Carchá

This past Friday, Monday, and Tuesday we spent time with the midwives of Carchá teaching them the same three topics that we taught the midwives in Chisec. That’s where the similarities end though. This group of midwives was vastly different from our first. There was a wider range of education to begin with, some couldn’t write or read and others who could read and write in multiple languages. There were women who were activists trying to fight for more rights for midwives. There was a mother of 19 who had delivered all of her babies herself – two of her daughters were there as midwives with her. There was a woman who had been a nurse for the government and changed to become a midwife.

I like to think that the six days we spent teaching these midwives has changed us all. We complain about salaries and hours and working conditions in the States, but it’s nothing compared to these women. They don’t get paid for anything that they do. They are on call 24/7. They don’t get vacations or sick leave. They walk at night for miles without lights to show them the way and then deliver babies on dirt floors by candlelight. I know they don’t have the same risk of malpractice – but they have a greater risk of maternal/fetal morbidity and mortality.

While I would like to say that all midwives in the States do what they do because they love it, I’d also like to think I’m not naive enough to believe that. The midwives here do this because they view it as a calling from a higher power. They do it for the love of their community and the love of their women. They do it in spite of constantly being put down by the government, of constantly being scorned, of constantly being waved off like they are unimportant – like they’re something less than others. I’m just in awe of them.

Teaching here was harder for all those who did it. We’re tired and languages are harder when your brain isn’t firing as sharply as it normally does. We all struggled to understand and to communicate. We struggled to accommodate the variety of educational levels. We struggled with illnesses taking out two of our more proficient speakers on the last two days. We struggled with patience for each other. It’s definitely been a harder go this time around on all fronts.

 

Share and Enjoy:
  • email
  • Print
  • Facebook
  • Twitter
  • Google Bookmarks
  • Add to favorites
  • RSS
  • StumbleUpon

Day 6 at Moultrie – Teamwork Makes the Dream Work

BSN Student, AshleyAnne James, checking hemoglobin and blood glucose while a pharmacy student helps comfort the child

Sunday night we arrived back in Moultrie, Georgia to our hotel that was comforting and familiar. They welcomed us back with dinner in the lobby and we got to meet and mingle with the new pharmacy students and dental hygiene students that would be joining us for our last week of work. Monday morning we were back at the Elementary School making sure we got off to a good start to help try to get the rest of the kids at the school seen by all of the stations this week. I was back at the kids’ favorite station, blood glucose and hemoglobin. Unlike the very first day where some kids didn’t know they would have to get their finger stuck, word of mouth had spread and they all knew that it was coming. Some kids had prepared themselves as they sat down with me, handed me their finger of choice, and looked away trying to focus on the stickers. Other kids had gotten so nervous that they were in tears before they even got to the table, thankfully there were not too many like that. Over the last week we helped learn and teach other some tips and tricks to make it easier for the kids such as having them count stickers when we did it or even holding their hand a certain way so they couldn’t see the blood. Even though this was the pharmacy students’ and dental hygiene students’ first day at the school and they were getting used to the flow, they were always so quick to lend a hand and help; whenever they would see a kid sitting with us starting to get nervous or cry they would immediately come over and comfort the kid and ask if there was anything they could do. Even in an unfamiliar environment, it’s so nice to see that everyone is so willing to help each other across our disciplines of work. All around the Elementary School the saying “teamwork makes the dream work” is proudly displayed on various posters and it definitely rings true for our team.

Dental Hygiene students setting up inside after escaping the storm

The storm at the camp approaching fast! Photo taken by NP Student, Geoffry Hall

After a little bit of rest back at the hotel, we headed out to a new camp to help provide services to the men. We drove through quite a few muddy roads but finally arrived and began setting up. After the first few men came through we noticed some dark clouds in the distance but were keeping our fingers crossed it would just pass by us. Every thing started getting busy which meant I normally just focus on my patient in front of me and not many other distractions around me, so I was startled when one of the faculties members came up to our station and told us to pack up because the storm was coming right for us and it looked bad.Thankfully, the night would not be a waste; there was a portion of the camp that had a building and screened in windows we could move to instead of heading home. We all crammed into this small space, setting up chairs and extra tables where we could and made do with what we were given. It was definitely a challenge working in a smaller space that got noisy and hot very quickly, but we were happy that we could help out everyone that came to see us. Not every thing goes according to plan when we are out working, but in the last week we learned so much about flexibility and cooperation and have seen in person how important it is. It really is a team effort these two weeks and I am so thankful to be on a team with everyone here.

