International Service Learning: Connecting communities through service

By: Monica Grice

In a small church 20 minutes outside of Masaya, Nicaragua, Lucia Rodriguez distributes medicine to members of a rural community deep in the rainforest, her face friendly and smiling at every person.

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Lucia Rodriguez, 16, is a translator for International Service Learning and recently worked with the Texas State University health professions team in Nicaragua.

This is Rodriguez’s second year working with International Service Learning and her role in January 2017 is an assistant team leader.

The nonprofit organization has been leading volunteer teams in Central and South America, Mexico, the Caribbean, and Africa since 1994. ISL assists more than 215,000 people every year and donates $180,000 in medical supplies.

“I saw how they work and how they help people, and that was a goal for me,” said Rodriguez. “You learn about culture; you learn about everything.”

ISL’s workforce is diverse. Ages, jobs, backgrounds and cultures provide a variety of differences in ISL’s team members which helps to provide perspectives and knowledge for the volunteers they lead.

Though Rodriguez is just 16 years old, she already knows what she wants in life and that working with ISL will help her achieve her goals.

Rodriguez, a senior in high school, was born in Jinotega, Nicaragua, and moved to the capitol of Managua eight years ago with her mother, two younger siblings and two aunts.

For people in her hometown of Jinotega, Rodriguez said most of their careers center around helping people. She is no exception.

“Most people want to work in medicine, agriculture, or with animals,” said Rodriguez. “But I want to do something interesting, not like a typical career.”

She got her start in ISL through her uncle, Pavel Guevara, the country coordinator for ISL in Nicaragua.

In the beginning, it was hard for Rodriguez because she was not fluent in English. Motivated by her goal to do something special for her country, Rodriguez learned enough English in two years to become a translator and assistant team leader for ISL.

“I just keep practicing and practicing; I’m determined,” she said.

ISL is the only non-governmental organization allowed by the government of Nicaragua to manage experiences for healthcare students from the U.S. ISL provides faculty and students with comprehensive logistical services from deciding the clinics they’ll serve to the restaurants they eat dinner at.

ISL chooses different communities for the Texas State students to serve each year.

“We don’t want to go just one direction – we want to bless everybody, not just one place,” said Harold Mojica, an ISL team leader.

The ISL team leaders deliver medical censuses taken in the communities to the health administration in Nicaragua and take inventory on medicine needed.

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Harold Mojica is a team leader for International Service Learning and recently worked with the Texas State University health professions team in Nicaragua.

A father of two girls aged 18 months and 10 years old, Mojica is a licensed tour guide that has worked with ISL for four years, and with other organizations for almost 12.

“You are not only helping in the clinics for a day or two, but you’re leaving a foundation for future actions in the community,” said Mojica.

He was born and raised in Casares, Nicaragua, a fishing community. He still lives there with his wife of 15 years, who is also a licensed tour guide and two daughters.

“I have had the opportunity to work with different institutions and different people and I always got committed to do my best and put my community first,” said Mojica. “So I love when I have the chance to bring a team to my community.”

Casares didn’t have a high school for Mojica to continue his education and his lifelong dream of becoming a doctor was a long shot away.

“As a consequence I couldn’t carry out my studies, and didn’t go back to school for eight years after elementary,” said Mojica.

At 12 years old he became a fisherman. After earning enough money for a round-trip ticket to the nearest school, Mojica attended Saturday school for five years to finish high school. Then in five more years, he finished his university studies.

When he was 20, he started working for a hotel that gave him the opportunity to be a translator for guests. This is where he gained the experience that would help him work with ISL.

Five years ago, the president of ISL came to Mojica’s hometown looking for properties to buy. After having a conversation, he offered Mojica a job with the organization.

“I love serving and I love helping other people, and I loved the idea,” said Mojica.

Three months later he took a job as a translator. Mojica would later be promoted to assistant team leader and eventually team leader.

Though his dream to become a doctor wasn’t realized, Mojica is still involved with medicine. He has worked with a team of surgeons from Sacramento, California sometimes being right in the operating room.

“I’m right there between the surgeon and the scrub nurse, doing ACL’s, or open heart surgeries,” said Mojica.

He recalls one moment working with an eye doctor that had a few elderly patients who couldn’t see enough to mend their clothes or even pick the rocks out of their beans before cooking. A simple pair of reading glasses would change everything for these patients and some of them would cry of happiness.

“The most rewarding moment for me is when I work with doctors,” said Mojica. “They will hit the nail on the head with a diagnosis, and you can see how happy people are.”

Desiree Davis, a senior nursing student from Texas State, worked closely with Mojica during the university’s recent inter-professional study abroad trip in Nicaragua.

“He was so much fun to be around and the joy he had never went unnoticed and he always had a joke to tell and for a lot of us that really was appreciated especially on days that were so tiring,” said Desiree Davis.

She said one day she became sick at the clinic and Mojica immediately noticed a change in her character. It was this day that Davis and Mojica spent time talking about both of their cultures and backgrounds. She realized the two were very similar.

