Archive for The Bahamas

Day One of Adventure

ADVENTURE was the theme Drs. Coburn and Abraham chose for our trip, but I don’t think anyone thought our first day would turn out the way it did. It started off well; our entire group made it to the airport in time for our first flight and that ride was uneventful in a great way (very significant considering I’m not the best flyer). The really adventurous part of our day started during our wait to get from Nassau to Eleuthera. We got to spend some time transitioning from chilly Atlanta to the breeziness and warmth of the Bahamas. We had a nice greeting at the airport of a Bahamian band playing live music in the terminal, then we checked in for our second flight and got settled in for the 3 hour layover. By the time the sun and breeze lulled me into two naps on the patio and our group had snacked through all the restaurants near our gate, our 3 hour layover turned into a 5 hour one. By 5PM, we were all boarded, waiting in an unusually long line of planes waiting to take off on the runway. Our captain assured us he would try to get us to Rock Sound airport before sundown, but warned that we wouldn’t be able to land if it was too dark outside. After sitting for a few more minutes, we were disappointed to find out that the timing was too close and we wouldn’t be able to fly to our final destination. That led us to a Wendy’s airport dinner and about 2 more hours laying over and searching for hotels. And now, although we had an interesting time getting here, my belief that things happen for a reason is confirmed. I’m writing this entry under a cool fan in the hotel’s restaurant, listening to one of the employees explain the unique decor. Our group is settled now and I think we’re starting to let the Bahamas’ relaxation come over us. Tomorrow, we get back to the airport for a 6:30AM flight to Eleuthera and the next day of adventure 🙂 To be continued…

Eleuthera Day 1

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30 May – After a fairly uneventful flight, we touched down in Nassau, where we met Dr. Coburn after a delicious lunch at Wendy’s. We had to wait a few hours for the puddle jumper that would bring us to Eleuthera, but there was an outdoor deck at the airport so we could sit and enjoy the sunshine. One twenty minute flight later, we arrived at Rock Sound International Airport. Baggage claim was a cart with everyone’s bags piled high; we were the only flight arriving that afternoon. We were met at the airport by Shaun Ingraham, the founder of One Eleuthera. This non-profit seeks to empower the citizens of the island by supporting local projects in five areas: sustainability, economic development, education, culture and heritage, and health and wellness. Emory’s School of Nursing is a partner organization of One Eleuthera, and with Shaun’s help, we will be getting not only an insider perspective on the island, but a chance to contribute to and learn from their mission. After this introduction, we piled into the van that would take us to our “home” in Tarpum Bay.  The views from our porch definitely make up for the long day of travel. We took a few pictures, checked out the beach, and then headed up the island to the main town, Governor’s Harbour, for their weekly fish fry. Before we got there, we stopped at the Eleuthera Cancer Center, where we saw their food garden they have been working on as an initiative to encourage healthy eating among the citizens of Eleuthera. There was also a breast cancer presentation going on, so we stayed for part of that. Once at the fish fry we got our first taste of the chicken, fish, and rice that seems to make up much of the local diet. It was delicious, even if I wasn’t exactly sure how to eat a fish head. After the food, there was a limbo contest and a dance contest, which one of our nursing students won! By the end of the evening, everyone was very tired from the day and we gratefully headed back to our beds to prepare for the next busy day!

Embracing Eleuthera

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Monday
 
Walking back from the picnic tables at the library (good wifi, scary bees nest) Elisabeth and I took the long way home. We headed down Lord Street waving at patients we had met last week, hanging laundry and preparing supper.  As we headed to the waterfront we passed Tarpum Bay Primary and a group of boys playing basketball.  We hooked a left onto Bay Street, passing conch salad stands closing for the night. Separating the road and the Caribbean is a cement wall with a few wooden staircases leading to the sand.  Recent storms left high waters and today the steps took us directly into the ocean. We took a quick dip and looked back on the past few days…
 
Friday was bitter sweet as we said good by to our week one clinic spots. After 5 days we felt competent screening patients, answering phones, filing, filling prescriptions, and communicating with the nurses, physicians, and locals. Earlier that morning Rock Sound Airport had a flag raising ceremony commencing the start of a 40 day celebration for the upcoming 40th anniversary of Bahamian independence. Why am I mentioning this you may ask?  Patrice and I walked into our clinic with a packed waiting room and no clinic staff. 
 
