Health Care

State pays nurse's way to South Africa

An employee at a state mental hospital in Goldsboro used $5,000 in public money to pay for a 15-day trip to South Africa.

Gladwyn "Shryl" Uzzell, a nurse at Cherry Hospital, visited medical facilities, an orphanage, botanical gardens, a former prison for political prisoners under apartheid and the houses of Nelson Mandela and Archbishop Desmond Tutu.

She also went on a safari at a wildlife preserve known for its lions, leopards, elephants and rhinos.

Uzzell said the trip, approved by the hospital's top administrators, provided insights that will apply directly to her state job training other nurses to care for the mentally ill back home in Eastern North Carolina -- especially the tour of an AIDS treatment ward in Cape Town.

"In that country, HIV/AIDS pandemic has such an impact on their nursing staff," said Uzzell, 52, who traveled from May 26 through June 9. "I saw nurses who were able to continue doing what nursing is supposed to be about, which is about caring and putting the patient first, continuing to give and to give, without complaint."

Uzzell, a registered nurse who is pursing a bachelor's degree in nursing at East Carolina University, asked supervisors at the state hospital to pay for the trip after receiving an invitation from the International Scholar Laureate Program.

"This is a once-in-a-lifetime opportunity will enable you to join other highly acclaimed college students on a journey of discovery to one of the most exotic destinations in the world," said a letter signed by Donna J. Snyder, the program director. "The legacy of apartheid will come alive for you as you venture to Soweto ... You will enjoy dinner under the African stars, hear tales of the bush as you spend your days with Kruger [National Park] game rangers and have plenty of time to explore on your own the wonders of this fascinating land."

Nowhere does the four-page letter, which features an official-looking seal incorporating an eagle with the globe in its talons, mention that the student is expected to raise thousands of dollars for the honor of participating.

According to the Better Business Bureau, the International Scholar Laureate Program is one of at least six names used by Envision EMI of Vienna, Va. -- a private, for-profit company that markets overseas travel to students and recent graduates.

A call to Envision's headquarters was not returned, but the company's Internet site touts its history of delivering "unique experiences" on five continents.

"To say we are an 'experiential education' company is akin to saying Microsoft is a software company ... true at the core, but doesn't at all capture the true essence," the site says. "At Envision, all of the 'experiential education' experiences we create and lead do far more than share knowledge by simply doing. They all impart wisdom."

More than a dozen complaints have been filed against Envision in the last three years, according to the Web site for the BBB chapter covering the Washington, D.C., area. But the business watchdog group gives Envision a "satisfactory" rating for resolving complaints from dissatisfied customers.

Jack St. Clair, the director of Cherry Hospital, said he and Uzzell's other supervisors approved spending the $5,000 for the trip. The money came from revenue the mental hospital receives through hosting students, primarily from medical schools in the Caribbean.

Uzzell, whose annual salary is $64,528, said she paid about $1,600 of her own money to cover a three-day extension to the trip.

"I suspect the trip gave her a renewed perspective on things," St. Clair said. "You know, we all kind of get caught up in our own world of work. To get out and see other cultures and to see how other people do things, as a way to benchmark and to help remind us what we are all about, what our priorities are all about, probably gave her a renewed focus that might not have been realized as readily as being here every day."

State law requires out-of-country travel expenses for employees to be authorized by "the department head or such departmental official designated by him or her."

Tom Lawrence, spokesman for the state Department of Health and Human Services, said Secretary Dempsey Benton's approval was not required for Uzzell's trip because it was not paid for with "state money."

Asked how state hospital revenue does not qualify as state money, Lawrence replied: "I'm not an accountant."

Uzzell will be required to make presentations about what she learned to hospital staff and community groups. A brief outline Uzzell provided lists topics she will cover -- apartheid, traditional healers, orphans and the fact South Africa has the "largest economy in the world."

The United States has the world's largest economy, according to the World Bank. South Africa ranked 28th, just after Denmark.

Asked about that, Uzzell said she was just going by what she was told on the tour.

A state employee for 29 years, Uzzell said it never occurred to her that the Africa trip was organized by a private company or that it might profit through honoring her. She plans to graduate in December.

"What I'm hoping to do that would benefit the patients is to be able to share with nurses here, in the United States, because we have so much technology and because we have so many people, like, thinking for us and telling us what to do, a lot of times we as nurses lose our economy, and our ability to critically think situations and do what is best for our patients," Uzzell said.

"So that's what I saw over there, that's what I'd like to share with the nurses here at Cherry Hospital, is that we do have a first-line responsibility to be advocates for our patients and just not accept what somebody says because they're a doctor or there is a policy."

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