back to church.

 

To understand the big picture community involvement is a must. Although CERA has recognised this and the public have been asked to be engaged in the rebuild of the city; in reality a top-down approach has been adopted. Where as the community was seeking a consultative process.

 

Transformation development can address issues with social systems and world views that may have previously allowed unequal opportunities for its members. Any transformation development project must be done in partnership. For a project to be successful, a leader with strengths in networking, coalition building and development planning and facilitation is required if the community is to birth a Faith Community Nursing project.

 

Faith Community Nurse Service

 

Faith Community Nurses work with clients and / or their families / whanau. Often health needs are complex. Health conditions dealt with could include chronic illnesses, physical and intellectual disabilities, mental health issues including depression, anxiety, eating disorders, addictions, suicide etc, age related and palliative care. The FCN works across the life span and each would offer a range of health services dependant on their qualifications / experience. This service may be done in conjunction with another health provider e.g. Medical Centre. The holistic health services that could be offered may include: health promotion, health education, health prevention, case manager, infant welfare checks, nurse led primary care assessments, health screening, emergency contraception pill, basic first aid / wound dressings, immunisations, antenatal support, weight / exercise / health food classes, foot cares (nothing could be more humble), alcohol / drug / smoking and grief counseling. The opening of a FCN service out of a Eastern suburb Medical Centre supported by local churches would be a good place to start such a role. And the appointment of a co-ordinator to manage the needs of a client’s health, social services / advocacy (for housing and WINZ benefits) and referrals would be beneficial. He / she would empower the clients to transform their world through self management of their well being. This will also include their spiritual well being. The Holy Spirit will be seen through the nurse’s Christian witness and the Word of God.  It must also be remembered in this new age that the power of social media should never be underestimated. Could a FCN or the church also use this tool to spread the Good News in an innovative way in Christchurch?

 

A band-aid solution will not succeed in Christchurch, a lasting solution is needed if hope is to return and that hope can be found in Jesus Christ. It has to be noted that some in Christchurch have already recognised this e.g. Christchurch Charity Hospital. [26] According to Dr Ann van Loon “The goal of all health ministry is the transformation of individuals and communities regarding conceptualization of health and healing, empowering people to act in ways that enable then to transition successfully through life’s changing conditions to maintain and improve their well being”.[27] She goes on to say “This transformative process is a dynamic life-long journey that enables us to grow closer to Jesus Christ, thus locating our wholeness in and through Christ”.[28] A community knows their needs, especially one poor in well being. A church working with such a community could be the development facilitator for a Faith Community Nurse project.

 

With a vision for an innovative project such as above, it needs to be taken to the community. For without their buy in it will not work. Only when capacity to do the project is available and constraints / barriers identified and addressed can a strategic plan be developed between the partners to show an outline of the goals and objectives with the expected outcomes. A Logical Framework Analysis may be used. Partners required for such a project must include the community, church and other relevant community organisations and local, regional and national authorities as appropriate. Collective planning and implementation by the stakeholders is the next part of transformational development. However it is not the final part, evaluation and reflection is needed to ensure that targets achieved match the outcomes expected. As the Holy Spirit works through a Social transformation programme we would expect there to be signs of the fruits of the spirit. There should also be increasing numbers of people returning to their faith. This will demonstrate the projects success; however if is was not to be the case, changes would be needed and if sustainability allows the project continues.  

 

CONCLUSION

According to the Oxford Dictionary, transformation is “a marked change in form, nature, or appearance”. [29] Needs of the Christchurch population are many and complex. If positive changes through a social transformation process are to occur, it will involve partnerships. It will not be easy and there will be many challenges to be faced and overcome if the outcomes aimed for are to be achieved. Those working with the displaced / homeless and marginalised will be taken outside of their comfort zones for they will see, hear and things that are not pleasant. We knew “From that place in occupied Israel, Jesus walked, lived, spoke and experienced all aspects of the human condition in order that He might communicate ‘up close and personal’ the message that God’s Kingdom has come”.[30] Television presenter Rod Harley once said one thing he liked about The Salvation Army is that they carried “the smell of the streets”.[31] According to Plantinga, Christians have a responsibility with their education and skills gained and that they should be used “on order to play your part in the drama of the Kingdom”.[32] This includes Christian Nurses. James Forbes is attributed to have said “Nobody gets to heaven without a letter of reference from the poor”.[33] Proverbs 31:20 reads “She opens her arms to the poor and extends her hands to the needy.” Christchurch needs to open their arms and extend their hands for a FCN project.

 

BIBLIOGRAPHY

Carville, O. Shelter for homeless women to be trialed, Christchurch: The Press, 18/07/12.