We jumped in and started the patient log, pulled files, and began screening. Filling out either a “general encounter” or “child health encounter”, Patty and I took turns taking blood pressures, recording medication histories, and establishing chief complaints. Did I mention it was wound day? We assisted Dr. Smith in draining an axillary abscess, suturing a leg wound, redressing a gangrene toe from a diabetic patient, and assessing an ocular puncture wound.  Patrice and I were moved by Dr. Smith’s empathy and tireless work ethic. He knows his patients beyond their acute or chronic conditions and provides compassionate, holistic care. He also provided us with numerous educational moments, calling us in to hear a murmur, or see an ear infection through the otoscope. We feel so fortunate to have had such a dynamic clinical experience. 
 
Friday night we headed North (or down the island as Eleutheran’s say–South is up island–we learned this the hard way) for the fish fry. We dug into the food–actually dug, with our hands (sorry Patty I had to put a picture in). We watched a man prepare fresh conch salad and participated in some fish fry festivities. Not to toot our own horn, but Emory really delivered-Joanna won second place at the limbo contest and went head to head with Jasmine in a dance off, having already out danced the other fish friers.
 
Saturday Robyn took us on a tour to preachers cave where British settlers first discovered the Bahamas after a ship wreck. On the way home we stopped by glass window bridge where the Atlantic meets the Caribbean. We also made a stop at the Governor’s Harbour library where the first annual youth art show was displayed. There was a band on the porch of the historic building playing what we’re fairly sure was “brick house” (Commodores).
 
On Sunday we attended a lengthy Methodist Father’s Day service at the church below our house. It began with a “welcome” time to meet and greet the congregation. As I reached out to shake the hand of Alia, a 7 year old girl who later read a poem, she bypassed my hand and leaned in for a full hug. We’re so thankful and appreciative of the warm welcome Eleuthera has given us.
 
Today was the first day at our new clinic spots and we all seemed to have a packed day. Patrice and I both removed sutures (two different wounds, two different fights), and provided diabetic education. The nurses at Hatchet Bay are encouraging and make sure to include us in every educational moment.
 
Meanwhile as we experience new clinic sights and gather feedback from the nurses, we’re pulling together some exciting quality improvement initiatives. While it’s hard to imagine coming home, I am beginning to developing heat rash in some unfortunate places…
I’ll leave you with as many pictures as this bandwidth will allow me. Much to my chagrin there is some documentation of my mosquito bites etc, I’ll spare you those. 
 
Warm regards, 
 
Elise  
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Follow Us to the Islands

We’ve now been in Eleuthera for almost a week, but let us go back to last Saturday at 12:00 PM when our adventure truly began. Eight eager students, one extremely brave instructor, and over twenty suitcases met at the airport to board our flight down to Nassau. After an unknown mechanical glitch kept us on the edge of our seats for two hours, we deplaned only to reboard the plane a mere 600 seconds later. Not to stray from the luxurious norm of us ABSN’ers, we were met by a friendly Bahamian taxi driver who somehow managed to squeeze all 9 of us plus luggage into his lavish van (we will spare you the details, but be on the lookout for us in next month’s issue of Ripley’s Believe or not).
Luxurious Taxi
Although Constance booked us a room at a casino resort, we focused on celebrating Amanda’s birthday, soaking up as much AC as we could, and resting up for our 4 AM wake up call (who thought a 5:30 AM flight was a good idea? we’ll never know). A quick 45 minute flight later brought us to our final destination – the family island of Eleuthera. Our “home away from home” for the next 14 days.
Our Casa

