Tag Archives: nursing

Oaxaca Clinic Receives Medical Equipment Gift

This week Federico Chavez Sosa and I made a visit to the Teotitlan del Valle, Oaxaca Centro de Salud (public health clinic) to present a gift of five stethoscopes to the clinic doctors.  The gift is from Dr. Deborah Morris, MD, PA-C, academic coordinator and the Methodist University Physicians Assistant Program in Fayetteville, NC.

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The Centro de Salud hosted two Methodist University physician assistant students, Ben and Megan, in summer 2013 for a one-month externship residency.  They reported that the doctors would benefit from better quality equipment and suggested that the stethoscopes would make an excellent contribution to improved quality of care.

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Of course, they asked the doctors first if they thought they would like to have new stethoscopes after the doctors admired the ones the students brought to use during their externship.

Federico made the presentation to clinic director, Doctora Elizabet, on behalf of the village as he ended his three-year community service commitment as one of three volunteer committee members to lead public health services, including water quality, sanitation, and community health.  This service, called a cargo, is a mutual support practice of Usos y Costumbres indigenous Mexican pueblos.

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We welcome university level nursing and physician assistant students to ask about participating in a summer residency.  Basic Spanish language is necessary.  Openings are available for summer 2014 and scheduling is flexible.  The cost includes lodging, two daily meals, facilitation, and a contribution to the clinic.  Please contact Norma Hawthorne if you are interested.

 

 

Student Physician Assistants Volunteer in Oaxaca Village Public Health Clinic

Two students enrolled in the Physician Assistant program at Methodist University in Fayetteville, North Carolina, will do a one-month volunteer clinical residency at the public health clinic in Teotitlan del Valle, Oaxaca, this summer.  Meagan Parsons and Benjamin Cook, who will both graduate in December 2013, land in Oaxaca next week!  Needless to say, they are excited.

And, we are grateful for their service.  They will work alongside local doctors, nurses, and other clinicians to support delivery of primary health care services to a rural and growing village of 8,000 people.

For those of you who don’t know, Physician Assistants (PA’s) are master’s degree prepared health care professionals who are trained to practice as part of a physician-led team.   This is usually a two-year program that includes a first year of classroom coursework followed by a second year of clinical rotations.

Nurse Practitioners (master’s prepared nurses who provide direct patient care) and PA’s are meeting the demands of our U.S. health care system, especially in underserved areas where there is a lack of adequate medical services.   Immigrant populations who speak Spanish and have cultural impressions of a health care system that hasn’t always provided access to quality treatment benefit from these professional services.  

Meagan Parsons, Benjamin Cook and Professor Deborah Morris, M.D., P.A.

Meagan Parsons, Benjamin Cook and Professor Deborah Morris, M.D., P.A.

Both Ben and Meagan speak Spanish and the experience will give them a chance to improve their language skills and learn more about how health care is delivered in rural Mexico.  What they learn will help them translate the experience to their own professional goals to work in rural North Carolina communities after they graduate.

Meagan graduated from The University of North Carolina at Chapel Hill in 2009 with an undergraduate degree in biology and a minor in Spanish for health care professionals.  She worked as a nursing assistant in a pediatric surgical unit before she decided to go on for the P.A. degree.  This will be her first trip to Mexico and Meagan is eager for the immersion experience that she knows will give her a greater understanding for the emotional and cultural issues facing North Carolina’s immigrants.  When she graduates from Methodist, she plans to return to Rockingham County where she will practice in a small-scale rural community working with Spanish-speaking populations.

Ben Cook completed his undergraduate degree in human biology and Spanish from North Carolina State University in 2011.  He always wanted to pursue a medical career and he wanted more time to have a family and be involved with family life.  He feels that by becoming a P.A., he will have the best of both worlds.  He chose Methodist University because it has a high pass rate on the national certifying examination and there is a dedicated laboratory for student use.   Like most men who pursue a career in health care, Ben wants to go to work in either the Emergency Department or in Urgent Care where the fast-paced excitement prevails.  He feels the Oaxaca experience will give him better ways to connect with patients here in the U.S.

