Ever since she graduated from Vanderbilt School of Nursing in 1975 with a master’s degree in psych-mental health nursing, Carol Etherington has been providing care to people grasping at life in the midst of unfathomable tragedy. She has responded to victims of the killing fields of Cambodia, floods in Poland, civil conflict in Tajikistan, and famines and massacres in African nations. She worked on-site in the wake of the 1994 earthquakes in California, Hurricane Katrina, and the collapse of the World Trade Center towers. She has counseled homeless families, orphaned children and refugees.
To honor such actions of compassion and caring, and in recognition of her work establishing mental health programs and delivering humanitarian aid in the United States and abroad, Etherington, an assistant professor of nursing, has been named the 2007 Vanderbilt University Distinguished Alumna.
“Whether I’m in a war zone or responding to a natural disaster, my goal is to help people move past the incident or incidents so they don’t feel permanently stuck in an event that took away their strengths,”Etherington explains. The key, she says, is to help them see beyond a traumatic experience so they won’t be “labeled” by it or allow it to define them as a person.
Etherington began her humanitarian activism shortly after receiving her nursing license. Early in her career she realized that once victims of rape, assault and child abuse were treated in a healthcare setting, they faced additional traumas as they were processed through the criminal justice mill. Appalled by the insensitivity of existing systems, she founded the Victim Intervention Program within the Metro Nashville Police Department, an innovative project that meshes crisis counseling with law enforcement.
A tall, statuesque redhead with a hearty laugh, Etherington exudes an aura of warmth and determination. “When she walks into a room, you can feel her force field,” says Rusty Lawrence, executive director of Nashville’s Urban Housing Solutions, an organization that provides affordable housing for lowincome individuals and families. Lawrence has worked with Etherington on addressing public health needs of the homeless and devising ways to “fix holes in the medical system” of this vulnerable population.
“Carol is a very good leader,” Lawrence says. “You feel her confidence, but she is also very clear about her limits–what she is and isn’t able to do.”
Etherington,who joined the faculty of the Vanderbilt School of Nursing in 1995 as a community health instructor, exposes nursing and medical students to the health-care dilemmas faced by immigrants, refugees, victims of crime, the impoverished and the homeless. Aware that many of these students will one day become leaders in community and international outreach, she is determined to get it right.
“This new era of globalization ups the ante for a university like Vanderbilt,” Etherington says. “Vanderbilt cannot simply be responsible for providing a learning opportunity. It must critically question not only how this experience will shape the lives of students, but also what students will leave behind.How will they affect the lives of those they come in contact with? These people, the recipients of our outreach, have much to teach us if we’re willing to learn. Helping my students understand this has become integral to my humanitarian work.”
Her global vision is a natural extension of her skills as a nurse. Etherington served six terms–two of them as president–on the board of directors of Médecins Sans Frontières (MSF), an international relief organization known in America as Doctors Without Borders.
“Carol was a constant reminder that we needed to focus not just on the medical issues, but on the mental health issues of those we were assisting,” says Dr. Darin Portnoy, current president of the U.S. branch of MSF. “People are deeply affected by displacement, war, personal loss, and physical illness and injury. You can take care of the immediate medical needs, but unless you also address their core emotional needs, they will still be suffering.”
Etherington pushed the MSF paradigm during her tenure, helping the organization see that mental health should not be addressed as an afterthought, but rather could be incorporated into an acute approach to humanitarian aid.
Nothing is more acute than a bomb launched from a rooftop or a missile attack or a drugged-out teenager wielding an Uzi submachine gun. Several times through the years, Etherington has served in some of the world’s hottest war zones–Cambodia, Tajikistan, Bosnia, Kosovo,Angola, Sierra Leone.
Bosnia holds a special place in her heart. Once a part of Yugoslavia, Bosnia-Herzegovina is a country of breathtaking beauty, with cloud-tipped mountains, quaint villages and cascading waterfalls. Tragically, this same scenic landscape served as a scorched-earth battleground between ethnic Serbs, Croats and Muslims, many of whom participated– some reluctantly, others enthusiastically–in a brutal campaign of ethnic cleansing. Four times during the 1990s, Etherington chose to join others in the trenches to deliver nursing and psychological aid during the Bosnian War and its aftermath.
