7:00 AM: I feel more confident going into clinical today. I did so many blood pressures yesterday and got really good at them so I’m excited about doing them again.
10:00 AM: We started the clinical with a song and prayer led by the pastor’s wife. The singing was so beautiful! I know religion is a big aspect of the Haitian culture and being a part of the prayer really made me feel like I was a part of their family.
12:00 PM: I’ve forgotten how hard it is to do interviews. I’m asking the patient questions to figure out what the problem is but I miss basic ones that Dr. T picks up on right away. She’s amazing!!! She can ask 3 questions and immediately figure out what the problem is versus me who has spent an hour with the patient and still hasn’t gotten to the bottom line haha. Her level of expertise only comes with time and I’m excited for the day that I can hopefully do what she does and as amazingly as she does it too.
6:00 PM: I am back home and today was a great day. I learned so much from Dr. T and saw the kindest patients again today. I saw Dr. T put her hand on a patient’s chest and say, “I would say that his temperature is 100.5” haha. The best part was that she wasn’t kidding. She said, “When you’ve been doing this as long as I have you don’t need a thermometer anymore”. She also loves saying what is going to happen then once it comes true replies with “Who said it? Not me!” hahahahaha. She’s the best. I worked with Elissa today. Taylor and Peyton were also doing assessments with me. It’s soamazing seeing how much they have grown as nurses and I am so proud to call not only my group but the entire class my friends and future colleagues.
I wasn’t sure what to expect from our first clinical day. Once we arrived at the site, we were given a tour of the area and began to set up for the clinic. The students were divided into 3 groups based on their clinical focus. One group was responsible for taking vital signs for each patient and determining their chief complaint while the other two groups were tasked with doing a full physical assessment on either adult or pediatric patients.
Before arriving in Cap Haitien, our cohort fundraised for the clinic and the orphanage by selling stethoscope name beads to students and faculty of the Nell Hodgson Woodruff School of Nursing. In just this first clinical day, we saw the impact that the money we raised had on this population. We distributed 50 meals to patients who were malnourished and reported not eating that day. Children with growth delays due to malnourishment were given ensure to promote growth and development.
One of the most memorable patients of the day was a 5-day-old baby who was completely lethargic. It was discovered that the mother had been feeding the baby watered down tea because a witch doctor instructed her not to breastfeed. Therefore, the baby was not receiving the nutrients he required that would have been provided by breast milk. Luckily, we had some formula on hand and were able to teach the mother how to mix the formula and feed the baby properly. Formula is an expensive commodity, so some of the money raised was used to buy her formula to feed the baby.
Towards the end of our day, a mother came in with her two young girls who were diagnosed with scabies and a fungal infection. The fungus was growing over their entire bodies and the younger girl had lesions on her head from the fungus. A classmate and I bathed the girls, scrubbing the younger girl’s head with a toothbrush, and treated them with an antifungal cream. After dressing both girls in new clothes, we held them and gave them lollipops. Both girls had the most beautiful smiles and were happy to be clean. We sent them home with the antifungal treatment and 2 new sets of clean clothes. The impact that our actions had on this population in need was apparent to us after just one day in the clinic and we all were excited for the remainder of our experience.
Today we got the opportunity to do a few different site visits to better understand the culture and lifestyle of the Haitian people. We took an open air truck which allowed us to really experience the sights and smells as we drove to our first stop, The University of Haiti Campus Henry Christophe located in Limonade. While there we visited several classrooms, the library and got to see the work of the art students and speak to the faculty of the music program. It was interesting to compare the similarities and differences between the university and universities in the United States. One big difference is the lack of an online system to share grade information; so instead, all student grades are posted publicly on bulletin boards outside the classrooms.
