As we drove through the Iraqi countryside, I sat in the backseat of the SUV looking out the window in amazement at the pastoral scenes passing before me. With my teammates, Otto and Deanna, I had just crossed from the Turkish border into what is known as the Kurdistan area of Iraq. We were a group of three American nurse educators who had come to teach Kurdish nurses more specialized care. I was curious to see what the hospitals were like there, and the level of nursing skill. I wanted to know what it was like to be a woman living in a Muslim country. And as a Christian, I was also very interested in attitude toward religions other than Islam. There were so many questions in my head, but I was able to enjoy the unexpected beauty of this very war-torn country.
The rolling green foothills were dotted with occasional fields of wheat and barley and an occasional settlement here and there. Behind the hills sharp, rugged mountains pierced the sky. It was hard to imagine that just three hours to the south of us in Kirkuk, soldiers were still exchanging gunfire with insurgents. A war continued to rage on in other parts of Iraq. Out my window were flocks of sheep and goats being tended by a lonely herder in fields of green.
Our final destination was the city of Suleymaniyah, a city of about 900,000 people nestled in a valley just a couple hours' drive from the Iran border. Suleymaniyah is a bustling city with encouraging signs of progress. Many new buildings are under construction, both commercial and residential. There was a new city park being developed just across the street from our hotel. Every day we would see cars decorated with flowers passing by and honking—inside were newlyweds wearing their wedding finery. In the afternoon the children would be walking home in small groups all wearing their school uniforms. Everyone seemed to be carrying a cell phone.
One of the first things that I did was to evaluate at what level the nurses practiced. I discovered that the nurses, even though they go through three years of training, are not allowed to take vital signs or to do nursing assessments. They do not have any background in anatomy and physiology, but are then expected to perform highly specialized skills such as delivering babies, inserting chest tubes, and intubating patients for anesthesia. Nurses, prior to being trained by us, did not perform cardiopulmonary resuscitation. They would call for a doctor to come if a patient was unresponsive, and then watch the physician perform CPR. There were so many things that needed to be addressed that we just had to start from square one and cover many of the basics with these "experienced" nurses.
Throughout my four weeks there I was able to enjoy many positive interactions with my interpreter and nursing students. I taught maternity care at the only maternity hospital in the city. My interpreter, Dr. Mariam Baker, was a young progressive woman. She spoke very good English and had a passion for learning and teaching. As we got to know each other better, Dr. Mariam began to share with me the different intricacies of the Kurdish culture. She also shared with me old wives' tales and would laugh because some people still put a lot of stock in them.
I learned of female circumcision still practiced out in the more isolated villages. I also learned that parents would bring in a daughter after a fall off of a bike or a car accident to have the doctors verify that the girl's hymen was still intact, and request a formal document stating the fact. This was to ensure that their daughter would still be acceptable for marriage. Dr. Mariam shared with me that on several occasions she had lied when a young woman had been brought in prior to her wedding to be examined, so that the bride would not be rejected by her fianc