 

Share and Enjoy:
  • email
  • Print
  • Facebook
  • Twitter
  • Google Bookmarks
  • Add to favorites
  • RSS
  • StumbleUpon

Men Nan Men and Church Service

We spent the last two days with complete immersion into the Haitian culture. We started Saturday morning at Complexe Educatif Men Nan Men which is a multi-lingual school funded by Foundation For Peace in pursuit of teaching English, Spanish, French, and computer classes for less than $4 to the student. The students were quite curious and eager in asking questions about the American culture and our perspective of Haiti.

        

Christine (left) and Ektaa (right) conducting English classes.

Later in the afternoon, we set up a clinic in the schoolyard where we saw about 80 students. What was unique about this experience was that some of the students helped in translating; they were very ecstatic to practice speaking the English they have been learning for the past few months.

Nicole gathering patient history.

We attended a Haitian church service on Sunday morning at Pastor Valentin’s church. We were greeted by a very friendly community and participated in singing and dancing at the church that was led by only children. It was great to see how involved the children were in putting this event together.

Our leader, Helen, thanking the church members for a warm welcome.

Shortly after the service, we were guided by the Foundation For Peace staff to tour the local community. We took a bit of a scenic hike through many fields to a small village where church members live. They were living in quite unfortunate circumstances where a small hut would be home to at least 8 people. Despite their living conditions, the people of the community welcomed us with open arms.

  

Share and Enjoy:
  • email
  • Print
  • Facebook
  • Twitter
  • Google Bookmarks
  • Add to favorites
  • RSS
  • StumbleUpon

Day 2 and 3 Care in the Community

Days two and three were a whirlwind, as we embarked upon an adventure in the villages of Kwa Kok and Jaquet. Within two days we were able to see greater than 200 patients. Making diagnosis were drastically altered by the norms of the Haitian culture and prevalences of diseases in the community such as malaria, dehydration, typhoid, parasites, and nutritional deficiencies.

  

 

 

 

 

 

 

 

We were able to gather information from our patients with the help of our hardworking interpreters, who worked hard at gathering appropriate patient history. They also went above and beyond about educating us on Haitian culture.

The eve of both clinical days were spent sorting and labeling medications appropriate for our patient population. In comparison to the US when treating our patients we were often unable to use first line treatment, we were required to be creative with our medication choices.

Despite the overwhelming amount of patients seen we were able to work well as a team and meet the needs of our patients.

  

 

Share and Enjoy:
  • email
  • Print
  • Facebook
  • Twitter
  • Google Bookmarks
  • Add to favorites
  • RSS
  • StumbleUpon

Day 5 at Moultrie – Rained Out and Moving Out

BSN students getting ready for the last night of the first week (featuring stylish rain boots and fanny packs)

Lightening lighting up the sky as we begin to pack up our stations

Yesterday and today are the last two days of our first week and the time absolutely flew by!! Last night we once again lined up in our cars and headed out to a new camp to work with. We set up quickly on the main road leading into the camp so everything was flat and there weren’t too many bugs bothering us. The men who come to us are usually just coming off from the work in the fields and they were running a little late yesterday so we had extra time to all hang out. Over the week everyone in the disciplines has gotten close and become great friends so we no longer spend our free time with just a small group of people in our same specialty; instead, we used our free time to organize a quick soccer game for all of the specialties to play while others watched and cheered on their friends. After a few good soccer games, the workers started coming and and we all headed to our stations. I was at the blood glucose and hemoglobin station, which has become by favorite station to work at during the camps at night. All of the previous camps we had been to this week had only men, but there was a fair number of women who were working that came and saw us which was a new experience. Unfortunately, a few hours in we heard lightening cracking nearby and had no coverings for any of us so we had to pack up quickly and head back to the hotel. Normally when we are in class as students and we hear that we get to head home early everyone gets very excited, but there was a different tone when we were told we would be leaving early last night. Many of else felt sad and disappointed. We knew there was nothing we could do about the situation since the approaching lightening was a major safety concern, but it was hard for us to leave knowing there was a lot of men and women that we could not see or help out, but we hoped that we made an impact on those we did see.