After touring the university, we headed back in the open air van to visit a local hospital, Fort St. Michel. It was shocking to see at first as it was very different from what you imagine when you hear the word hospital; it was mostly outdoors, with small treatment rooms for separate needs, such as tuberculosis, a dental clinic, and different areas for pediatrics and adults. Although it may be so different from what we are used to here, it was also inspiring to see how the Haitians do the best they can to take care of sick individuals. There were easily over 100 patients waiting to be seen and the director of the hospital informed us of the many free services provided to locals. I really appreciated the opportunity to visit these different sites and get information directly from local residents of Haiti because even if I return to visit Haiti again, it is unlikely I will have the chance to go on similar visits.
After getting our bearings in Haiti, it was time to begin preparation for researching the population around us as well as preparing for the upcoming clinical days. We set out from the resort towards town to meet with Dr. Twilla Haynes and Elizabeth Woods. On our journey down the mountain, we were able to view the culture around us and how it impacted each of our senses. The sights of brightly colored buildings and vibrant social scenes easily caught our gaze. The sounds of music, laughter, and continuous honking became the soundtrack of our trips to town. The smells were dependent on our location in town. You could smell a range of things such as beach air or food cooked by local vendors. The taste of the air around us was a mixture of humidity and dirt stirred up from the streets by taptaps weaving in and out of the traffic.
Once we arrived at the Mont Joli, we were able to acclimate ourselves to the supplies needed for the clinic days. Dr. Twilla went through each “tackle box” thoroughly and explained to us where it would be located on clinical days. These tackle boxes contained medications and supplies needed to treat patients for various issues such as scabies, diabetes, and hypertension. This orientation to our supplies helped put our first day jitters somewhat at ease as we prepared to serve the people of Haiti.
This was the perfect day before diving fully into our long clinical days. It was a day of relaxation on a private island in beautiful Haiti. We took a taxi boat to get to the island, passing beautiful scenery such as the mountains. The waters were crystal clear and the sound of the roaming waters was refreshing. To top off the beautiful day, we got to indulge in freshly caught seafood, perfectly seasoned with Haitian spices.
What a great day! We woke up early, had breakfast at the hotel and then travelled by bus to the Citadel. It was amazing to drive through the different towns on the way. So many different smells and scenes than we are used to: children getting washed by there mothers in outdoor wash basins, the trash along the coastline with goats and pigs intermixed, the women carrying heavy loads on their heads with perfect posture and balance, and the tap-taps, motorbikes and other vehicles going in every which way. We slowly made our way out to the rural area that surrounds the citadel and the scene changed to open fields peppered with palm trees, with cows grazing. We quickly learned that Haiti is a beautiful country with a diverse landscape. Once we finally arrived at the Citadel we climbed on all climbed on horses and rode up the mountain. It was wonderful to see the view from the trail as the horses carried us. When we got to the top we were given a guided tour all around the grounds and throughout the structure. We learned that the Citadel was built to help protect Haiti from any possible French invasion, because at the time Haiti had recently earned its independence. We also heard the folklore of how Henri Christophe, Haiti’s president, committed suicide by shooting himself with a silver bullet and that his remains are buried somewhere on the Citadel grounds. After the tour most of us walked back down the mountain where we loaded back into the van and headed to the Sans-Souci Palace. This was a magnificent structure that housed Henri Christoph and his wife, Marie-Louise. We walked over the grounds and took pictures. It was a marvelous day and a wonderful experience to see the local people of Cap Haitian and to learn more of the history of beautiful Haiti!