After catching up on zzzzz’s, Monday morning arrived, and we hit the ground running. Students were paired and dropped at 4 different clinics across the island. Rock Sound and Tarpum Bay clinics in the south, and Governor’s Harbour and Hatchet Bay clinics in the north. These clinics have provided us with a snapshot of the people, culture, and the function of healthcare on the island.
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We have witnessed the nurse take on the role of doctor, pharmacist, social worker, secretary, psychiatrist, and friend to all who walk through her door. Here in these community clinics, incredibly personable care (always with a smile) is provided with fewer commodities than we are afforded in our skills lab. The nurse’s ingenuity and passion for her craft and native people mitigates for the lack of resources seen across the land. Throughout the past week, we’ve witnessed first-hand their desire to educate and motivate patients to tackle their non-communicable diseases such as hypertension and diabetes.

But we must mention, it is not all work.. Thursday we took a field trip to The Island School, which is a sustainable, eco-friendly, and research driven boarding school (for details refer here http://www.islandschool.org/). After learning all about permaculture, aquaponics, and marine conservation initiatives, we set out on a winding, unpaved road to Mrs. Rose’s for a delicious, family-style traditional Bahamian lunch. Mrs. Rose's House
Following lunch, we spent the afternoon swimming along the beautiful pink sand beaches on the Atlantic Ocean until a massive storm sent us running for home.Storm on the beach
We wrapped up the night with an evening filled with karaoke and fellowship with the Tarpum Bay locals (all footage of karaoke will be destroyed upon leaving the island.. sorry folks! But whether she claims it or not, Dr. Coburn can “sang” my friends).
Karaoke Night

So far we’ve met some of the nicest, cutest, and most grateful Bahamian people forever changing our perception on how to provide compassionate and competent patient care.
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Beaches in Nassau

Please stay tuned for updates as we continue our experience immersed in Bahamian culture.

Elisabeth and Jamar

 

So long for now,

Mary Chandler & Elisabeth

 

January 9th 2013- Blog Day Two

The Bahamas trip consists of helping in the clinics and teaching at the schools. The students are placed in clinics through out the island. There are two students placed in Hatchet Bay, three students in Governor’s Harbor, two students in Rock Sound, and two students in Tarpum Bay.

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Today, for some of the students was their first day teaching at the Bahamian schools and for some students, it was their second day teaching. Some of the topics that were covered were: Substance abuse, family planning, respiratory, and STDs.

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We visited the Leon Levy Native Plant Preserve today in Governor’s Harbor. The Preserve is the first national park on the island of Eleuthera. It is an environmental educational centre as well as a facility for the propogation of native plants and trees.

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^View from the tower

Until next time,

Laila Nurani

The Bahamas group consists of 9 nursing students and 2 instructors. There are 5 juniors and 4 seniors. The 2 instructors are Corine and Caroline. The group arrived in Rock Sound, Eleuthera on January 5th. The group is living in Tarpum Bay, which is 15 minutes away from Rock Sound.

Arrival in Rock Sound, Eleuthera

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Sight Seeing on the Island:

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Attending the Anglican Church:

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Until next time,

Laila Nurani

Alternative Winter Breaks – Recap of Bahamas, Dominican Republic, Jamaica

The weeks following my Alternative Winter Break – Bahamas trip have been both challenging and rewarding. With the start of my final semester in Nursing School, I’ve begun a variety of different tasks and processes to complete my transition from “Student Nurse” to “BSN-prepared Registered Nurse”! There have been so many wonderful moments throughout the past years of Nursing School, but I can’t say I’m not incredibly excited to graduate and begin working. However, that process can still seem quite far away, especially when getting caught up in readings, assignments, papers, quizzes, and tests. I know I’m not alone, though, as many of my fellow Senior Year classmates are always able to provide the exact countdown to graduation – 96 days as of today! Overall, though, it’s the little things throughout the process that make the entire journey worthwhile – one of the most recent ones being the presentations of all the Alternative Winter Break students.