“It was also that day that I realized I had just gained a friend,” said Davis.

For more information about ISL and volunteer opportunities, visit their website.

 

God and science: the relationship between healthcare and religion in Nicaragua

With a 2015 GDP per capita of $1,869 USD, Nicaragua’s rural demographic struggles to access the country’s free public healthcare.

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A local home in a village located in the mountains of rural Nicaragua.

For Fermina, a local villager living in the jungle outside of Ticuantepe, accessing healthcare in the nearest city is a secondary priority. Like most other villagers, her and her husband’s first priority is to provide for themselves by living off the land.

With a limited source of monetary income, accessing healthcare is put on the back burner, while religion is the central point of philosophy to the villagers.

“We owe everything to God,” Fermina said. “Our health, home and family is all for the glory of God. We are always thankful when people come to help through his work.”

Fermina, like the other villagers, struggles to find access into the city as transportation in rural Nicaragua is expensive and time consuming. This lack of resources becomes problematic for these people as illnesses and health concerns are treated to the best of their ability.

When money is available, villagers must choose between buying food and supplies for their land, or traveling into the city for healthcare.

Camilo Jose Gutierrez, a doctor at el Maestro Hospital in Diriamba, volunteers his time in the remote villages of the country to help provide healthcare for the people.

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On top of Our Lady of the Assumption Cathedral in Granada, Nicaragua.

“Most of the people in Nicaragua are very religious and believe that doctors are truly a blessing from God,” Gutierrez said. “We believe as doctors that both God and science can work together for the good of man kind.”

There are 425 million practicing Catholics in Latin America amounting to 40 percent of the world’s Catholic population. In Nicaragua, 90 percent of the population practices some form of Christianity and 73 percent of the population are Catholic.

With such a high population of practicing Christians in Nicaragua and a low education rate, Gutierrez said educating people on healthy living habits helps bring a connection between healthcare and religion.

For Moises Alarcon Cabera, the pastor of Iglecia Restaurecion, bringing religion to the rural communities of Nicaragua has been his calling from God.

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Villagers wait in line to be seen by the Texas State healthcare students inside the local church.

“This church is a gateway for people to bring good health into the community with healthcare workers coming in to assist, and for practicing our religion,” Cabera said. “The people here believe that medicine is a gift from God.”

Cabera has been the pastor at the church for six years.  Before he arrived, the religious part of life in the village was more private, Cabera said. As the church has grown, the people have become more comfortable with sharing their religious beliefs with others.

“I’ve gotten to know these people extremely well, and after six years, I’ve learned that no matter how much medicine you can provide for them, they understand that God is the one who has the last word,” Cabera said. “Death isn’t a fear, but rather an acceptance to these people. Yes, it can be frightening to think about, but we have our faith.”

Healthcare is one of the most important aspects of human life next to religion, as it provides people the strength to become closer with God, said Angel Miguel Lopez Martinez, pastor of Iglecia de Dios dela progrecia. With or without medicine, prayers to God guide people to better health, he said.

“When we set up a clinic in the church, it allows the people to see a positive image of medicine because we are in the house of God,” Martinez said. “They become comfortable with new ways to take care of their bodies, because God is present here.”

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Martinez’s church, located outside of Ticuantepe

Karina Cavazos, a senior nursing student at Texas State, was working at the medical clinic at Cabera’s church when she spoke with a patient who was suffering from insomnia and hair loss.

During the assessment, the patient was concerned about her health and asked if any medicine could be provided to help. Jessica Yehl, a senior nursing student, asked the patient if she had a history of high stress.

The patient began crying, repeatedly telling Yehl and Cavazos that she didn’t want to talk about what was causing her stress.

“We were told by our interpreter that people in this country keep to themselves about personal issues, so we moved on with the diagnosis and soon enough, the doctor came to give her the medication she needed,” Cavazos said.

Once the patient was alone, Cavazos began to explain to her how the hair loss could be caused by stress, something Cavazos said has happened to her from high levels of stress in the past.

“I told her that she might be having problems at home that could be causing the hair loss, and she ended up telling me that the only thing she has to her name is this piece of land that she wanted to give to her youngest son,” Cavazos said.

The son denied the land and left the mother saying that he wanted nothing to do with her and she hasn’t heard from him ever since, Cavazos said. The patient could not sleep at night and was losing her hair because of the stress caused by her youngest son.

“Knowing that religion is a big part of the culture, I wanted to help and I asked her to pray,” Cavazos said. “I know the power of prayer is such a power thing no matter what religion you are, and I feel like I connected and related to her on that level.”

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Karina Cavazos enjoying the company of the local children.

People in Nicaragua are so connected to their faith, and the patient saw that, Cavazos said.

“Sometimes medicine can only go so far, and with this patient in particular, we helped her understand that sometimes all you need is God and your faith,” Cavazos said.

 

 

 

 

Desiree Davis: A personal journey providing healthcare services in Nicaragua

By: Allison Fluker

Desiree Davis was sitting in the window seat of the 28th row on the plane headed for Managua, Nicaragua, that would take off Jan. 2. Her pink neck pillow hugged her neck as she quietly waited for the plane to take off.

