Despite the many things they learned in the University of Virginia School of Nursing before they graduated in May, Rebecca Thornton, Megan Veasey and Erin Donnelly never got a primer about how to administer physical exams by cell phone light.

But when the trio of newly minted nurses traveled to rural Malawi just two days after earning their degrees, care by cell phone light was just one of many improvisations they made work during their stay in the inner African nation of 13 million.

“We gave the patients care right there in the moonlight,” recounted Donnelly, who, with nursing professor Lucy Goeke, conducted a series of home visits to patients too ill to travel to the village’s daytime clinic. “It touches your heart. Everyone was so grateful: their families, their children – they all laid out mats for us when we came. They didn’t want us visiting and sitting in the dirt. It was so humbling.”

The team was organized by the Villages in Partnership project, whose director, Liz Heinzel-Nelson, [mb1] worked with Goeke to set up this service learning experience for the newly graduated nurses. The Malawi location is one of about a dozen sites where nursing students trek to gather clinical experience and a broader world view.

Goeke’s group, which presented its experiences Tuesday at the School of Nursing’s first International Forum, is a typical size for a study-abroad group, including a small number of students and a professor or two. About 10 percent of the School of Nursing’s students opt to travel abroad during their education, a number that’s grown in recent years, according to international initiatives director Marianne Baernholdt.

“There is nothing quite like leaving the comforts of home for service abroad,” said Baernholt, who regularly travels to South Africa – most recently as part of a growing partnership with the Water and Health in Limpopo project, a collaboration among U.Va.’s Center for Global Health, the University of Venda and three rural villages in Limpopo province. “Our students do phenomenal work that’s not only upping their understanding of the world on a global scale, it’s honing the compassion of their craft.”

Led by Goeke, a nurse practitioner, the group offered information on sanitation, hygiene – washing hands, brushing teeth – and nutrition to the eager villagers, some of whom had seen their black, curly hair turn red and lose its crimp due to severe malnourishment. Rampant HIV/AIDS has created about 1 million orphans in the country, and many households are headed by children struggling to survive in a local economy where caskets are a chief source of income and corn mash most often provides nourishment, Heinzel-Nelson said.

The U.Va. group toured local health care facilities, including a hospital four hours away by foot where medications and dressings were scarce and conditions for the ill were eye-opening.

“Their public hospitals have nothing – the patients lie on the floors, holding their own IV bags, if they’re lucky enough to get one, and the entire country smells like a campfire,” Goeke said. “Burns are a huge problem there, especially among children; children who would live here, die there.”

Though residents have little, the students said they were struck by Malawi’s generosity and hospitality. The experience – which also included trying grilled goat intestines from a roadside stand and donning African skirts over their Western style clothing – left them transformed.

“It’s hard not to think that we’re putting Band-Aids on a big, gaping wound,” Goeke said. “We’re so used to having the basics. There, the soap we gave them – to them, it’s like little bars of gold.”