Archive for July 16, 2018

Clinical experiences in Haiti leave lasting impression

Photo by Kaitlyn McGregor

By Samantha Stacks

We are back from completing our last clinical day in Haiti, sitting around the table in the Foundation for Peace Compound yelling over the noise of a generator while playing Uno. Any hope we had of adapting to the Haitian climate has been lost, we still all are sweating, but we also appreciate the warm breeze.

Our final day operating the clinic in Bousquet went shockingly smooth. Of course, on the last day, we worked out all the kinks. We had triage nurses arrive early to have patients’ vitals taken and chief complaints known before being seen. For those who were waiting, we had patient education sessions running on a myriad of topics such as hygiene, stretching, hydration, hypertension, women’s health, and eye problems, just to name a few. I helped stock and run the pharmacy along with Ben, an FFP staff member, filling prescriptions and troubleshooting when we ran out of stock. Every patient today was so gracious and friendly, thanking us for our work. We all thought the day went better than any of us could have hoped.

Now, we are back, bags packed for the flight home tomorrow, with some time to reflect on the whirlwind that has been the last nine days. Even though this was a very unique population for all of us to practice with, I get the feeling that we all are leaving with sentiments similar that we would have towards patients back home. We hope that their conditions improve, we hope that they will take their medications as prescribed, we hope that they will take into consideration the advice we have given them to help prevent future illness. Tonight, the group discussed what we would take back with us from our trip. Top of the list were things like patience, posativity, humility, new friendship, and an appreciation for diagnostic tools.

We have learned so much from our time here. Working with translators has made us more cognizant of our wording and phrasing of questions; slowly uncovering Haitian culture and religious practices has opened our eyes to the complexity of treating both body and spirit. While treating individual patients every few months is just a drop in the bucket for all that needs to be done in Haiti, getting rid of a woman’s UTI or a baby’s ear infection does create real change in patients’ quality of life. We leave here knowing that however small the contribution, we have made a difference.

And just an update on this Uno game (I know you’ve been on the edge of your seat), its been 3 hours and still going strong (with two intermissions). We hope the effects of our work here this week will be as never ending as this game.

Lessons from Koray

Photo by Crista Irwin

By Samantha Stacks

Monday we visited a village that Foundation for Peace had never been to before, Koray. This was a last minute addition to our schedule and we didn’t quite know how many people to expect. Despite this being an unexpected visit, we had a crowd awaiting us as soon as we stepped off the bus.

We quickly got our stethoscopes and other supplies ready to begin the day and dove into seeing patients. This was our 5th clinical day and we definitely had learned a thing or two along our trip. Our excellent triage team and pharmacy were working efficiently and the nurse practitioner students had learned by this point what questions were best to ask to aid in diagnosis.

There were many of the same problems we had seen in the past week such as back pain, worms, vaginal infections, staph infections, dry eyes, and dehydration but we did have a few interesting additions: a simultaneous hydrocele and testicular hernia, a prolapsed uterus, and a wound that was infected down to the bone made the list (all these cases will be referred to surgery at a nearby hospital).

I think something that struck a lot of us was how many people came in with complaints of pains or problems that had happened long ago. We would work up a patient for abdominal pain or a fever, only to find out it had been weeks or months since such a thing had occurred. It really confused and frustrated us. But I think what we sometimes forget is context. We visit villages where there are no clinics; teams from the US working with Foundation for Peace might only come every six months or so. When you live in circumstances of poverty, poverty so profound you can’t drink clean water, feed yourself nutritiously, or get access to medical care, of course you want to take advantage of services when they finally come to you. I also think a general lack of health education contributed to this. When you don’t understand the factors that led to you being sick and a medical professional is in front of you, it only makes sense that you relay every problem you’ve had because you’re not sure why it happened or if it is permanent. It was very difficult to tell people that they were healthy because it was so clear that they weren’t always that way.

Care delivered in medical trips like ours is necessary for the moment in Haiti but what is truly needed is permanent access to healthcare for all. But for now, we can only do our part and trust, as the Haitians say: piti piti na rive, little by little we will arrive.

