Partners in Health Care

St. John鈥檚 College President Mirtha Alicia Peralta, center, has been the driving force behind her school鈥檚 new nursing program. Pictured with her are the program鈥檚 first four faculty members, Belizean nurses who are all at work on masters degrees at BC鈥檚 Connell School of Nursing. From left are Ingrid Asusenia Gomez, Marcia Aldana-Lennen, Areli Rodriguez, and Brithney Ortega.

Photo: Michael Palacio

Partners in Health Care聽聽聽聽聽聽聽

How tiny St. John鈥檚 College and BC鈥檚 Connell School joined forces to launch a desperately needed new nursing school in Belize.

This is the story of a newly launched nursing school in Belize, a tiny English-speaking nation in Central America that is home to four hundred thousand people. But really the tale reads more like the parable of the loaves and the fishes, and it stars a vigorous and driven Belizean woman, Mirtha Alicia 鈥淎lice鈥� Peralta, who has never had many resources at hand, even though she is the president of a small Jesuit college.聽聽

St. John鈥檚 College sits in a country where the per capita income is about a fifth what it is in the US, and it has just 103 university students (along with 700 high schoolers and 1,305 junior college students). It鈥檚 received financial help and scholarly guidance from md传媒国产剧 College in recent years, but its endowment is tiny. But that was no roadblock for Peralta when she began thinking, a couple of years ago, of launching a nursing program at St. John鈥檚. It was just another obstacle to wriggle past.

Peralta yearned to start minting nurses because Belize has a shortage. There are an estimated 1,200 nurses in the entire nation, and the need for more is particularly acute in the poorest and southernmost of Belize鈥檚 six districts, Toledo. Most of the residents there are Mayan and they tend to live on dirt roads far from medical help. Diabetes and hypertension are rampant.

Peralta started working toward addressing this need in 2017 when she had her college conduct a survey of high school students to ask whether they鈥檇 enroll at a St. John鈥檚 nursing school. The results were encouraging, which hardly came as a surprise. At the time, the country had only one nursing school, at the University of Belize, located in its sleepy capital, Belmopan. St. John鈥檚 sits a little over an hour away, in Belize City, the country鈥檚 only metropolis.聽

But how was Peralta going to open a nursing school? She had no connections to major donors鈥攑hilanthropy is minimal in her country鈥攁nd she knew very little about nursing. She did, however, have two things going for her: a long history of making the improbable happen, and a connection to BC, which has an internationally respected nursing program of its own.聽

Connell School Professors Colleen Simonelli (left) and Donna Cullinan (center) have led BC鈥檚 partnership with St. John鈥檚 College as the small Jesuit school has launched its new nursing program in Belize. The professors traveled to the college last year, along with BC nursing students (from left) Vidisha Pandey '23, Aoife Goggin '23, Sinead Dunn '23, and Megan Borchick '23 (not pictured). Photo: Lee Pellegrini

In 2003, Peralta arrived for a high school teaching position at St. John鈥檚 College. She soon became the head of the college鈥檚 business department. After that, she was named a dean and then, finally, in 2015, the first-ever female president of St. John鈥檚, which was founded in 1887 by Jesuits. As president, she launched departments of music and civil engineering and also helped develop a software program that brought St. John鈥檚 paper-based documentation system into the digital age. Always, she said, she was driven by her deep Catholic faith. 鈥淚鈥檓 not the kind of person who goes to church five times a week to pray the rosary,鈥� she explained. 鈥淚 have too much energy for that. I like to serve people.鈥澛�

In 2020, Peralta was able to gain St. John鈥檚 admittance to the Association of Jesuit Colleges and Universities, a network whose twenty-seven other schools are all situated in the US. That same year, at a gathering of the association鈥檚 presidents, she found herself eating lunch with BC President William P. Leahy, SJ, whom she said she admires for 鈥渓iving the mission of the Society of Jesus. He creates opportunities for people who need it.鈥�

