Nursing Faculty Member Offers Guidance in Kabul

It had been more than 20 years but the desire to return to Afghanistan was a strong one for Paula L. Herberg, who recently returned to campus after an intensive three-month infrastructure-building visit to the war-torn country.

“My memories of Kabul are bittersweet - I returned to a much different Kabul than the one I knew in the 1970s - places were no longer in existence, and buildings had fallen into disrepair, but many of the students are now the health educators and leaders. A former patient, and even a shopkeeper, still recognized me,” said Herberg, associate professor of nursing. She also found that she had to quickly get back up to speed on her Urdu and Dari (a Farsi dialect) language skills, which were only conversational.

Herberg's latest international venture was the result of an invitation by Aga Khan University in Karachi, Pakistan, to work on a collaborative effort by the university, the World Health Organization and the government of Afghanistan. The three entities are charged with strengthening the nursing/allied health education system in Afghanistan.

Herberg lived and worked in Kabul for three years during the 1970s when she was with CARE Inc. as a nurse educator. From 1988 to 1998, Herberg taught at Aga Khan University, serving as associate dean of nursing for three years, as well as director of the School of Nursing for seven years. Herberg helped develop the university's nursing curriculum, implement the first baccalaureate nursing program in the country and worked at the local hospital.

Surprisingly, Herberg learned that nursing education for women continued even under the Taliban rule – “It was just kept quiet,” she said. Most of the faculty members in Kabul remained, but Herberg found that it was as if time had stopped. Programs had not been updated, curriculum content was not revised.

“The faculty members are existing in a time warp in terms of their understanding of modern healthcare delivery,” the educator said.

Herberg's objective was to assess the present situation, focusing on Kabul's Central Intermediate Medical Education Institute, which serves as the central facility for nursing and allied health education in the country. She visited local hospitals and met with health officials in the Ministry of Health, as well as local donor/aid agencies in the field, such as UNICEF. Herberg developed a five-year plan of goals, strategies, activities, resources and budgeting.

She also agreed to return to Kabul this summer to evaluate the project's status, although her return is dependent on security issues and the status of the military situation in Iraq. If she is able to go, Herberg hopes to see that steps have been taken to implement the plan for curriculum improvements, course content and faculty development.

“I would like to see a good infrastructure in place for the university team working in Kabul, and that relationships between the university team and other stakeholders, such as the Ministry of Health, IMEA administration and UNICEF, have been well established and maintained.

“Personally, I would like to be able to spend more time with some of the nurses and hear their stories - especially through the Taliban times - in order to get a clearer picture of how they survived and how nursing fared during that time,” she said. “I hope to see that the level of returning to normalcy in Kabul has been maintained and that there has not been an escalation of violence or worsening of economic conditions.”

Herberg is a nurse with 15 years of experience in international work. “I've lived and worked in Afghanistan, Pakistan, Nepal and Thailand - at a Cambodian refugee camp. I've been in east Africa, in Kenya, Uganda and Tanzania/Zanzibar. I also visited Tajikistan as a nurse consultant.”

After 10 years in Pakistan, the Southern California native felt it was time to come home and re-establish her roots. She continues work overseas on a consulting basis, such as a visit to Tajikistan in 1998 and a four-month trip to East Africa in 1999. She joined the Cal State Fullerton faculty in 2000.