BSN Student, Jessica Yang, testing blood glucose and hemoglobin on an Elementary Student while a pharmacy student helps keep her distracted and happy!

Today we woke up with our cars packed to go home and ready to head out to the last morning session at the Elementary School for the week. There were not too many kids to see and we got them all in and out quickly. I was working at the audiometry station testing the kids’ hearing with another BSN student which went smoothly since the kids knew there were no needles involved and they got to wear cool headphones instead!! We did not have to pack up too much since we would be back again on Monday but we made sure our stations were clean before getting into our cars and making the drive back up to Atlanta to be able to rest and refresh ourselves for a few days. I have had such an incredible experience this past week and feel like I’ve already learned and grown so much. Working in this unique setting has taught me so much about teamwork, flexibility, cooperation, and patience. I am so excited to be able to come back for one more week with people I’ve grown so close to and some new faces as well!

First week group with all of our BSN students, NP students, Pharmacy students, Dental Hygiene students, Physical Therapy students, and faculty!

Share and Enjoy:
  • email
  • Print
  • Facebook
  • Twitter
  • Google Bookmarks
  • Add to favorites
  • RSS
  • StumbleUpon

Day 4 at Moultrie – Blood, Sweat & (no) Tears

The farmworker camp we worked at and set up our stations

Last night a little after 6:30pm we arrived at a new farm, covered head-to-toe in bug spray and ready to tackle whatever the night threw at us. Thankfully there was no rain on the radar for the night, but this camp definitely brought some new challenges and surprises; there were no coverings at the camp so we were outside with the grass coming up to our knees. Even though we were at a new location, the set up went smoothly since we have settled well into all of our roles throughout the different disciplines. I was placed at the blood glucose and hemoglobin stations where we were doing finger sticks on the men that came through. Doing the finger sticks on the farmworkers can sometimes be challenging because their fingers are often very callused making it harder to draw blood for both machines. We’ve all learned techniques from each other to make the process easy for us and the men so we don’t have to stick them again. Sometimes we have to squeeze and massage down their hands (a process some nurses have termed “milking” the arm) and holding their hands down at their side to let gravity help the blood flow. The men were able to go around and see all of the nursing stations, the nurse practitioners, physical therapy, and dental hygiene throughout the night and get the help and referrals they needed.

 

One of the nursing students getting a good stretch from a physical therapy student during a break!

This morning we went back to Cox Elementary School to continue our care and screening for the kids. Another one of the nursing students and I went upstairs and got ready at our station that was testing height, weight, and BMI. Working with the children at the station was pretty simple, all we had to do was weigh them and measure their height but it required a lot of charting so, like yesterday during the vision screening, we took a lot of turns charting and keeping the kids entertained who were waiting. In our room we were testing in we also had a physician from Guatemala who was sitting with the kids waiting teaching them about Zika virus. She used coloring books and pictures to explain to them what the virus is and how they can help prevent it for themselves and others. The Zika virus is becoming an increasingly difficult problem, especially here in rural South Georgia during the summer months, so teaching these kids from a young age is very crucial. Our hotel we are staying at is also very kindly serving all of us dinner tonight before we head out to our last night at a farmworker camp for the week. We head home for the weekend tomorrow afternoon but we’ll be back Sunday night to start our second week of service here!

Share and Enjoy:
  • email
  • Print
  • Facebook
  • Twitter
  • Google Bookmarks
  • Add to favorites
  • RSS
  • StumbleUpon

Day 3 at Moultrie – Getting off on the Right Foot

Enjoying our delicious food prepared at the camp!

