Thank you so much for taking time to look at our blog! We are a group of edical students who are passionate about training and in underserved areas. This January and February, we are in Peru, the Dominican Republic and Costa Rica internationally as well as locally in Flint and Lansing completing volunteer service, rotating in hospitals and clinics, and learning about international medicine and local underserved health care. We appreciate any time you take to read our reflections and any donations you might offer.
Please click the “Donate” link on the side for more details on how to give directly to these communities.
Saturday, February 28
Over the last week, we've been working on a “proyecto” (project) that we created to help improve the management of four major chronic illnesses that is commonly seen in the clinic such as diabetes, hypertension, obesity and asthma. Our group was asked to develop a plan during which we would produce a volunteer handbook that would help guide future volunteers in managing these illnesses when they come through the door.
For each of the chronic illnesses, we provided basic disease pathophysiology and specific socio-cultural-economic factors that are unique to the patient population here in Alajuelita that further complicates chronic disease management that goes beyond access to resources and medical attention. Next, we created step-by-step instructions on how patients with know history of chronic disease or demonstrate risk factors that would indicate screening and identify scenarios in which the physician or clinical staff should be notified emergently i.e. a child struggling to talk in full sentences during an acute asthma exacerbation or an adult having a blood pressure above 180/110. Our goals for these step-by-step instructions is to help streamline patient check in, provide appropriate medical care (urgent in certain cases) and allow time for health promotion and education. This leads us to the other component of our project, and arguably the most important component: health education and disease prevention. Through health education and empowering patients to take ownership of their own medical care, we hope that this would translate into creating long lasting change in people’s lifestyle habits, behaviors that would ultimately lead to better physical and mental well being.
Our completed binder!
Our focus for health education was primarily based upon providing basic medical knowledge that would be comprehensible at the population's general level of education (often is limited to grade school), discuss about risk factors for developing these chronic illnesses (tailoring these to the environmental/social/cultural practices that may contribute as a risk). We also wanted to focus on the importance of disease prevention and provide patients with tangible ways to prevent or control their chronic illnesses.
This portion actually required a lot of thought and insight into the living circumstances of the patients that we see in clinic. Having lived and worked in this community for an extended period of time, we gained an understanding of the limitations of treatment of these diseases necessary to give realistic advice and guidance. While we can argue that hypertension is shown to be most effective controlled by at least 2 anti-hypertensives, the reality is within our clinic that is situated in the slums of Alajuelita is that this treatment method is close to impossible to sustain over time due to limited resources. Instead, we tried tailored our treatment through non-pharmacological methods such as encouraging a low sodium high fruits and vegetable diet, 20-30 min of exercise on most days of the week, weight control etc. As this is our last week in Costa Rica, we also started brainstorming ideas for how to best disseminate health education, through activities that would cater to the local community. We discussed about hosting cooking classes during which patients can swap recipes and learn about healthy eating, exercise classes with yoga or simple exercise that patients can replicate at home or going into the schools to talk about asthma and incorporate the use of games and interactive workbooks. Our hope is that future volunteers can use this binder to identify patients with chronic diseases and use the educational materials that we made to educate patients on their disease, prevention, and treatment that is catered to unique challenges this population faces. We hope that the program is sustainable and will eventually help patients better control their chronic diseases in ways that make sense to them. We are planning to work with FIMRC to send some of this information to volunteers before they arrive in Costa Rica so they can jump right in and educate patients on day 1 and perhaps even use our posters and other educational materials to hold a charla (lecture) or a support group meeting!
Our patient learning about diabetes complications from Diego, diabetes man!
Serena giving a diabetes charla with brochures she made for future volunteers to distribute!
Too cute not to share! These kids were so interested in learning about how to use my stethoscope... he even asked me to turn around and breath so he could hear my lungs like I did to him!
