Social entrepreneurship works by identifying large-scale social problems and then finding innovative means to solve them.

As part of a group 20 UI students in a social entrepreneur class, who traveled to rural southeastern India Dec. 28 - Jan. 19, BSN student Reed Underwood learned firsthand how such an approach can empower and improve the lives of the poor, the handicapped and the disadvantaged. She was assigned to work with the Satya Special School in Pondicherry.

In parts of India, many disabled children are kept at home due to parents' fear and ignorance. Due to social stigmas, a lack of care and medical treatment exists for the mentally and physically impaired. "Often the condition of the disabled child worsens as a result of little social interaction and physical immobility,"said Underwood, a junior finishing her first year of nursing education.

Because of the needs of these particular children and the lack of awareness about various health conditions, the Satya Special School was founded in 2003. The school, which is supported entirely by private donations, provided free medical care, physiotherapy, speech therapy, vocational training, language courses, and family counseling for disabled children and adults in the Indian state of Tamil Nadu.

"It is the first school program in the area to integrate a holistic care philosophy and allow handicapped individuals over the age of 20 to attend," said Underwood. Their disabilities include autism, Down syndrome, mental retardation, epilepsy, and cerebral palsy.

"After my first visit to the school, it was easy to recognize a multitude of problems," Underwood said. Enrollment is currently limited to 66 students, due to scarce resources. The building is inadequately sized, and not disabled-friendly. Little equipment exists. Students are crowded on the floor, and must share assistive devices, and the school is understaffed.

Care model requires modification

"As a nursing student, I am forced to solve all kinds of seemingly insurmountable concerns," Underwood said. She thought, "If I can quickly act in a time of crisis, I can find a way to resolve social stigmas and improve support for the school!"

"I intended to develop a nursing care plan. As taught, I would develop a clear diagnosis, supply necessary interventions, and provide outcomes for later evaluation." Underwood quickly discovered this situation was a different sort of problem. "There was no explainable cause, no simple diagnosis, no quick medication to remedy the disease, and no foreseeable solution. For the first time, I was forced to confront the social issues along with the disease."

So, instead of focusing on an obvious concern, Underwood made an effort to understand the cultural views. "I made trips to various families' village homes." She discovered the holistic approach is essential in designing a method of treatment.

"I did not enroll in the course to change the world, and I was not going to change the social stigmas associated with disabled individuals in India," Underwood points out. "I signed up to learn about social entrepreneurship, and I witnessed it firsthand. It truly was an incredible opportunity, and it has sparked my interest in global public health projects throughout my nursing career."

June 2008