A little after 5:30pm yesterday evening, we once again loaded everyone in the program into our 30 car caravan to go back to the camp we helped at on Monday night. I felt a lot more comfortable and confident going back now that I had a night to see how everything was run and get used to the language barrier. Set up went smoother since we knew where everything went and it thankfully wasn’t raining or muddy (yet). All of the workers at the camp very graciously served our entire group a traditional Mexican dinner. The food was delicious and it felt so nice for them to welcome us into their lives in such a kind way.

Some of the housing facilities for the camp

Last night I was assigned to the foot care station where we cleaned the mens’ feet, cut their nails, moisturized and massaged their feet, and assessed for any infections or problems to refer them to the nurse practitioners and clinic. The foot care station is often the station that a lot of us nursing students dread, but it was set off to the side of the camp where we weren’t in the center of the hustle and bustle. A big part of the station involved educating the men on proper foot care and how to protect them from pesticide exposure in the field that can accumulate in their shoes, but since we got to sit with the men in a quieter environment, we could talk with them and connect and give them a bit of much needed relaxation and pampering. Unfortunately, a few hours into being at camp the clouds moved in and it began pouring so we had to close up the foot care station since it was outside. The other people working at the station and I ended up circulating and offering help at different stations as needed and tried to make the rest of the night as productive and smooth as possible.

 

BSN Student, Jessica Yang, hula hooping before the kids came in!

This morning we again returned to Cox Elementary School to help continue assessments and screenings on the kids in the summer school program. I was working at the vision testing station where we used picture charts to help test their vision for distance and also a book to check for color blindness. Gabrielle, one of the other BSN students, and I were working together and had a great flow with the kids as we would switch off having one of us filling out the kids’ charts as we tested their eyes and the other person pointing at the pictures and keeping the kids in the room entertained with stickers and funny glasses. I really enjoy starting the days working with the kids; they are so much fun to work with and they bring out a funny, silly side in everyone working and make the day so much more enjoyable. Tonight we are at a new camp working with a new group of men where more help, education, and learning can happen!

Share and Enjoy:
  • email
  • Print
  • Facebook
  • Twitter
  • Google Bookmarks
  • Add to favorites
  • RSS
  • StumbleUpon

Day 2 at Moultrie – Feeling the Pressure

High fashion for nursing students at the first camp!

Yesterday we had our first night working with the farmworkers at their camps and it was quite an operation; everyone in the program throughout all of the disciplines lined up in their cars next to our hotel for a giant caravan drive to our first farm of the week! We all arrived together through muddy roads and began unloading and setting up numerous truckloads of supplies in our finest rain gear: ponchos resembling giant plastic bags and our scrub pants tucked nicely into our rain boots.

 

Sun goes down, head lamps go up!

Everyone was very excited setting up and preparing to meet and work with the men here. One of my favorite parts of this program is how we have so many different medical fields working together and learning from each other. Molly, one of the other nursing students, and I got to teach a group of the pharmacy students how to use the blood sugar and hemoglobin machines and then they were able to help us throughout the night when that station got busy. Even dental hygiene students helped the student nurse practitioners identify problems in the mens’ mouth. It was really great to see all disciplines finding ways to help each other and give the men we are assessing the best help they can get. Once all of the workers started filing in, I was definitely feeling the pressure… possibly because I was assigned to the blood pressure station… but also because I was facing the reality of trying to assess and educate these men when we didn’t have a language in common. I felt confident in my technical skills in taking blood pressures but that confidence was immediately lost when I tried to introduce myself, explain what I was doing, what their results were, and education on high blood pressure management when I only spoke English and they only spoke Spanish. Thankfully, like all students do in nursing school, I figured out a way to make it work. I learned a few phrases to help build some connection and realized how important a smile and a reassuring hand on the arm can be. We also have amazing translators with us that helped with some more complicated translations and education between us and the men. At around midnight we finally had everything packed up and drove our long line of cars back to the hotel.