Over 30 Emory School of Nursing students (from juniors to nurses in Master’s programs) traveled to either Jamaica, the Bahamas, or the Dominican Republic in the early part of January. We reconvened just a short while ago to present our trip highlights and information taught (and most importantly – learned) to a variety of fellow students and faculty at the School of Nursing.

The Bahamas group focused on the variety of care that the nurses provide on the rural island of Eleuthera, and the way that these nurses act in a variety of roles that far surpasses the work I’ve ever done as a student nurse. We spent a great deal of time either in the clinics, working directly with these nurses, or at schools providing health talks and education on a variety of topics. The Bahamas group was also especially amazed by the level of community involvement, knowledge, and caring throughout this culture. We couldn’t overemphasize how welcomed, respected, and appreciated we felt throughout the entire trip.

The Dominican Republic group similarly felt this same sense of welcoming and appreciation while they were working with a variety of different patients in the DR. Many of these students were able to work in a maternity/labor & delivery clinic, where they were able to perform perinatal and neonatal assessments, as well as actually deliver some infants! They described how the nurses in this community were able to do so much with the limited resources that they had; a finding also similar in the Bahamas. Many of these students participated in a new infant care system in this clinic known as “Kangaroo Care” – a process in which there is almost constant skin-to-skin contact between mother and baby during the initial days after birth. This Kangaroo Care is able to keep a great deal of premature babies alive at this clinic, despite the fact that they do not have many technologically advanced tools and resources.

The Jamaica group had a variety of different experiences, some of them arguably the most challenging of all three groups. These students explained how the majority of the patients they interacted with were incredibly poor, needy, or abandoned. Much of the time was spent at the “Missionaries of the Poor” Catholic monastery near Kingston, where different missionary Brothers provided care to anyone who was in need. They described the importance of religion in this care, and how it was incorporated into their daily lives. These students also had the initially heartbreaking experience of working with many abandoned and disabled children through this program. The students expressed their initial feelings of overwhelming sadness, but soon learned to see the joy and resilience of these young children. One of the students emphasized how much happiness she found in these patients, despite their obvious hardships. Finally, two of the Missionary Brothers actually came from Jamaica to sing a song for us and promote a concert they are having in March to raise money for the Missionary, which is funded completely through donations.

Overall, it seemed quite clear that all of the students not only had an amazing experience and provided a great deal of teaching while abroad, but they also learned so incredibly much. Some of the common words throughout all three presentations included: “helping,” humbling,” and “enlightening.” We all expressed that all of the hard work before and during the trip was more than paid off whenever we received a smile, hug, or “thank you” from any of the patients we interacted with. We’ve all gained so much respect for these countries, and especially the work that the nurses and medical personnel do there. We’ve learned how dedication, perseverance, and motivation in any situation can enable such incredible things to be accomplished, especially in healthcare settings with such low resources. I’m sure that for many of us, including myself, these trips were some of the best highlights of our entire Student Nursing career.

Day 4 in Eleuthera, Bahamas

For our fourth day on Eleuthera, we had the opportunity for some sight-seeing and touring across the island. Our first stop was to the new Centre for the Arts that is being built in Tarpum Bay, an area that will soon hold an outdoor amphitheatre and stage. In fact, this very stage will hold a concert for Earth Day this coming year with a variety of well-known American artists. While construction is being completed on this new addition to the area, we were also able to see where time has stood still on another part of the island. Part of our tour included visiting the abandoned VentaClub, an Italian resort/club that was abandoned decades ago due to lack of sustainability. As we walked through the remains of the resort, we saw a once beautiful property with direct access to the soft sands of the Atlantic Ocean. Unfortunately, the lot was deserted, and is now only minimally maintained by one sole caretaker. VentaClub is not the only abandoned resort on the island; farther down, there is also a deserted and overgrown Club Med that was once a popular, elegant place for tourists.  However, neither of the resorts was properly built for sustainability on the island, and eventually both were simply left as empty buildings.