Moultrie experience broadens horizons for nursing students

Judith Wold is the Distinguished Professor for Educational Leadership at the Nell Hodgson Woodruff School of Nursing at Emory University, an American Nursing Education Fellow of the NLN, and a Fellow of the American Academy of nursing. She directs the annual Farm Worker Family Health Program (FWFHP) for Emory’s Lillian Carter Center for Global Health & Social Responsibility.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

By Colleen Closson

As our time at Moultrie ended, we were surprised by how quickly time had flown by. It felt like just yesterday we had carried our belongings into the Hampton Inn, uncertain of what awaited us. This immersion gave us incredible insight into the daily life of a migrant farmworker. During our class prior to our departure, we learned how hard it was to collect data on the migrant farmworker population because they are a population that is constantly moving, going wherever produce needs to be harvested. We feel so privileged to have been a part of a solution for migrant farmworkers’ healthcare needs. It was saddening to see the needs that farmworkers had that had been neglected for so long due to limited access to healthcare. It is incredible what simple interventions, such as a blood pressure screening, can provide so that people are aware of their risks and educated accordingly.

As we move forward, we are considering how best to apply the tenets of public health to our own practice. Public health, of course, is necessary regardless of where you are, and so many of the chronic health issues that we see can be remedied through public health interventions, such as screenings and education.

We cannot overstate how grateful we are for this opportunity. Without the support of the Lillian Carter Center, Ellenton Health Clinic, and the willingness of the farmworkers to work with us, we would not have been able to see and learn so much in just two short weeks. There is no doubt that our time in Moultrie will significantly impact our future nursing practice.

Feeling thankful in Haiti

Carissa Vyhonsky

By Carissa Vyhonsky & Amelia Remiarz

“Mesi Bondye, Mesi!” This sentence was the theme of today. Translated to English, this sentence means “Thank you God, thank you.” Today, we started off our day with a beautiful church service. Pastor Valentin, who is the National Director of the Foundation For Peace in Haiti, and with whom we are staying this trip, led the service and made sure that we felt included by having our friend Joson translate his message into English. Beginning his message today with the Scripture reading when Jesus invited Peter to walk on the water, Pastor Valentin was able to capture a larger message of trust and love. By listening to Pastor encourage the community to trust in the Lord and hold fast in their faith, many of us felt that this message also described the Haitian people as a whole community. Ever since arriving in Haiti, we have gotten to experience the love and the courage of the Haitian people.

Amelia Remiarz

Learning about the history and all of the hardships that the people of Haiti have had to endure over their years, they always come out of the struggles even stronger than before and with more trust in each other and the Lord than could be imagined. Being invited and included in this church service made us feel so welcomed and loved and accepted, and it was truly an amazing experience.

The second half of our day included a journey into Port-au-Prince, the capital of Haiti. We expected a short bus ride into the city; however, we were greeted by a traffic jam that would rival I-85 on the Friday before a holiday weekend. For three hours we entertained ourselves by watching the menagerie of goats, chickens, and pigs that roam the streets of Haiti. Upon arriving to Port-au-Prince, our first stop was an open-air market where local vendors sold hand carved wooden items and hand painted canvases. We excitedly bartered with the vendors, purchasing souvenirs and gifts for our family and friends. After working up an appetite with our fast paced bargaining, we visited a restaurant and supermarket where we gleefully perused the shelves of Haitian cookies and candies, satisfying our sweet tooth and immersing ourselves into the local cuisine. We returned to the compound with full bellies, ready to prepare our medications and supplies for our final two days in the clinics!

Second pap campaign a success

By Kiah Ford

Today we were back at work servicing the Peruvian women at Colegio Matto de Turner, a primary school located in Cusco. Our second pap campaign was a success and we saw twice as many women this time around than our first campaign. We once again provided blood pressure and blood sugar screenings in addition to the pap smears. After spending 5 hours at the campaign we enjoyed a free afternoon exploring the city!