But even if Peralta was starstruck, she was also shrewd. Here she was, sitting next to the president of the university that鈥檚 home to the vaunted Connell School of Nursing. This was her moment, and in bright tones she told Fr. Leahy about her ambitions to launch a nursing school at St. John鈥檚. 鈥淲henever you鈥檙e ready,鈥� Fr. Leahy told Peralta, 鈥淚鈥檓 ready to help you.鈥澛�

By that time, Peralta had already had similar discussions with two professors at the Connell School, Colleen Simonelli, whom she鈥檇 met a year earlier, and Donna Cullinan. She knew that the professors had led nursing students on work trips to Haiti, Jamaica, and Chile. Now, with Fr. Leahy鈥檚 commitment of support, she sensed鈥攃orrectly, it turned out鈥攖hat they would be enthusiastic partners in her quest to launch a nursing program.

鈥淚t鈥檚 about living out the Jesuit mission of being men and women for and with others,鈥� Simonelli said. 鈥淚t鈥檚 about engaging where we see inequity or injustice.鈥澛�

鈥淲e want to put ourselves out of a job,鈥� Cullinan added. 鈥淲e want to teach the people of the country we鈥檙e serving to take care of themselves.鈥澛�

Peralta had long conversations with Simonelli and Cullinan about what a nursing college needs. Then, emboldened by her new liaisons at BC and working with Solangel Alvarado, dean of the St. John鈥檚 College Junior College, and Lydia McCoy, the school鈥檚 assistant dean of academic affairs, she dug into St. John鈥檚 minimal coffers and added a nursing lab鈥攁 mini hospital room with six beds鈥攖o a $5.2 million STEM building that was already under construction on the college鈥檚 campus.

Early in 2022, BC paid for Simonelli and Cullinan to travel to Belize for five days. With Peralta, they visited a leading private hospital, Belize Healthcare Partners, in Belize City, and convinced administrators to hire nurses who would eventually come out of St. John鈥檚 new program. The hospital was expanding, and after years of depending on Nicaraguan and Guatemalan nurses, who often aren鈥檛 proficient in English, there was an eagerness for homegrown professionals. 鈥淚t didn鈥檛 hurt,鈥� Peralta added, 鈥渢hat I know the CEO of the hospital personally.鈥�

When Simonelli and Cullinan returned to Belize in January 2023, they brought with them four BC nursing students, Megan Borchick, Vidisha Pandey, Aoife Goggin, and Sinead Dunn (who all graduated last year). Dunn, now an oncology nurse at Massachusetts General Hospital, came to understand why Belize was suffering聽a health care shortage. 鈥淣ursing students were getting their degrees and then leaving the country for better-paying jobs overseas,鈥� she said. Peralta was intent on resolving the problem immediately, Dunn continued.聽

鈥淭he second we got off the plane, she said, 鈥榃e can open this nursing school next week.鈥� She was the most ambitious person I鈥檝e ever met.鈥�

It fell to Simonelli and Cullinan to rein Peralta in, to bring a dash of pragmatism to the project鈥攅verything from a more realistic time frame for opening the school to the sort of supplies that St. John鈥檚 new nursing lab would need. The BC nursing students spent long days on the trip making lists of those supplies, which included stethoscopes, rubber gloves, and surgical masks. Peralta and the BC professors, meanwhile, considered a weightier question: In a country direly lacking high-level nurses, who was St. John鈥檚 going to get to teach at its nursing school? They hit upon a plan: They鈥檇 select four talented nurses within Belize and arrange for them to pursue master鈥檚 degrees in nursing at BC remotely, via Zoom. These students, whom BC agreed to enroll free of charge, would then become the first faculty members in the St. John鈥檚 program and key players in a crucial cultural shift. 鈥淗ere in Belize,鈥� Peralta explained, 鈥渙ur nurses function more like family doctors in the US. They have to do everything, so it鈥檚 important our students learn from nurses who鈥檝e worked in Belize and know all the conditions the health care system faces here.鈥�

