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.

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Sunday, January 24

Tragedies on buses and Training for bomberos

As we depart La Merced for the next phase of our journey, I wanted to post about a particular experience that meant a lot to me.  For my primary outreach project I have been working with FIMRC Peru to develop a series of "Emergency Preparedness" didactics for their partner communities, with the goal being for me to train one of their staff to head up the project for sustainability into the future.  Like I mentioned previously, the first lesson FIMRC requested was to teach CPR to laypeople in rural native communities, which I had some ethical dilemmas in doing.  The compromise I made was to teach the CPR lesson I designed to first responders in the city, which for La Merced is basically just the volunteer firefighters ("Los Bomberos").
And then, something tragic happened - a couple days before the lesson a bus crashed just outside the city.  The driver reportedly passed a car on a two-lane road only to be confronted with a potential head-on collision as he turned onto a bridge.  Rather than swerve back into his own lane, the driver did the unthinkable - he jumped out of the door onto the road, leaving the bus to drift sharply to the left, through the bridge's guardrail, and into the river below.  14 people died, and many more were critically injured.  The bomberos responded to the scene but many would later relate to us that they felt unprepared.

And so, two nights later we came to their firehouse to teach CPR.  I was worried it would be too basic for them. Quickly, though, we found that many basic skills were unpolished or unlearned.  I had them demonstrate taking a pulse, and many reached for the ulnar side of the wrist, or lateral to the SCM in the neck, or somewhere else that wasn't likely to elicit a pulse even in a healthy person.  I was happy that we could identify such a basic deficiency and provide an effective learning intervention.  So it was too with the CPR - many did not perform fast enough compressions, or deep enough compressions, or even more importantly, did not know the indications for CPR.

It was gratifying to be able to teach this lesson.  More importantly, the FIMRC staff member I've been mentoring for my project took well to the lesson and really seems primed to continue teaching this and other lessons we design going forward.  The biggest goal for me in global health projects like this is to achieve self-sustainability of any intervention I design, and I think this was a great start toward that end.
At the end, the fire-chief thanked us and related that she wished we had only been able to come a few days earlier, before the tragic bus accident.  Hopefully implementing this program will be a small step towards making sure that the next time tragedy strikes, they'll be that much better prepared in their response.

UPDATE 1/30/16: Dinah (FIMRC Field Operations Manager, in navy blue t-shirt above) has informed me that in the past week Alvaro (the FIMRC-Peru staff member I'm training for their "Emergency Preparedness"project, in red above) has independently taught the CPR lesson in addition to a Wound Care lesson I prepared and taught with him last Friday.  It's only one repetition and just a start towards sustainability, but this made me so happy :)


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