Caring for children in Moultrie

By Sophie Katz

This week we have been reflecting on the work we are doing with migrant children in addition to what we have been able to do for the farmworkers themselves. Through this experience, we have learned how unstable life can be for the children of migrant workers, frequently not knowing where they will find themselves from one week to the next. We wonder what happens to their records, their grades, their developmental screens and glasses prescriptions and dental records as they follow their parents from crop to crop across the growing seasons. The Moultrie project has opened our eyes to the world the children at the elementary schools we’ve visited occupy, and it has shown us how much more our screenings and checkups can do than just scratch the surface.

We test the students’ eyes and ears, take their blood pressures, heights, and weights, measure their hemoglobin and blood glucose if necessary, and pass them onto the other disciplines for sealant and cavity checks, motor screenings, and their well child checkups. What we find often takes us beyond concerns of the body. We have to carefully consider whether a silent child has a developmental disability or is simply shy or frightened. Perhaps she doesn’t speak English or Spanish, and hasn’t been in Georgia more than a month. What we decide is true for her matters because it will be on the form that determines whether she can start kindergarten.

Often in Moultrie it is easy to feel that the main event is night camp with the farmworkers. However, what we do for the children is just as vital, if not more so. We are starting medical records that will be passed to clinics that are integrated into the migrant stream. The screenings we perform help ensure that they have a chance at success in school. At night we see hard workers, chasing their dreams and ambitions across blazing hot fields. In the mornings we are lucky enough to have a chance to help those dreams grow.

Learning about University Hospital in Haiti

By Sophia Chin

Today’s adventure was to Mirebalais, Haiti to visit the Hopital Universitaire de Mirebalais, or University Hospital for short. The hospital opened in 2013 founded by Partners In Health (PIH), a nongovernmental organization seeking to put into practice the conviction that healthcare is a human right. In Haiti, the woman is the pillar of the family otherwise known as poto mitan. If the mother’s health deteriorates, the rest of the family suffers considerably. Since the maternal mortality rate is significantly higher in Haiti than any other western country, PIH directs resources and efforts toward improving the health status of women.

We started off early at six in the morning and headed up the Haitian mountainside for close to two hours. Immediately upon arrival, we were awe struck by the serene atmosphere, splashes of colorful mosaics and artwork paired with the lush greenery scattered throughout the open hospital setting. We were greeted by our host, the administrator of Graduate Medical Education and Research for the hospital, who is involved in several projects in Haiti including directing and managing the educational program at the hospital. It was eye opening to learn all the in’s and out’s of operating a 300-bed hospital while in the process of acquiring international accreditation – all without accepting payments from patients. As a donor and grant based hospital, patients who came to the hospital paid a flat fee of $2, which included a hospital card and medical record. The patients received food, medications, as well as a separate hygiene and sanitation unit for families of extended care patients.

During our tour, we saw outpatient centers for men, women and children, a new oncology unit, NICU/PICU, a community and immunization center, rehabilitation center, and even a helipad for mass casualties. There was also a facility dedicated to mothers in waiting to deliver called Kay Mamito created specifically for those who traveled from afar. One of the most impressive (and coolest in temperature) spaces in the hospital was the new lab, which was just inaugurated last month. The lab consisted of a clinical lab, microbiology and pathology, gene expert technology as well as a brand new biosafety TB lab due to open in September of this year. Although rapid tests for HIV, malaria and syphilis are done at the lab, tests for urine and blood will start being tested starting in December. In the meantime, cultures and tests are sent to a private or a national lab in Haiti and some are even sent to the U.S. with delayed and long turnaround times for results. As the director of the lab stated, more work for construction and quality improvement is to come, but her determination to get things done as beyond admirable.

We wrapped up the day with a visit to an artistic village consisting of ornate metalwork crafted by all the locals living in the village. This handy craftwork has been passed down from generation to generation, which showed in the extensive detailed works of art polished off with shiny varnish. Everyone in our group left the village with unique souvenirs for our loved ones and homes. With so much new insight from just one day, we simply cannot wait to see what more Haiti has to offer in the days to come.