 

Cresa, D., Australian health Care: Closing the Service Gap. Nursing Management. Vol 18. Number 8, ?

 

Gauntlett, S.C., Strickland, D. Challenging Evil Dispatches from the frontlines of Radical Justice. BSA Print Group: Melbourne, 20 ?

 

Healthy Christchurch Project. Christchurch City Health and Wellbeing Profile2012, Christchurch: Community and Public Health, 2012.

Ngatoko Lavina. Challenge Weekly, Parish Nurses play vital role, Auckland: Challenge Weekly, 2006.

http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2009128884&site=nrc-perc">Developing homelessness prevention practice: combining research evidence and professional knowledge. Accessed 09/11/12

http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2009316931&site=nrc-perc">Royal District Nursing Service providing holistic health care for the marginalized. Accessed 09/11/12

http://www.ccc.govt.nz/homeliving/civildefence/chchearthquake/index.aspx Accessed 11/11/12

http://www.ccc.govt.nz//homeliving/civildefence/chchearthquake/temporaryhousing.as... Accessed 11/11/12

http;//cera.govt.nz/recovery-strategy/social Accessed 11/11/12

http://www.charityhospital.org.nz/ Accessed 13/06/13

http://www.loveyourneighbour.co.nz/?sid=5599 Accessed 11/11/12

http://www.nelsonanglican.org.nz/ministries/fParishnursing.aspx Accessed 11/11/12

http://www.oxforddictionaries.com/definition/english/transformation?q=transformation Accessed 09/11/12

http://www.ronrolheiser.com/columnarchive/?id=662 Accessed 06/11/12

http://www.stats.govt.nz/Census/2006CensusHomePage/CHCHstats/AboutAPlace/Sn... Accessed 11/11/12

http://www.stats.govt.nz/Census/2006CensusHomePage/QuickStats/AboutAPlace/SnapShot.aspx?type=ta&ParentID=1000013&tab=PopulationDwellings&id=2000060 Accessed 18/06/13

http://www.un.org/en/documents/udhr/index.shtml Accessed 31/10/2012

http://www.un.org/News/Press/docs/2005/dsgsm269.doc.htm Accessed 31/10/2012

http://www.populationmedia.org/issues/populatiion/population-and-poverty/ Accessed 13/10/12

Myers, Byrant L. Walking with the Poor: Principals and Practices of Transformational Development. Maryknott: Orbis Books, 1999.

Plantinga Jr., Cornelius. Engaging God’s World: A Christian Vision of Faith, Learning and Living. Grand Rapids, MI: Eerdmans, 2002.

Solari-Twadell, P.A. & McDermott, M.A. Parish Nursing: Promoting whole person health within faith communities. California: Sage, 1999.

.

 



[2] Cresa, D., Australian health Care: Closing the Service Gap. Nursing Management. Vol 18. Number 8, pg 18.

[3] http;//cera.govt.nz/recovery-strategy/social Accessed 11/11/12

[9] Healthy Christchurch Project. Christchurch City Health and Wellbeing Profile2012, Christchurch: Community and

   Public Health, 2012.

[10] Ibid.

[11] http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2010588726&site=nrc-perc">Collaboration of a model osteoporosis prevention and management program in a faith community.</a>

[12] Ibid.

[14] BSK pg 29

[15] Carville, O. Shelter for homeless women to be trialed, Christchurch: The Press, 18/07/12.

[16] Ibid.

[17] Ibid.

[20] http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2009128884&site=nrc-perc">Developing homelessness prevention practice: combining research evidence and professional knowledge. Accesses 09/11/12

[21] http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2009128884&site=nrc-perc">Developing homelessness prevention practice: combining research evidence and professional knowledge. Accesses 09/11/12

[22] http://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=2009316931&site=nrc-perc">Royal District Nursing Service providing holistic health care for the marginalised. Accessed 10/11/12

[23] Myers, Bryant L. Walking with the Poor: Principals and Practices of Transformational Development. Maryknoll: Orbis Books. 1999.

[24] Ngatoko Lavina. Challenge Weekly, Parish Nurses play vital role, Auckland: Challenge Weekly, 2006.

[25] Solari-Twadell, P.A. & McDermott, M.A. Parish Nursing: Promoting whole person health within faith communities. California: Sage, 1999.

[28] Ibid.

[30] Gauntlett, S.C., Strickland, D. Challenging Evil Dispatches from the frontlines of Radical Justice. BSA Print Group: Melbourne, 20   Pg 69.

[32] Plantinga Jr., C. Engaging God’s World: A Christian Vision of Faith, Learning and Living. Grand Rapids, MI: Eerdmans, 2002. Pg 126.

 

 

 

 

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