Nursing Graduate Finds Calling through South Africa Journey

Carr applying lessons learned in Johannesburg to work in the Delta

Kayla Carr (right), nurse practitioner, charts while third-year medical student Kristen Dent (left) helps nurse practitioner Kathy Rhodes examine 13-year-old Antavious Singleton at the Mercy Delta Express Project’s clinic at South Delta Middle School.

Kayla Carr (right), nurse practitioner, charts while third-year medical student Kristen Dent (left) helps nurse practitioner Kathy Rhodes examine 13-year-old Antavious Singleton at the Mercy Delta Express Project’s clinic at South Delta Middle School.

JACKSON, Miss. – Six weeks after traveling more than 8,000 miles from her hometown of Flora, Kayla Logan Carr, a sophomore biology major, decided to become a registered nurse.

While conducting exploratory research in HIV education and prevalence in Johannesburg, South Africa, in 2006, Carr’s professional trajectory took a different course. She originally wanted to finish her biology degree and begin a career teaching English as a second language. After seeing a community-based approach to health care involving mobile units where HIV educational materials and medical supplies were distributed, Carr made the decision to change her major.

“I served alongside nurses and community educators who would drive through local townships and hold impromptu, roadside health-education classes about HIV/AIDS,” Carr said. “Many of these patients were homebound or had no access to transportation. There wasn’t always an appropriate local meeting place. A mobile model was part of the solution.

“I was energized by the way they met people where they were living to provide these much-needed health services.”

Her first trip to South Africa was so profound that one year later, she returned using funding from the university’s Sally McDonnell Barksdale Honors College. With a growing interest in global health, particularly reproductive health, Carr returned to Mississippi armed with a new perspective on the stark similarities between public health challenges faced by South Africa and the American South.

“There are certainly similar challenges in rural South Africa and the rural Southern United States,” she said. “There are issues of transportation, health literacy challenges, unemployment, sub-standard housing and poverty, to name a few.

“I became interested in the mobile model and other innovative health care delivery models and how they could be implemented to address public health concerns, especially in rural areas.”

It was during Carr’s third semester of nursing school that she began her honors college thesis research and, consequently, connected with Lisa Haynie, professor of nursing and director of the Mercy Delta Express Project.

Mercy Delta is a UM Medical Center School of Nursing faculty-run clinic that provides mobile, school-based health care to children in the Mississippi Delta, one of the most impoverished, medically underserved regions in the nation. As there are no pediatricians in Sharkey or Issaquena counties, the two counties served by Mercy Delta, the clinic serves approximately 500 children and adolescents and fills the gap in care by providing medical, dental and health-education services.

“I was thrilled when Kayla approached me about the work we were doing in the Delta and her interest in conducting research in that area,” Haynie said.

Having just been approached by the superintendent of the South Delta School District about the possibility of opening a school-based health center at the middle school in Anguilla and later at the elementary school, the timing was perfect, Haynie said.

The superintendent was concerned because children were missing school frequently for non-contagious illnesses, and there were no health care providers in Anguilla and limited health care resources in Rolling Fork, the next-closest town. Parents were picking children up from school and keeping them home for several days at a time. As a result, students were missing valuable classroom time and were not adequately prepared for state testing, Haynie said.

“Kayla and I discussed these concerns and developed a plan,” said Haynie. “We knew the first step was to conduct a needs assessment in order to determine if the parents, faculty and staff perceived that there was a need for a school-based health center. Kayla submitted a proposal to IRB, developed a questionnaire and implemented the research throughout the South Delta School District.

“The results revealed that there was a definite need for a health center at all schools, as well as a need for health education on a variety of topics. These results were used in a successful application to W.K. Kellogg Foundation for funding in late 2011.”

The first clinic opened Feb. 1, 2012, at South Delta Middle School. Since then, clinics also have opened at South Delta Elementary and Ripley-Blackwell Head Start.

“My experience in the honors college helped me identify where I wanted to take my life and career,” Carr said. “I knew I loved biological science and enjoyed working with people, but I wasn’t sure what this looked like long term. Seeing South Africa’s health disparities, coupled with ‘out-of-the-box’ solutions like a mobile unit, inspired me to seek innovative ways to care for patients back home. The experience was invaluable.”

Carr has not been the only student to benefit from unique research opportunities made available by the honors college and the School of Nursing.

“A wide variety of exploratory research studies have been conducted by Ole Miss Honors College students who graduated from our School of Nursing,” said Robin Wilkerson, director of the School of Nursing’s north Mississippi campus.

In addition to Carr’s research, other examples include 2007 graduate Elizabeth Fowler’s research on risk factors and co-morbidities in patients who have a do-not-resuscitate order and 2012 graduate Micaela DeLashmit’s qualitative research study of elders’ perceptions and expectations of health care. Current senior nursing student Charlsie Murphy is conducting a research study, “The Traditional Baccalaureate Student Nurse’s Experience in Choosing an Initial Area of Practice.”

Now, eight years after her maiden journey to South Africa, Carr, a 2010 honors college graduate, has completed a master’s degree and works as a family nurse practitioner for Mercy Delta. She also serves as a part-time faculty member in the School of Nursing, where she teaches Accelerated BSN students. She is also in the process of applying to doctoral programs.

In preparing for the future, as Carr grades nursing students’ care plans and gives STD and abstinence talks to groups of South Delta High School seniors, she remains grateful for the early lessons on rural health and access to care that she learned in South Africa nearly a decade ago.

“My experience in the honors college has brought me further than I ever thought possible,” Carr said. “It is a blessing to see a research idea come full circle into a project like Mercy Delta. I appreciate the opportunity to explore a problem like rural health-care disparity, research it and implement a plan of action.”