Deborah Morris, M.D., P.A., is the faculty member who supervises the cultural immersion program in Teotitlan del Valle for Methodist University.  She says this experience is essential for giving students a broader perspective of the world and the ways that health care is delivered in a system that is different than ours in the U.S. She says, There is a flow of people between Oaxaca and North Carolina.  It is helpful for students to have this experience to be more effective as P.A.’s.

For the village of Teotitlan del Valle, the students will trail and support the work of Mexican doctors, nurses, social workers, psychologists and dentists.  They will start out doing basic health assessments and physical diagnosis, assist in giving innoculations, and update handwritten medical records.  As they get to know the population and their needs, they will develop a health education project with local participation and input, that can be used for continuing health care improvement.  The biggest health care issues in Oaxaca are women’s and children’s health, pre-natal care, diabetes and its prevention, and cancer treatment.

Meagan and Ben will overlap with UNC Chapel Hill School of Nursing student Leonora Tisdale who arrived to volunteer in the clinic in early June.  I am so gratified to be able to organize this experience that benefits the students, the people of Teotitlan del Valle, and people here in the U.S. who will be better served as a result of Leonora, Meagan and Ben’s immersion.

I work with universities to place students in the health professions for a volunteer experience in the Teotitlan del Valle public health clinic. Please contact me for more information.

 

 

Nursing Student Volunteers in Oaxaca Public Health Clinic: Health Care Externships

Aside from organizing arts workshops in Oaxaca, Mexico, I also work with universities to place students pursuing a health care degree in the Teotitlan del Valle public health clinic for student exchange externship experiences.   I started doing this during the ten years I worked at The University of North Carolina at Chapel Hill School of Nursing.  This gives me a great deal of pleasure and personal satisfaction because of its positive impact on people.  This is international cultural and health care education that can change lives.

In a week from now, Leonora Tisdale, a thirty-two year old second degree nursing student at The University of North Carolina at Chapel Hill, will spend a month volunteering in the clinic, which serves the primary care needs of eight thousand residents, plus those who come from smaller villages nearby.

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Leonora is bilingual, a trained doula, and holds an undergraduate degree from Guilford College.  She is interested in learning more about the medical culture of Mexico and its standard of care, maternal childbirth practices and women’s health.  After she returns, she will do a North Carolina clinical rotation at a rural clinic that serves immigrant families from Mexico and Central America.  Neither the professionals in or patients accessing the Teotitlan del Valle clinic speak much, if any, English.  This will give Leonora a perfect opportunity to build her medical Spanish vocabulary as she prepares for her nursing career.

When we met for coffee yesterday, Leonora said she is excited and energized.  She has prepared well by reading about Oaxaca health care needs:  the mental health issues around migration and being left behind, why indigenous women choose traditional birth methods, and the stigma of HIV-AIDS.  She wants to build relationships with the people who live in the village and learn the cultural nuances that one can only get by being there.  And, of course, she wants to eat all  seven Oaxaca moles (though, I suspect, not at the same time!).  At the end of her service, Leonora will write a reflection paper about her experience and I hope to publish it here.

One of the public health officials of the village tells me that better health care is a priority for Teotitecos.  The externships not only provide a cultural exchange, they give the clinic doctors, nurses, psychologist, and social worker clinical help in an overburdened system where the population is growing and there are not enough providers.  I explained to Leonora that diabetes occurrence is high in the region and there are health education opportunities working with local people to sustain programs around nutrition and exercise, and maternal and child health, and other chronic illnesses.

Students and/or university faculty members work with me directly to make the arrangements for student volunteer service. I facilitate the residency and make arrangements with those in the village.  Students work directly with their universities for academic credit, travel and insurance requirements.

At the end of June, two physician assistant students — Ben Cook and Meagan Parsons — from Methodist University in Fayetteville, NC, will begin their month-long externship at the Teotitlan del Valle clinic.  They will be joined by Professor Deborah Morris, MD, PA-C, who will be the on-site supervisor of their experience.