Connell School of Nursing Dean Katherine E. Gregory said it is part of the school鈥檚 mission to help grow the capacity for nursing education around the world. 鈥淲e are delighted that our partnership with St. John鈥檚 will lead to increasing access to nursing education in Belize and Central America,鈥� Gregory said. 鈥淚 am grateful to md传媒国产剧 College and especially to our Connell School Faculty and Staff for making this education possible.鈥�

The four Belizean students who will become the new program鈥檚 first faculty members鈥擬arcia Aldana-Lennen, Brithney Ortega, Ingrid Asusenia Gomez, and Areli Rodriguez鈥攂egan taking classes in August 2022, and are expected to graduate in May.聽 Rodriguez is currently a nurse supervisor at Belize Healthcare Partners. Working a recent shift, she talked about how her classes at BC have led her to a broader understanding of medical afflictions. 鈥淵ou can鈥檛 just treat the symptoms,鈥� she said, summarizing. 鈥淢aybe there are psychological reasons why they鈥檙e having those symptoms. I want the students I teach at St. John鈥檚 to think about cultural factors. I want them to get practical experience with patients early on, so they can apply theory as they鈥檙e learning.鈥�

From left are Belizean Ministry of Health official Lizett Bell; BC student Megan Borchick 鈥�23; St. John鈥檚 College Junior College Dean Solangel Alvarado; BC Professor Donna Cullinan; St. John鈥檚 College President Mirtha Alicia Peralta; Karl Heusner Memorial Hospital CEO Chandra Nisbet Cansino 鈥�91; BC student Aoife Goggin 鈥�23; BC student Sinead Dunn 鈥�23; BC student Vidisha Pandey 鈥�23; and BC Professor Colleen Simonelli. Photo: Courtesy of Chandra Cansino

St. John鈥檚 nursing school opened in October 2023 with an inaugural class of sixty-three students. Its four nursing faculty members were still at work on their master鈥檚 degrees from BC, but they weren鈥檛 quite needed yet鈥攖he Belizean students were starting out by taking prerequisites: biology, chemistry, and psychology.聽

Simonelli and Cullinan said they urged Peralta to take a more cautious tack and open the school with just twenty students in 2024, after the nursing faculty was in situ, but Peralta is never inclined to take baby steps. The classes began the moment the new STEM building opened.聽

Six of the nursing students now at St. John鈥檚 are from the impoverished Toledo district, and one of them, Dorla Kal, is an eighteen-year-old Mayan woman who hails from a tiny village, Corazon Creek, that does not have electricity, running water, or internet. There鈥檚 one lightly trained medical worker in Corazon Creek, population three hundred, but if a resident requires stitches, he or she needs to travel two hours over bumpy roads to the district capital, Punta Gorda. Pregnant women often deliver children in the backs of chartered cars as they make their way to the city.

Kal said that, in traveling to Belize City to study nursing, she is bucking Mayan gender norms. 鈥淢ost girls stop their education after elementary school,鈥� she said. 鈥淭here aren鈥檛 enough finances, and people just say, 鈥楪irls should stay home and do household chores.鈥� My parents don鈥檛 think like that, though, and since I was small, I鈥檝e been really interested in science. When I graduated from high school, I decided to just follow my dream of being a nurse.鈥� She received a full scholarship at St. John鈥檚, as did two of the other Toledo district students. In exchange, when this trio graduates, they will be聽 required to spend five years working in their district.

Peralta is hopeful that, as time passess, St. John鈥檚 will train more nurses to serve Toledo鈥攁nd that, within five years, the college will have two hundred nursing students matriculating each year, with both two- and four-year degree programs. 鈥淲e are going to have them serve communities that have never had good health care before,鈥� she said. 鈥淲e are feeding a real need. Nurses are in demand in Belize, and soon we鈥檙e going to have more of them in our hospitals, both public and private. This nursing program will impact Belize in ways that last beyond our lifetime.鈥澛