For our last weekend, we were able to enjoy the beautiful coastal city of Montezuma and Santa Teresa with our adopted group member Luke and captured some of the most beautiful sunsets over the Pacific Ocean! We also visited Montezuma Falls, which consists of three sets of waterfalls emptying into freshwater swimming holes, one of which even had a rope swing!
Playa del Carmen
It has been such a pleasure to have had the opportunity to work with the clinic staff and the patients here FIMRC Alajuelita. We are grateful for the help and guidance that we received from Tatiana, Dayon and Dr. Natalia during our time here. It has truly been a once in a lifetime experience and we have all learned so much about the practice of medicine in Costa Rica, international medicine, public health, and the beautiful language, culture and people of Costa Rica. Thank you so much for all your support and for following our blog!! Muchas Gracias y Ciao from Costa Rica Team 2015 “Las Chicas”!! Ya Vengo, which means be back soon!
Tuesday, February 24
|Beautiful views on the hike to Bufuma Primary School|
|Photo from our two-hour hike to Bufuma|
|Finally arriving at Bufuma Primary School!|
|The P6 and P7 girls from Bufuma Primary School received washable menstrual pads during a menstrual health education session. All the pads were hand sewn by FIMRC volunteers.|
|As part of the heart health talk, students used stethoscopes to hear their own heartbeat.|
|Photo with students from Bufuma Primary School|
|Marsel and Ben help clinic staff member, Irene, see pediatric patients in Station 3 Annex|
|Group photo with FIMRC clinic staff|
|Rainbow over Murchison Falls|
|Group photo from our safari van|
Saturday, February 21
To mulembe, we were sent,
Bushika Junior empowerment.
Mona mona, coffee roasting,
Childhood rashes, Post Test Club,
Pepto-Bismol, pink with love.
Richard, outreach, miles, who’s countin?
Kids with babies, up a mountain.
Hey muzungu, how are you?!
Morning nausea, diarrhea x2.
Bufuma in the morn with Bosco,
Rafting down the Nile, also.
Homebrew or mosquito nets,
Cetamol 1gram TDS.
Matoke on a plate like Nuusu,
Passion fruit I could get used to.
Excess matatu, rising sun,
Going to get Bududa lung.
Mai the cat, such a pest,
Fan-taa, Stoney or a Krest.
Popcorn and a movie screen,
GO GO Bushika soccer team!
Puzzle pieces missing still,
DEET latrine. All bugs. Must kill.
Sipi falls, a mighty wind,
Masala fries all day, a binge.
Setting goals with OVCs,
Tuesday meat not what it seems.
Eggs, toast and G.nut paste,
Bucket showers IN THEE FACE.
Lugisu, Musa’s time to train us,
Always, Quoc, ali kuena?
Monday, February 16
Our asthma posters!
Jen training our new secretary.
Serena interviewing a clinic patient.
On another note, we've been very fortunate to be able to enjoy the beautiful landscape of Costa Rica. A couple of weekends ago we went to Volcan Arenal with another volunteer, Luke. Last weekend, we went to Monteverde, a city in the mountains, and hiked through a cloud forest. Here are some photos!
The sun is setting on our trip here, but we've all learned so much. We are excited to wrap up our project in the coming days and hopefully make understanding, preventing, and treating chronic illnesses a little easier both for the clinic and its patients. Until then, Pura Vida!
Saturday, February 14
|Drama Group performs a new act one Wednesday a month. The acts are suppose to be educational for the patients waiting at the clinic.|
|Stephanie and Irene walking with Arlington students home from school|
|Our amazing friends came by to the clinic to visit us after seeing patients. They are always looking for somebody to carry them.|
|The peds ward at Bududa Hospital|
|Irene educating Richard's students on nutrition|
|We made cut-outs of the different food commonly found in Uganda. The kids were really excited about getting the photo taken|
|CME on hypertension management|
|Immunization outreach with Kaliste|
|Setting up shop for immunization outreach|
|Paying close attention to our guide, Moses, at Sipi Falls|
|A picture of some our members at the bottom of the last waterfall; Sipi Falls|