International Service Learning

In spring 2015, nursing and pre-med students embarked on a health mission trip to Cochabamba, Bolivia under the direction of Dr. Carolynn DeSandre. Over the next ten days, students delivered much needed healthcare services to over 500 men, women, and children in a variety of vulnerable settings, including: family prisons, orphanages, a government funded clinic for the poor, mountain communities, and on the city square in Cochabamba for homeless youth and families. Students facilitated care for many needs including abdominal and musculoskeletal pain, diabetes, hypertension, malnutrition, acute wounds, and family planning. Students worked in interprofessional teams to deliver necessary medical care and health education to Bolivians in need. The healthcare team was honored by the Governor of Cochabamba for their exemplary work and encouraged to return again soon.

For the past two years, physical therapy faculty and students spent their spring break time providing PT services in the Dominican Republic. Students, under the supervision of the faculty members and Dominican therapists, demonstrated their patient management skills, treating individuals at El Buen Samaritano Hospital and two private physical therapy clinics. Groups of students treated Haitian workers in batayes in the sugar cane fields. Although students received no academic credit for their efforts, they were willing to raise the funds necessary to take advantage of this opportunity. Plans are to continue these trips on an annual basis and to study the possibility of expanding cross-cultural experiences to other locations.

As part of a Healthcare Cultural Immersion Study Abroad course, twenty-one nursing and pre-med students, along with nursing faculty, traveled to the Dominican Republic in May 2015 to offer healthcare services to residents in the bateyes. This trip was in partnership with Rivers of the World (ROW) and El Buen Samaritano Hospital in LaRomana. The groups treated 569 patients with conditions ranging from high blood pressure to skin infections. Students overwhelmingly enjoyed this international experience. Dates for next year’s trip have already been set for May 14-22, 2016.

Making a Difference in the Dominican Republic

Recounts by Heather Harris & Elaine Taylor

As part of a Healthcare – Cultural Immersion Study Abroad course – a group of 21 University of North Georgia (UNG) nursing students, pre-med students and nursing faculty spent May 16-22 in the DR providing healthcare to residents in the bateyes. This trip was in partnership with Rivers of the World (ROW) and El Buen Samaritano Hospital in LaRomana. Care was provided to 569 patients during the trip for conditions ranging from high blood pressure to skin infections. As is so often true – a few patients were particularly memorable.

Alexander

During the clinic on Tuesday in Batey Magdalena we met Alexander, a six month old infant who was very small for his age, gaining only a pound since birth. (FYI – a normal infant doubles their birth weight by 6 months). Alexander’s mother tried to breastfeed him, but after every feed he would spit-up most of what he consumed. Alexander had been diagnosed with gastro esophageal reflux months prior, but his mother had no resources for his treatment. Reflux is a frequently occurring condition in infants, commonly treated with small frequent feeds, upright positioning, rice cereal to thicken feeds, and acid reducing medications. Alexander’s reflux was worse than most with the only curative treatment being surgery.

Education about small frequent feeds and keeping him upright as much as possible was the best we could offer his mother during clinic. These few educational pearls were simple and seemed very inadequate. After leaving the batey that day, Alexander and his family were in our thoughts. We knew we could not leave this country without offering him more. Jumbo (the DR’s equivalent to Wal-Mart) was our next stop. We perused the baby aisle looking for helpful gifts for the family, infant formula, rice cereal, bottles, and most importantly a plastic infant bath tub that we creatively transformed into a bassinet that could keep the infant elevated while he slept. Friday we returned to visit Alexander and his mother in their simple home. A smile lit up her face as she realized that her son had not been forgotten. Before we presented our gifts, she proudly reported that she had been continuously holding him upright since she had seen us three days earlier – even sleeping with him to hold him upright. Surprisingly, the infant seemed improved with this simple intervention. We were amazed that education alone could have such a positive effect. By this time, curious neighbors accumulated, forming a small crowd to view the excitement. We offered our gifts and left the village with the contentment of knowing that our efforts had blessed this family. Alexander will likely still need surgery. Our hope is that our feeble efforts will sustain him until that time.

Michel

On Wednesday, May 20th we had clinic in Palo Bonito where we met Michel, a 12 year old boy who loved baseball. He was in respiratory distress during clinic triage. He struggled for air, using accessory muscles in his chest resulting in retractions. (Chest retractions are a sucking in of the skin in between or around the bones of the chest when inhaling and are usually is a sign of severe respiratory distress.) In addition to retractions, he had obvious high pitched breath sounds called wheezing, a sound that occurs when air is unable to escape, due to inflammation and crackles, signs of fluid in the lungs and fever. With these signs, it was apparent he had pneumonia with an asthma exacerbation.

We worked quickly to stabilize him. With limited medication and no electricity or oxygen we used the few resources that we had to care for him. Fortunately, we had a steroid and a potent antibiotic injection that worked quickly and within an hour Michel was breathing easier. We sent him home with more antibiotics and steroids and hoped it would be enough for him to recover.

That evening our thoughts reflected on the day and on the young barefoot boy. His home was a small block structure with no electricity, water, or sewer. He likely had little to eat that night. We hoped that our meager efforts would bring healing to the boy. Two days later we had the opportunity to visit Michel. We didn’t know where he lived but with our brief description of the boy with breathing problems, the villagers lead us to the baseball field. Michel came running toward us, interrupting the game. He was breathing normally and his lungs were clear. The boy that only days earlier was struggling to take a breath, was now playing his favorite game. We left his mother with more medication for him and instructions on treatment in case of another emergency.

We left the DR knowing that we played an important role in the future of the patients that we served. It was a wonderful experience for all that were on the trip and a vivid reminder of how blessed we are to live in the United States.