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Partners in Health Care
How tiny St. John’s College and BC’s 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 “Alice” Peralta, who has never had many resources at hand, even though she is the president of a small Jesuit college.
St. John’s 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’s received financial help and scholarly guidance from Boston 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’s. 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’s 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’d enroll at a St. John’s 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’s sits a little over an hour away, in Belize City, the country’s only metropolis.
But how was Peralta going to open a nursing school? She had no connections to major donors—philanthropy is minimal in her country—and 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.
In 2003, Peralta arrived for a high school teaching position at St. John’s College. She soon became the head of the college’s business department. After that, she was named a dean and then, finally, in 2015, the first-ever female president of St. John’s, 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’s paper-based documentation system into the digital age. Always, she said, she was driven by her deep Catholic faith. “I’m not the kind of person who goes to church five times a week to pray the rosary,” she explained. “I have too much energy for that. I like to serve people.”
In 2020, Peralta was able to gain St. John’s 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’s presidents, she found herself eating lunch with BC President William P. Leahy, SJ, whom she said she admires for “living the mission of the Society of Jesus. He creates opportunities for people who need it.”
But even if Peralta was starstruck, she was also shrewd. Here she was, sitting next to the president of the university that’s 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’s. “Whenever you’re ready,” Fr. Leahy told Peralta, “I’m ready to help you.”
By that time, Peralta had already had similar discussions with two professors at the Connell School, Colleen Simonelli, whom she’d 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’s commitment of support, she sensed—correctly, it turned out—that they would be enthusiastic partners in her quest to launch a nursing program.
“It’s about living out the Jesuit mission of being men and women for and with others,” Simonelli said. “It’s about engaging where we see inequity or injustice.”
“We want to put ourselves out of a job,” Cullinan added. “We want to teach the people of the country we’re serving to take care of themselves.”
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’s College Junior College, and Lydia McCoy, the school’s assistant dean of academic affairs, she dug into St. John’s minimal coffers and added a nursing lab—a mini hospital room with six beds—to a $5.2 million STEM building that was already under construction on the college’s 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’s new program. The hospital was expanding, and after years of depending on Nicaraguan and Guatemalan nurses, who often aren’t proficient in English, there was an eagerness for homegrown professionals. “It didn’t hurt,” Peralta added, “that I know the CEO of the hospital personally.”
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 a health care shortage. “Nursing students were getting their degrees and then leaving the country for better-paying jobs overseas,” she said. Peralta was intent on resolving the problem immediately, Dunn continued.
“The second we got off the plane, she said, ‘We can open this nursing school next week.’ She was the most ambitious person I’ve ever met.”
It fell to Simonelli and Cullinan to rein Peralta in, to bring a dash of pragmatism to the project—everything from a more realistic time frame for opening the school to the sort of supplies that St. John’s 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’s going to get to teach at its nursing school? They hit upon a plan: They’d select four talented nurses within Belize and arrange for them to pursue master’s 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’s program and key players in a crucial cultural shift. “Here in Belize,” Peralta explained, “our nurses function more like family doctors in the US. They have to do everything, so it’s important our students learn from nurses who’ve worked in Belize and know all the conditions the health care system faces here.”
Connell School of Nursing Dean Katherine E. Gregory said it is part of the school’s mission to help grow the capacity for nursing education around the world. “We are delighted that our partnership with St. John’s will lead to increasing access to nursing education in Belize and Central America,” Gregory said. “I am grateful to Boston College and especially to our Connell School Faculty and Staff for making this education possible.”
The four Belizean students who will become the new program’s first faculty members—Marcia Aldana-Lennen, Brithney Ortega, Ingrid Asusenia Gomez, and Areli Rodriguez—began taking classes in August 2022, and are expected to graduate in May. 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. “You can’t just treat the symptoms,” she said, summarizing. “Maybe there are psychological reasons why they’re having those symptoms. I want the students I teach at St. John’s to think about cultural factors. I want them to get practical experience with patients early on, so they can apply theory as they’re learning.”
St. John’s 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’s degrees from BC, but they weren’t quite needed yet—the Belizean students were starting out by taking prerequisites: biology, chemistry, and psychology.
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.
Six of the nursing students now at St. John’s 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’s 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. “Most girls stop their education after elementary school,” she said. “There aren’t enough finances, and people just say, ‘Girls should stay home and do household chores.’ My parents don’t think like that, though, and since I was small, I’ve been really interested in science. When I graduated from high school, I decided to just follow my dream of being a nurse.” She received a full scholarship at St. John’s, as did two of the other Toledo district students. In exchange, when this trio graduates, they will be required to spend five years working in their district.
Peralta is hopeful that, as time passess, St. John’s will train more nurses to serve Toledo—and that, within five years, the college will have two hundred nursing students matriculating each year, with both two- and four-year degree programs. “We are going to have them serve communities that have never had good health care before,” she said. “We are feeding a real need. Nurses are in demand in Belize, and soon we’re 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.”
Bill Donahue is a writer living in New Hampshire.