 

After what only felt like 30 minutes of sleep, we were up again today and back at Cox Elementary School in the morning. Thankfully, almost all of our supplies were still set up from yesterday so it didn’t take too much work before we got to start seeing the kids. I was at the blood pressure station, but unlike last night I also had the added bonus of handing out stickers to the kids who came through. Many of the kids were very young and could only speak a little bit of english but we still made sure to have fun! They all got excited to get their blood pressure taken by a cuff that would “give their arm a big hug” before picking out the perfect sticker. I loved being able to joke around with the kids and show them how all of the equipment worked, which for them included squeezing the air pump of the blood pressure cuff until their hand got tired and tapping on my stethoscope as soon as I placed it in my ears. All of the kids there are so sweet and I’m so glad we can come and do our part to help them the next two weeks. Tonight we are back at the same camp we were at last night to continue our care for the rest of the men. It’ll be another muddy night but I know it will be worth it!

All smiles in the car ride back from the Elementary School!

Share and Enjoy:
  • email
  • Print
  • Facebook
  • Twitter
  • Google Bookmarks
  • Add to favorites
  • RSS
  • StumbleUpon

Guatemala Day Three-Five

Part of the fun of international travel is always finding reliable internet connectivity. Since my last post I have been fighting quite aggressively with the internet and my computer, but finally I overcame (which is impressive if you knew how little I understand about computers). Anyway here is what I had typed up for day three and then some extra added to it to include days four and five (so it’s crazy long):

Afternoon storms are becoming a normal part of our routine – I think that they’re the only thing that actually runs on schedule here. Those of us who need internet, for homework or more leisurely activities like Netflix viewing, are watching the clouds and lightening roll in from the open, covered area where we get internet at this hotel. It’s making things significantly cooler here, which is such a blessing. The rainy season has begun in Guatemala, which means that the entire night was filled with rain falling on the tin roof of our room and that the entire day felt sticky and hot.

This morning, as the midwives started walking into the courtyard this bubble of excitement overwhelmed the table that where we were all sitting. We wanted so badly to go and greet them, and know them, and express our appreciation for them being there. Two issues with that desire: we didn’t want to overwhelm them and none of us speak their native language. Instead we settled for the traditional “Buenas días” and a pat on the arm/kiss on the cheek as they headed to our conference area.

Rebecca Gloss and Hannah Lake-Rayburn did the teaching today. The spent the entire morning dialoguing with the midwives about high blood pressure during pregnancy, preeclampsia, symptoms of these conditions, and when women were traditionally referred out. We then broke off into small groups and taught these midwives how to take blood pressures using the BP cuffs and stethoscopes we brought down for them. It was so exciting to realize how veracious these people are to learn new skills and about new equipment that they knew would help the women that they love so much.

Not that this teaching didn’t come without challenges: the majority of our group speaks some Spanish, but that becomes completely moot when trying to communicate with the majority of the midwives because they speak a traditional Mayan language that sounds and tastes nothing like Spanish. It’s harsher sounds, stronger syllables, thicker tongues. Luckily, we had a translator there, Maria, and quite a few of the midwives also spoke both, so in the end it all worked out from that standpoint. We were also educating a couple of illiterate individuals, which made taking blood pressures difficult for them because while they could hear the sounds and understand where on the monitor they needed to note numbers, they couldn’t dictate what the number actually was – which almost defeats the purpose. Our solution? Mark on the cuff monitor which pressures indicated an emergent situation and necessitated a referral. This job requires nothing if not adaptability.

After eating lunch with the midwives, they began there journeys back home – some of which would be more than two hours – and we returned back to our rooms for a quick siesta. At 1530, we met back up with one another and took the bus into the town of Chisec. We could hear and see the storm rolling in, but we were determined to get in a little bit of walking in spite of the obvious incoming weather. We paid for our stubbornness and got caught in a small shoe shop during a torrential downpour. All of the people who were in town took cover under something and we just watched the streets quickly fill with water. Luckily, the shop keepers were extremely pleasant and allowed us to stay under cover until Oswaldo came and picked us up in the bus.