On Thursday, June 26th, eleven (11) intrepid nursing students from the Emory School of Nursing’s Distance Accelerated BSN program embarked upon a two week immersive population health clinical practicum in Cap-Haitien, Haiti. After a short 1-1/2 hour flight from Miami, our first glimpse of Haiti was from above, eagerly peering through the airplane windows. Striking was the turquoise colored water that was so clear it allowed unobstructed views deep beneath the ocean’s surface. Then, starkly contrasting nature’s splendor, the cityscape began to come into view showing dense clustering of buildings and people. Clouds of smoke dotted the landscape which we later witnessed was from the burning pile of trash. Our plane continued its descent and soon we were on the ground, the plane filling with the applause of passengers aboard. Upon landing and deplaning, we were warmly welcomed and greeted by a local Haitian band. With traditional music playing, we made our way through passport control and collected our bags from baggage claim which contained many medical supplies and donations that students brought with them, including collectively ~20 lbs of suckers for the pediatric population (adults, too) that we would be serving during this clinical rotation. Once outside the airport, we boarded our bus and began our trek to the hotel, the Cormier La Plage. Our population health assessment began in earnest as we viewed the street scenes. We observed massive traffic, mostly of motorcycles and automobiles, racing and swerving with no stoplights, signs or speed limits, all avoiding the dips and broken pavement. The buildings seemed to be in various states of decay/repair, affected by earthquakes, hurricanes and overpopulation which have affected the island. The greatest contrast, against the backdrop of the beauty of Haiti, were the waste disposal issues, trash covering the beach and roadways and the acrid smell of burning trash filled our nostrils.
We arrived safely at the Cormier La Plage, we were again struck by the beauty of Haiti – the waves crashing on the beach, palm trees swaying and bright blue skies. We had made it! As we settled into our rooms and unpacked, we met for a debriefing of our first impressions and an overview of our itinerary. As we arrived safely at the Cormier La Plage, we were again struck by the beauty of Haiti – the waves crashing on the beach, palm trees swaying and bright blue skies. We had made it! As we settled into our rooms and unpacked, we met for a debriefing of our first impressions and an overview of our itinerary, ready for an experience of a lifetime.
The Moultrie Farmworker Program serves both migrant
farmworkers and their children. Migrant farmworkers come here on a special visa
called an H-2B visa which allows them to work on a farm in an area that was
unable to hire residential workers. They fill an important gap in human capital
and without them you’d be hungry. Oftentimes they leave their families and
their home country and go months or even years without seeing them. In addition
to emotional stress, they also face multiple challenges such as long work
hours, sub-optimal working conditions, and limited access to healthcare. This
benefits not only their families but your families across America.
The interdisciplinary team that comes to Moultrie for two
weeks every summer seeks to alleviate some of the physical and emotional
pressure that is inherent to these individuals. For some, this is the only
interaction they will have with the healthcare system while they are in the
United States. By the end of week 2 we were able to do more than 300 well-child
exams, and provided episodic care about 300 farmworkers. While this is a small
drop in the bucket, we hope to have alleviated some of the discomforts faced by
this population during our time in Moultrie.
Each discipline was able to expand their cultural and
clinical horizons during our time here and we feel grateful and humbled by this
After 5 am wake ups, we were all eager to begin our day of travel. Our first stop on our journey to Eleuthera was Nassau – the capital of the Bahamas. Nassau is a city on the island of New Providence and is a popular destination spot for tourists. As we would also soon learn, it is also where the closest major hospital to Eleuthera is. Critically ill patients on Eleuthera must be air lifted to the hospital, or if they are stable enough, they can take a commercial flight or boat ride (ranging from 2-3 hours long). Once it was time to board our final plane, we got a nice walk in some rain showers and then loaded up. The flight to Eleuthera was only 30 minutes and filled with amazing views. Then finally – we arrived! Eleuthera is what is called a “family island,” which basically means it’s a small, tight-knit, and non-metropolitan island. The island itself is very long and skinny – 110 miles long and only 1 mile wide. From the north to the south, there are many small settlements that we were going to be spread amongst to work in the clinics. The northern group would be split amongst the Lower Bogue and Bluff settlements and two small islands associated with Eleuthera – Harbour Island and Spanish Wells. The Southern group would be split amongst the Hatchet Bay, Palmetto Point, Rock Sound, and Tarpum Bay settlements.