I welcome inquiries to arrange for spring break, winter intercession, and summer externships.   We ask that students be enrolled in a four-year academic institution, have at least one year of Spanish language proficiency to participate, be an excellent student, and participate as part of their academic experience for academic credit with the supervision (on-site or remotely) of a faculty member.

For more information, contact Norma Hawthorne at normahawthorne@mac.com  (copy and paste my email address into your email program if you can’t get the link to work.  It’s funky today!).

Multicultural Learning Experience for U.S. Nursing Student in Oaxaca

“I loved it!”

Kathy Ray, a bachelor of science in nursing (BSN) student at the University of North Carolina at Chapel Hill, spent two weeks volunteering in the rural public health clinic in Teotitlan del Valle, Oaxaca.  The learning experience was invaluable.  She developed what will be, she is certain, lifelong professional relationships with local nurses and doctors.  She improved her Spanish language skills and she developed a greater appreciation for Mexico.

The village has one of the better-equipped clinics in the region and many patients from smaller villages are referred there for their primary care.  Because of that, the patient census on a given day can be high.  The clinic has two general practitioners, a pediatrician, a psychologist, social worker, nurses and a dentist assigned for patient care.  It serves 8,000 village residents plus people from more remote rural villages.  They welcomed Kathy Ray with open arms.

Kathy loved living in the village and volunteering there.  “It was the first time in my life I have been on my own,” she said.  “I got married young and started raising children when I was 22 years old.”  She had never been out of the U.S. before.

What Kathy Ray was able to accomplish in two short weeks

She started a fun Brazilian exercise program, called capoeira, for teens and pre-teens held in the central plaza in front of the church.  The exercises incorporate music, games, dance, acrobatics, and martial arts (it is non-violent, she explains).  The children loved it, and she got several repeat participants. (You can see examples on YouTube.)  Pre-teens and teens everywhere are at risk for early onset diabetes and fun exercise helps overcome the risks.

Kathy gave rubella, DPT, and hepatitis-B vaccinations to children and adults, and shadowed the ob-gyn doctor.  She learned hands-on techniques, and also shared ways that Carolina nurses are taught to give emotional caring and support to patients who are in medical crisis.

“The nurses and doctors are all very professional.  I was able to shadow the nurse who was in charge of vaccinations and the OB-GYN doctor who cared for pregnant women.  I learned the techniques for vaccinating infants, children and teens, and learned to read ultrasounds to identify gender.  It was great.”

Kathy is a mature and wise 39 year-old mother of teenagers.  This gave her the ability and perspective to become a peer professional.

She shared her perspectives about needed safety education materials

Even in the two short weeks that Kathy volunteered, she knows she made a difference.  She recommended that the clinic publish educational pamphlets for parents about unintentional accidents, including how parents can protect their children by encouraging the use of helmets, seatbelts, and to not to ride in the back of pick-up trucks (how many accidents happen).  Kathy saw she could influence and encourage safety education by reinforcing the message that “it only takes one person to make a difference.”

Kathy and I spent over an hour together in my office while she recounted her experiences during her two-week stay with a local family.  She has written about living in Teotitlan del Valle and being a volunteer nursing student on her blog: http://onceuponatimeinoaxaca.blogspot.com/

She has posted photos there, too.

Placing student nurses between their junior and senior years

For me, it has been such a delight to place nursing students in Oaxaca as part of a global study experience.  It has been four years since I started this program with the help of Federico Chavez Sosa.  And, it is beneficial for students to be volunteering in Mexico since many of our immigrants are from Spanish-speaking countries.  Teotitlan is perfect because it is safe, small, welcoming and we have a network of relationships there.  The village health professionals receive the benefit of smart, educated and dedicated nursing students to help.

“I was excited, but also nervous about going to Mexico on my own.  It turned out to be one of the best experiences of my life.  The relationships I developed will be life-long.  I loved the beautiful scenery, the visual imagery, the rolling farmland surrounded by mountains. And, I walked everywhere.”

“And, of course, Oaxaca Cultural Navigator was my bible.”

How did Kathy manage on a strict student budget?