The rest of the evening was spent putting together small packages for the midwives – consisting of gloves, umbilical ties (they don’t do clamps down here), new scissors to cut the umbilical cords with, sterile blue towels, and a couple of pairs of sterile gloves. All of these new goodies will provide the midwives with a very limited supply of some of the resources that they need – but we’re trying. These packages coincide beautifully with the educational session about sepsis and neonatal infections that will be conducted tomorrow by myself and Tamara Noy.

Our teaching went well. We got to have lengthy conversations about infections and how the midwives traditionally care for their women. I think at this point we were all quickly coming to the realization that these midwives are so so so knowledgable and so passionate. It becomes much more of a dialogue and much less teaching – an exchange of treatments and options and ideas. It’s so inspiring to learn from them and to hear what they go through on a daily basis.

We got to do a home visit with one of the comadrones, which was very eye-opening. The woman we saw five months pregnant with her fifth child. Her husband, her four daughters, and she lived in a building that is roughly the size of typical dorm room with dirt floors and a large curtain splitting off some of the sleeping areas from everything else. There were three chickens living in the house with them and a large (I mean large) bin of corn in one corner. Even though it was small, and the family was obviously impoverished, everything was clean and well-cared for – and the woman had pride showing us where she lived and introducing us to her daughters (all through the interpreter mind). We also got to see the return OB visit, the midwife did Leopold’s (basically felt the belly to determine the size and position of the fetus) and then did a mini rubdown of the woman’s legs and belly and arms – kind of like a massage. It was wonderful to see a midwife in another country utilize similar tools that we do in the States.

Finally, on Thursday, Chelsea and Michelle did their teaching on postpartum hemorrhage. They used chucks and poured different amounts of fake blood on to them to have the midwives determine which needed a referral and which was okay. We also supplied the midwives with headlamps and showed them how to use them so that they could see when they were walking in the middle of the night and check for tears in poorly lit buildings. Chelsea and Michelle mimed a birth with a postpartum hemorrhage and asked the midwives what they would do throughout. It was a very successful learning day.

We then went a stood in a circle with all of the comadrones and began throwing a ball of yarn from person to person. The person with the yarn would share what they had learned or what they enjoyed most about the past three days, would keep a hold of the string, and pass the ball along. At the end, we were all connected by this string which physically exemplified the way in which we were connected by our profession and our passion for the women that we get to care for on a regular basis. I think it’s safe to say that these three days in Chisec were inspiring and uplifting on both ends and just made me so much more excited to enter this profession.

BP practice with the midwives.

Erika, Hannah, and Becky teaching the midwives.

Jenny, Becky, and Tamara teaching more about BP

Share and Enjoy:
  • email
  • Print
  • Facebook
  • Twitter
  • Google Bookmarks
  • Add to favorites
  • RSS
  • StumbleUpon

Moulin Sur Mer and Tabarre

After seeing hundreds of patients this week, we spent our day off with some R&R at Moulin Sur Mer. It was a beautiful beach with clear, blue waters and soft waves. Later that evening, the Foundation For Peace organized a Creole class to help us better communicate with the patients we were seeing.

Relaxing and bonding at Moulin Sur Mer

The patient population we saw that day was quite different from those earlier in the week. They were more educated and some even spoke English. The kids were more playful and eager to ask questions. A lot of the care we provided was surrounded around patient education and prophylactic treatment.

Joya discussing adolescent growth

The day was filled with a great amount of teamwork as the Pastor of the church, Pastor Valentin, was present the whole day to keep things organized. Pastor Valentin’s sister, who is a NICU nurse in Haiti, was also present to help triage and assess vital signs.

Our amazing team for the day

We were fortunate to work on a team with many hard workers that came together to provide optimal patient outcomes!

Share and Enjoy:
  • email
  • Print
  • Facebook
  • Twitter
  • Google Bookmarks
  • Add to favorites
  • RSS
  • StumbleUpon