Anne Rooney (right) with Training Coordinator and Nurse Examinations Officer Dorcas Phiri of Zambia's General Nursing Council

Imagine a city with 500,000 citizens and only one hospital. Armed sentries stand guard inside a barbed wire fence. People wait in line for hours to be seen in a one-room emergency department. The facilities are absolutely minimal, and the workers often are not paid. Anne L. Rooney, RN, MS, MPH, does not have to imagine such a place. She's been there.

"N'Djamena, the capital of Chad, looked like Biblical times to me," Rooney says. "I went to Sunday markets in the bush where people live in thatched huts. Goats and camels were wandering around. In the cities, it was surprising to see university students wearing Chicago Bulls t-shirts. They were fascinated that I was from Chicago, and they thought I must be a personal friend of Michael Jordan."

When Rooney began her career in health care, it never occurred to her that she'd be visiting Chad, let alone Kirghizstan, Turkmenistan, and Gabon. She calls her career path circuitous and unpredictable, but in fact her excellent education, years of hands-on experience, and rock-solid health care philosophy led inevitably to involvement in the Third World.

Rooney grew up in Dubuque, Iowa. She received a BS in nursing from the University of Iowa in 1975 and an MS in oncology nursing from Rush University in 1981. She had intended to work in bone marrow transplantation, but soon determined that an acute care medical setting was not for her. Master's degree in hand, she became director of hospice for Community Nursing Service West in Oak Park, Illinois. "In the acute care setting, patients with terminal illnesses were given every aggressive treatment," Rooney says. "Hospice care was a better fit with my philosophy of allowing patients to be empowered, to know all their choices, and feel in control of their own health care."

In 1986, Rooney was recruited by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), Oak Brook Terrace, Illinois, to serve as associate director of the hospice accreditation program. Her job entailed developing standards for hospices, training and managing hospice surveyors, and working with hospices nationwide. She was also involved in the development of a home care accreditation program, and eventually became director of both the hospice and home care accreditation programs for JCAHO. Around the same time, Rooney began working toward her MPH.

"An MPH is a really good generalist kind of degree," Rooney says. "Whatever your background, it can be a wonderful asset. It's multidisciplinary, and the average age of the students is a bit older. They've mostly been out working, so they bring professional experience and wisdom to the program."

When Rooney received her MPH in 1993, she became an independent consultant to several health care organizations including the JCAHO, Quality Healthcare Resources, Inc., Oak Brook Terrace, Illinois, and The Corridor Group, Inc., Overland Park, Kansas. It was the JCAHO connection that turned her into a world traveler. Through that organization's new Joint Commission International (JCI), Rooney was recruited as a consultant for a major contract with the Peace Corps. The Peace Corps sent her out to do an external evaluation of the health care system that cares for its internationally placed volunteers. Rooney worked as a JCI nurse-consultant with the Peace Corpsí Office of Medical Services in Washington, helping to develop baseline standards for health screening of volunteers, and for training them about their own health care. She also worked on standards to use in assessing the health care services available for volunteers in the Peace Corpsí ninety-three host countries.

"Each Peace Corps country has a Peace Corps medical officer at a post that is like a clinic for volunteers. In 1994, we evaluated their operations in six countries," Rooney says. "We also looked at existing local health care services available to volunteers and investigated what emergency transportation was in place to get volunteers out of the countries when necessary."

In 1995, Rooney helped the Peace Corps develop training materials for use in teaching volunteers about health issues. She helped the organization devise an internal quality monitoring system so that its own epidemiologists could track health services indicators such as cases of malaria, motor vehicle accidents, and deaths.

In the summer of 1997, Rooney was off to Africa once again, this time to Zambia on a month-long JCI consultation project funded by the United States Agency for International Development (USAID). She worked with Zambian health care leaders, using knowledge gained in her years with the JCAHO to help them develop standards for their own hospitals.

In January 1998, five Zambian leaders arrived in Chicago on a two-week study tour. Rooney took them to Mercy Hospital in Aurora, Illinois, where they were amazed by the physical resources, cleanliness, and quality of care. This March, Rooney returned to Zambia for three weeks to train a first group of hospital surveyors and test previously developed hospital standards.

"I feel very fortunate to be involved personally in these projects. It's professionally gratifying," Rooney says. "In the arena of international health, an MPH is expected. It opens doors. Without it, I would not have been hired for these exciting and stimulating jobs."

Contributed by Janice Rosenberg

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