She first went there in 1993 to offer medical and psychological support as a humanitarian aid worker with the International Medical Corps. She returned for six months in 1994, followed by several visits in 1996 with MSF to help emotionally damaged survivors sort through the carnage they had witnessed and the atrocities they had endured.Although she was an expert in crisis counseling for rape victims, and rape was being used as a tactic of war in Bosnia, she actually spent much of her time helping to establish a mental health program for war-traumatized children.
Because many children were too shellshocked to discuss what they’d undergone, relief workers had them draw pictures instead. Elementary-aged youngsters colored images of relatives being shot at point-blank range, of houses exploding, of soldiers firing randomly into villages–horrifying acts of savagery rendered in crayon.
After 1996, Etherington revisited Bosnia once more, briefly in 2001. International relief, however,works best if undertaken as a longterm commitment. For that reason, and because a unique opportunity presented itself, Etherington returned to Bosnia in July 2007 to explore how a nation absorbs the pain of unspeakable cruelty and devastation.
Her latest journey began through the Institute of Global Health and the Emphasis Program, which allows Vanderbilt medical students to focus on an area of interest for eight weeks during the summer after their first year of training. Medical student Demetrius Tavoulareas expressed an interest in working in Bosnia, so Etherington dusted off some of her old contacts and agreed to act as his mentor for a project examining mental health programs in a post-war society. She requested that she also travel to Bosnia to oversee his work and that she bring nursing student Jessica Van Meter along as well.
In nearly every village, Etherington was greeted like a returning hero.Van Meter says that one man told her,”Carol made very beautiful things happen during the war.”
In fact, the child-centered program she and her team originated,which works towards peace and social reconstruction, is still going strong and is being used in the schools to educate young children with the hope they will one day rebuild an equable mixed society.
Etherington says that while she did perceive a renewed hope for the future among her Bosnian colleagues, they are sorely aware of the precariousness of their political situation. Many have come to believe that all their politicians, regardless of ethnicity, betrayed them. Even today, she adds, some of those leaders covertly continue to excite tensions between and among the factions. Theirs is a country tied together by a fragile and uneasy peace; people are now queuing up in line at the local market behind the same neighbors who once pointed guns at their heads and threatened to pull the trigger.
Yet, in many cases, Bosnians are not just pushing forward.”They are dancing forward,” she insists. “They love life. They drink too much. They smoke too much. They stay up too late. And they dance.”
Which makes them that much more a part of the global brotherhood. Etherington says, “If you look across borders, class, geography and religion, there are basically four things that everybody on the planet wants: They want to live and be healthy. They want someone to love them. They want to have some sense of purpose. And they want to be respected.”
Anyone reading this article understands these needs. But so does the young Angolan mother, exhausted by disease, who is nursing not only her own starving infant, but another child orphaned by war. So does a little girl in a frilly blue taffeta party dress, wandering the streets alone after rebel African forces razed her village. So does the widowed mother who brings her children into the humanitarian-aid office to read poetry to the workers because she wants Westerners to know that most Bosnians not only despise killing, but appreciate literature and art.
Carol Etherington also understands. Through the years she has reached out to these very people, encouraging them to be stronger than their circumstances and to cautiously dare to dance forward.
© 2015 Vanderbilt University
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A young man in Sierra Leone had both arms chopped off at the elbows by a guerrilla group of child soldiers. He couldn't imagine a future. Carol Etherington encouraged him to reframe his self-image. "How do you define what's valuable about a human being?" she asked him.With her help, over time, he became reconciled to the idea that while nothing could replace his arms, he still had value as a man and could go forward on strong legs.
A woman in rural Kentucky was brutally assaulted and raped. After she recovered from her wounds, she refused to go to church because in her congregation, rape victims, as well as perpetrators, were thought to have sinned. She didn't want to stand up before her neighbors and apologize for what had happened to her.
Etherington said, "Have you considered that you have every right to go to your church, sit quietly if you want, and find solace in the ceremony? You survived this because of your strengths. If anybody questions that, then they need to ask your forgiveness."
A year ago former Chancellor Gordon Gee was visiting the Mercury Courts program that supports those in Nashville without housing. One formerly homeless man desperately wanted to talk to him. "Go ahead," Etherington urged him. "Your opinion matters." The man mustered his courage and told Gee to ignore his critics, because he had made the right decision in dismantling Vanderbilt's athletic department.