She bought pre-cooked food at the local market, purchased prepared yogurt mixed with fresh fruit, cooked beans, rice, red pepper, and choyote squash in the house she was staying where she had kitchen privileges.  She drank the purified water and didn’t brush her teeth with tap water!  She didn’t get sick :)

“Every day, someone would come to the clinic with a frozen milky drink flavored with cinnamon (horchata) that we would all buy for 40 cents each.  That was a highlight of my day,” Kathy remembered with a smile.

Kathy will receive university credit for this experience after she writes and submits a paper under the guidelines of the global study program at the school of nursing.

Norma Hawthorne works with accredited schools of nursing to place talented student volunteers for two- to six-weeks in public health clinics in Oaxaca.  If you would like to discuss this opportunity for summer 2012, please contact me.  (The relationship must be with the university/college rather than with individual students.)

 

 

 

 

 

 

Oaxaca Health Clinic Welcomes Carolina Nursing Students


The School of Nursing at the University of North Carolina at Chapel Hill encourages students to develop the knowledge and skills needed to provide quality care in global environments and to recent immigrants to the United States. Students can do this by taking a summer course and meet requirements by volunteering with a nongovernmental organization or local health care agency in a global health setting.

One such agency is the El Centro de Salud in Teotitlan del Valle, Oaxaca. The public health clinic offers preventive family care as well as low-level emergency services for about 8,000 residents of the village. At the clinic, Carolina nursing students get hands-on practice in a cross-cultural learning environment.

Teotitlan del Valle is in rural southern Mexico, about 17 miles (about 30 minutes) outside of the city of Oaxaca in the Tlacolula valley. In this centuries-old indigenous village many of the older residents speak only Zapotec — the predominant language of the region — and only know a smattering of Spanish. The area is high desert plateau at about 6,000 feet altitude, nestled at the foot of the 9,000-12,000 Sierra Madre del Sur mountain range. There are 2,000 looms in the village, which is known for its fine textiles.

Since 2008, Carolina nursing students have spent several weeks during the summer before their senior year living with a family and working alongside local doctors and nurses. The program was established by Norma Hawthorne, director of advancement for the School of Nursing, who has a long-term relationship with a village leader, Federico Chavez Sosa. In 2007, she asked if a UNC Chapel Hill nursing student could live, work, learn and share in an intercambio – an intercultural exchange and the opportunity was launched.

Today, Mr. Chavez Sosa heads the committee responsible for the village’s public health, including the clinic – one of the newest and most modern in the region. He talked to us recently about the community health concerns articulated by the new governor of the state of Oaxaca, Gabino Cue. Women’s and children’s health is a high priority, especially pre-natal care, labor and delivery. Mr. Chavez Sosa is interested in having many more Carolina nursing students participate in the experience. He notes that the village values participation by Carolina students because of their knowledge, dedication and contributions.

Students receive academic credit for NURS 489 Practicum in Nursing: Global Health Experience. This class is specifically designed for students with an interest in traveling abroad so that they may learn about health systems and the nursing profession in other countries. The academic program director is Christine Harlan, BSN, RN, MA, (chris_harlan@unc.edu). Some financial help may be available to students through various funding sources.

A History of UNC Chapel Hill School of Nursing Volunteers in Teotitlan del Valle:

2008 – Leilani Trowell

Leilani traveled the village by foot with local nurses to immunize children in their homes, did patient intake in the clinic, and assisted in out-patient procedures.

2009 – Lindsay Bach

Lindsay developed a diabetes education program for village women that included exercise and fitness as well as healthy food choices and recipes.  She had spent two years in the Peace Corps in Uzbekistan before coming to Carolina for nursing.

2010 – Amy Faline Davenport

Amy was a doula and interested in women’s health, prenatal care, birthing and post delivery, and assisted in birthing procedures.  She had already earned the MPH and decided to become a nurse.

2011 – Kathy Ray

Kathy is pursuing her second degree and is the mother of three older teenagers.  The experience will give her an opportunity to brush up on Spanish language skills as well as preparing her to care for new NC immigrants from Mexico.

Photos feature Lindsay Bach, BSN, RN who graduated in December 2009.