Campaign cares for dozens in five hours

Taking blood pressure.

By Kiah Ford

Today was nothing short of amazing! We started our day with a pap campaign in a local market not far from CerviCusco. It was amazing to see how a group of 30 student nurses & med students with the help of our amazing faculty and three tables could transform a food stall into a clinic. For five hours we saw dozens of women (and some men too), checking blood pressure & blood glucose and performing pap smears. Another company actually partnered with us to provide rapid HIV & STI testing for the women as well! Those of us fluent in Spanish were able to help translate and make sure our patients understood their test results and recommend referrals. Today’s work was absolutely fulfilling and we all left with a sense of accomplishment and pride knowing that we were able to give our all to the local women of Cusco. We can’t wait to do it all again tomorrow!

Nursing students arrive in the Bahamas for service learning

Nursing students at the clinic.

By Erin Conlin

We arrived on the beautiful island of Eleuthera on Saturday afternoon and settled into where we’ll be staying during our time here, the Tarpum Bay Methodist Church. Sunday was spent touring the island, becoming familiar with the different clinics we’d be working at throughout the week and their surrounding neighborhoods and beaches. We also stopped at the Glass Window Bridge in the northern part of Eleuthera, a stunning part of the island where the Atlantic Ocean and the Caribbean Sea meet.

A view of the Bahamas.

Our work week began in the various clinics working with the Bahamian nurses, providers, and patients. We were able to become acquainted with the scope of the nursing practice in the Bahamas and were surprised by how great that scope truly is. Everyone has been incredibly welcoming and friendly so far and we’re looking forward to spending more time with them in the coming days!

A ‘happy birthday’ while providing care

Having a happy birthday in Haiti.

By Crista Irwin

Today, my translator, Nellio taught me how to say “jodia se anivesem” (today is my birthday)! This marvelous day began as they all do, with a scrumptious breakfast. Today’s menu: pumpkin, vegetable soup and sweet, strong Haitian coffee. The bus drove us to the Pastor’s church enveloped by blue sky, panoramic mountains and neat rows of sugarcane. Our clinic would be in an open air, picturesque, covered building, with tables organized into stations allowing for an easy flow of patients and clear communication among staff members. While smiling young faces peeked around corners and played futbol with exam glove balloons, we met each patient with a “Bonjour” and “kisa ki fe ou mal?” (what is wrong). With my translator, Ero (my hero), by my side and my teammates, men and women with an array of talents and buckets of expertise, saw every man, woman, and child who came for help, well over 200 souls altogether. Men anpil chay pa lou (many hands make the load lighter).

On the bus ride back to home base, Ben, one of the leaders of FFP (Foundation for Peace), passed around the tough stalks of sugar cane he harvested from the field and demonstrated how to use our back teeth to bite and with a swift yank, separate the skin to reveal the sweet and creamy sweetness underneath. My friends sang Happy Birthday to me as I took a bite of the stalk! “Don’t swallow,” Lauren said as they passed me the basket to discard the cud. After a long, breezy day and a seemingly endless flow of people, song and laughter billowed from the bus!

A happy surprise came following another fabulous meal of fried plantains, sweet potatoes, goat, and pikliz. Our hosts presented a moist, layered, birthday cake with glossy white icing, like my Nana used to make, and all sang the English and Haitian versions of the birthday song! I asked Ben, how Haitians spend their birthday. They spend all day cooking and preparing for the party, friends gather, dance, drink, and fellowship. At last they eat the meal, sometimes at 12 a.m. or later and then everyone leaves. They celebrate first and wait all day to eat, because the meal ends the party. With us the meals bring us together, and we continue to play and laugh until it is time to sleep.

I wish I could more eloquently convey to my new friends how much this day, this week, this experience lifts my spirits. Sometimes I find myself consumed in the negativity that surrounds us at home, stifled by hurry and “to do” lists. Today was simply marvelous! Not because we solved world peace or any problem at all, but we did what we could to help, with love and joy and gratitude with the gifts that are ours to give.