Despite seeing these beautiful shells of a wealthy time once past, we also saw that many people on the island are busy working hard towards promoting sustainability and sustainable projects on the island. In addition to the new Arts Centre being built in Tarpum Bay, we also visited the Leon Levy Native Plant Preserve. This area is a 25 acre stretch of land that was renovated through a donation by Mr. Leon Levy to be a preserve to a large variety of native plants, and even some animal species. During the tour, we saw numerous plants that are used for natural bush medicine in Eleuthera, such as certain leaves that one would make into a tonic or tea in order to cure different problems like colds or the flu. In addition to the growth that we were able to see at the Native Plant Preserve, we were also able to see the work the community has done for their own volunteer fire station, which also houses the area’s ambulance. Shaun Ingraham, one of the top community leaders, and the contact from Island Journeys that sets up the Bahamas alternative winter break trips for Emory, even took the student nurses on a special trip on top of the fire truck. Shaun has been incredibly helpful to us the entire time we’ve been here, and has let some of the students stay in his childhood home throughout the trip. Although, I think he may have a special place for Emory in his heart, as he is a master’s graduate of Emory University’s Candler School of Theology.

After the excitement of taking our first ride on a fire truck, we traveled farther up north to a unique, historical spot known as “Preacher’s Cave”. The specifics behind Preacher’s Cave vary, but the general story is that it is the original founding spot of the Bahamas. There were missionaries traveling throughout the Atlantic Ocean who wrecked their ship on a dangerous spot near Eleuthera called “Devil’s Backbone.” When they survived the shipwreck, they took cover in a nearby cave that came to be known as “Preacher’s Cave.” This is the spot considered to be the founding place of the Bahamas.

Finally, we were allowed a very special treat to attend the Eleuthera Rotary Club’s meeting, where some of the strongest and most progressive leaders in the community meet monthly to discuss community needs and goals. Dr. Thomas has been working with a variety of the Rotary Club members for a number of years now, and they were very excited to meet another group of her nursing students. We all loved the warm, good-humored atmosphere that the members kept even while discussing important events on the island. It was refreshing to see so many people coming together with honest, sincere interest in bettering the island of Eleuthera. And, as we have noticed is custom on Eleuthera, we were made to feel right at home amongst all of the most important members of the community, and like they truly appreciated our work here. I think all of us felt proud of not only ourselves as Emory nurses, but also of the Bahamian nurses that we have learned so much from throughout this journey.

SuperNurses and Community

Being here in Eleuthera has been truly amazing. Physically interacting with the people in the clinics and schools has changed our perspectives of community. The people of Eleuthera have been welcoming and pleasant!

Following our experiences in the schools, actually talking with the students and hearing feedback from the teachers, I was proud, knowing I was able to make a difference. After a young, teenage girl asked if there was a way for her to keep in contact with me following our STD Presentation, I was ecstatic! I hope the knowledge we shared will save lives and encourage the students to make responsible decisions. They can now use and share the knowledge they learned with others. Hopefully, our efforts can assist with slowing the spread of STD’s, especially herpes. According to an Eleuthera nurse, it is currently on the rise on the island. It was truly an experience I value and wish to continue in schools and other “at risk” populations.
I definitely honor volunteering and sharing knowledge. When I think over my goals of serving the underserved, I definitely see the possibilities here. These amazing people of Eleuthera deal with what they have, hope for the better, but the are not greedy or wasteful. They don’t fret over what they do not have available, they simply value their blessings.
Everyone knows everyone and they all help and share with each other. I have still been unable to digest how amazing the nurses are in Eleuthera. They are literally “Superwomen!” They have to work autonomously as they are sometimes the only healthcare personnel available. They can do everything except major surgeries, trust me, they do! The main focus for Eleuthera nurses is preventive health and hypertension and diabetes surveillance, although they respond to all patient concerns. Under the Eleuthera’s Government and the Department of Health, the healthcare workers attend to school aged children, in at least grades 1, 5, and 10. It is mandatory for them to do health screenings for the students at the schools. I remember a similar process when I was in elementary school, so assisting with the screenings, brought back memories. The nurses do general screenings of height, weight, blood pressure, vision with Snellen charts, immunizations, and sometimes hemoglobin tests. The doctor then follows up with “at risk children,” or children with abnormal values.