When we first arrived on the island, we were driven to where the Southern group would be staying – a mission house in Tarpum Bay right on the ocean. We were introduced to Audrey, Vince, and Andrea with Island Journeys, the non-profit organization that would be facilitating our stay. Island Journeys organize sustainable development-oriented trips in Eleuthera and also work with locals and partner organizations to, according to their website, “rebuild and transform island communities.” Audrey gave us a quick history of Eleuthera and the Bahamas and introduced us to the space. We learned that Eleuthera means “freedom” in Greek and is one of 40 inhabited islands in the Bahamas out of 700 islands in total! With dinner we all got to try some conch chowder – the first of many conch dishes we would be eating throughout the trip. Finally, though we were all exhausted, we had to take a walk along the beach before bed. The beaches on Eleuthera are absolutely stunning. The water is unbelievably clear and clean, and the sand has a subtle pink tint to it. We knew we were in for an amazing time in the coming week!
This morning we headed to the once thriving and largest city of the Mayans, Chichen Itza. We were greeted by a tour guide who directed us to a map of Chichen Itza. He briefly explained the different architectures and its relationship to astronomy, religion and Mayan culture. Then, he led us to the entrance while we were filled with excitement and anticipation of seeing the monuments with our own eyes. Finally there it was, the Temple of Kulkulkan! This sacred pyramid caught everyone’s attention and we were in awe with this 75 feet tall marvel.
An impressive astronomic feature of the pyramid is that during the equinoxes each year, an illusion of a shadowy serpent created by sunlight makes it way down the platform. Another interesting element was that every time our tour guide clapped his hands near the pyramid, we heard a mysterious echo of a bird’s chirp. Specifically, we were told it was the sound of the quetzal, a divine bird to the Mayans. Several of us attempted to replicate this impressive sound; unfortunately, we could not execute the clapping technique correctly.
Surrounding the Temple of Kulkulkan were many other major monuments, such as the Platform of Venus, Temple of the Warriors, Observatory, and the Great Ball Court which had acoustic sounds of its own when the tour guide clapped his hands underneath the court’s rings. Again, we could not execute the clapping technique! Our final stop was the enormous Sacred Cenote –also known as the sacrificial Cenote to the Rain God, Chaac. Jewelry, weapons, tools, as well as humans, were among some of the offerings. It was clear that all monuments had social, astronomical or religious significance. Chichen Itza was a prominent ceremonial center for the Mayans. Being able to see the marvels that the Mayans constructed was definitely one of the many highlights of our Mexico trip.
After walking around Chichen Itza in the hot sun for most of the morning, we were able to cool down and relax at the Xcajum cenote. The cenote was surrounded with amazing wildlife and a natural landscape. After spending over an hour and a half swimming around with the fish in the cenote, we ate at the cenote buffet which had some really great tacos. Following eating, some of us decided to hang out in the hammocks before heading back to the hotel.
On our way back, we decided to stop in Izamal, also known as the Yellow City. Almost every building in this city has been painted yellow.
In the center of the city is a convent and church, which was built atop a flattened Mayan temple/pyramid. This convent boasts the largest atrium in the Americas and the second largest in the world following the Vatican atrium. Pope John Paul II visited Izamal in August of 1993 and performed a mass here during which he celebrated not only the Mayan indigenous population, but all indigenous populations across the Americas. The people of this town were very honored and erected a statue in his memory which can be found by the entrance of the church. Scattered around the city you can also find crumbled remains of Mayan pyramids that once were.
After returning to our hotel, we decided to make the most of our last night in Merida and explore the night life once more. As some of us headed out around 9:30 pm, restaurants were just putting out their outdoor seating on blocked off roads inviting us inside. We found our way to Mercado 60, but not before stopping for the crunchy and extremely delicious marquestia filled with your choice of gouda cheese, nutella, or cajeta. Mercado 60 is an outdoor market with lots of food options and a live band. As the live band played, people would go up and start salsaing with others to the music. Two of our very own found the courage to ask some of the locals to show them how to dance!