The Eleuthera nurses definitely have encouraged me to go far, embrace nursing and my explore my capabilities to heal and impact the lives of my patients.

Day 3 in Eleuthera, Bahamas

Today was our third day on Eleuthera, Bahamas. During the morning, my group was sent to Tarpum Bay to work with the nurses in the clinic there. The majority of the clinics in Eleuthera serve a variety of different patients, and they attend to numerous ailments. Each day, they typically have one type of service offered (such as a well-baby clinic day, a day for general ailments, and a day to see the doctor). Wednesday is their well-baby clinic day, so we were able to work with many different children coming in for general check-ups and vaccinations, although some sick children also came in. Once again, the nurses here had to do the initial intake of the patient, assess the child, and then either provide a treatment in the office, or prescribe the appropriate medication to go home with the child. I am continually amazed by the amount of work that they have to do, and the knowledge they must to possess in order to do that work effectively.

After we finished our nursing work during the well-baby clinic (where we made friends with many adorable, tiny patients), we went with the nurses to do two home visits. These home visits are done approximately once a month for patients who are unable to come into the clinic for whatever reason. The nurses go to their houses, perform a general assessment, and determine what the patient’s plan is for the upcoming weeks. One of the aspects of these visits that I found most special is how much the nurses know about the patient’s social history and family history. As one nurse put it, “everyone knows everyone on Eleuthera. Well, almost.” Both patients seemed especially appreciative and happy to see the nurses as they came in to care for them. I was impressed by the way the nurses incorporated their knowledge of the patient’s family history (such as their brother, father, or grandfather having hypertension, diabetes, cancer, etc) into the planning for the patient. The community of Eleuthera is so tightly knit together, and it seems to truly pay off not only through increased social interaction, but also healthcare planning.

Our last stop for the day was at the primary school near the Tarpum Bay clinic to watch the students practice their dance routines for the upcoming Junkanoo Festival. Junkanoo is a masquerade/parade type of street festival common throughout the Bahamas during the month of January. The adults have their own version, and the younger kids celebrate a Junior Junkanoo, where they make elaborate costumes and masks and dance in a street parade with songs and drums. All of the students were busy practicing their dances when we stopped by to see them perform. Even though the dance seemed fairly exhausting under the warm Bahamian sun, the students truly seemed to enjoy themselves and to want to work together on their dance. I thought this was an especially fun way for them to get exercise, given the concern with obesity and diets on the island. One of our own faculty members here with us, Dr. Tami Thomas, had suggested this to the students as a great form of exercise on one of her previous trips to Eleuthera. As Dr. Thomas said, “the people of the island have such a great culture and such great resources here…someone just needs to tap into that, and many of their problems could be solved.”

Finally, at the end of the day, we were surprised by a special visit at our house by some of the local neighborhood children. They came up to our door twice and gave us various little “presents”, such as flowers, berries, and a bracelet. Their kindness and generosity shocked us, and I know it touched my heart. We didn’t have much to offer them in return, but they really weren’t even expecting anything of value from us… They seemed excited when we were able to give them some of our stickers from our previous days of teaching in the schools. We were once again shown how caring this island is, especially in our community of Tarpum Bay. The Bahamians on this island truly have a way of making everyone feel at home, and like we’re part of their family.