Davis is from San Antonio, Texas. She is senior at the St. David’s School of Nursing at Texas State University.

At first glance, she looked calm.

When the plane lifted off from Austin, Texas, she let out a small scream as the air pressure popped her ears.

A team of 24 students from the Texas State University College of Health Professions was on its way to collaborate with the International Service Learning organization in Nicaragua to set up free medical clinics in small villages outside of Masaya.

When Davis found out about the trip last year, she didn’t hesitate to apply.

“We’re so used to being in America, it’s forcing us to have to embrace a new culture we’re not used to,” said Davis after spending a day seeing patients in La Borgoña. “It is important to connect with people who are not like me.”

Davis’ determination to get outside her comfort zone caught the attention of her friends and colleagues.

“She’ll take the opportunity that’s most challenging,” said Madeline Longtin, a senior in the nursing program. “Even if she’s scared, she likes to push her boundaries to see where her limits are.”

Davis does not speak Spanish, but was called on to communicate with patients in their native language. Her nervousness was evident, but she overcame that obstacle and looked people in the eye and nodded her head in understanding.

A Life-Long Dream

Healthcare has always been important to Davis.

During her senior year of high school, she participated in a certified nursing internship at local hospitals and in nursing homes. Her dream job is to be a pediatrician.

“I love working at the bedside with patients,” Davis said. “I love to be there for people and to take care of them.”

Davis has a strong will for taking care of people. When she graduates college, she wants to work at Brackenridge, a level-one trauma center, in Austin, Texas. She ultimately wants to work in an intensive care unit.

“Level one is when you get the most critical patients, like from air support,” Davis explained.

Davis’ love and compassion for patient care have not gone unnoticed from her peers.

“She has so much joy,” said Longtin. “She cares so much, beyond words.”

Davis’ joyful attitude and pleasant demeanor makes her patients feel comfortable and at ease.

“She’ll help you out before she takes care of herself,” said Rebecca Duffy, a senior in the nursing program.

How the Clinics Worked

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Davis and her colleague completing a census form during home visits in La Borgoña. Photo by Allison Fluker.

On Jan. 4, the health professions team was split into three groups and named themselves: Group Peanut, Group Butter and Group Jelly. Each group followed a community leader into the villages to visit residents in their homes and take a medical census. They used this opportunity to invite community members to the clinics, which were held in local churches.

Davis’ group – Jelly – went to La Borgoña, a community near Masaya that received three free clinic days.

“There was a reason why we were there,” said Davis. “We were there to show them love.”

 

The local residents attended the clinics to receive care for illnesses ranging from diabetes to allergies.

During the operation of the clinic, the health professions students split into groups of two and, with a translator next to them, conducted focused assessments on the patients who had lined up outside the church to be seen.

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Davis completing a focused assessment form. Photo by Allison Fluker.

Davis exuded confidence expected from a seasoned professional. A curious fire raged in her eyes when she consulted with patients.

“You start to see the same illnesses and know the right questions,” said Davis. “It gives you a lot of confidence.”

By the third day of the medical clinics, the previously nervous students grew confident and eager. Their confidence was built, in part, by consulting with the Nicaraguan physicians who pushed the students to utilize the knowledge and skills they learned in nursing school.

“You’re able to sit down with the doctor, tell them what is going on with the patient and you’re able to give your own assessment,” said Davis.

 

Some students began to assess patients without one of their colleagues by the third day of clinics.

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Davis filling a prescription after completing a consultation with a patient. Photo by Allison Fluker.

“I was by myself the rest of the day,” said Davis. “I began to ask questions like ‘Has anything changed in the last 6 months?’ A lot of education went into finding out what happened to some patients.”

One patient stood out to Davis. The woman they were performing an assessment on who already knew what was going on with her health.

“We had a 47-year-old woman that was diabetic who was diagnosed 13 years ago,” explained Davis. “When we took her blood sugar, it was 448. In that moment, she automatically knew it was high when we showed her. She started to tell us how stressed she was. Her son had just gone to jail. While my partner, Mady, was taking her blood pressure, we started hugging her and holding her. You could tell she was just so stressed out. We asked Harold, our translator and ISL assistant team leader, to take her to the hospital with one of the buses.”

 

Giving Back

After the three days of clinics ended, the health professions team returned to the village, Chocoyera, to give back to their community. Everyone in the team went to the store earlier in the week and bought things for the children to play with.

“There were tons of kids,” said Davis. “Everyone was so comfortable with each other. Some of us started blowing up balloons inside (the church) and others set up the health fair outside when we arrived.”

Some students played with children from the community while other health profession students set up a couple of tables outside the front of the church. These students would continue to take blood pressures for local residents and give smaller focused assessments.

“I played with a little girl named Carmen,” said Davis. “She was teaching me little words (in Spanish) the whole time. I asked her what she wanted to be when she gets older and she said ‘doctor.’ I had brought a doctor play set with me and I decided to give her the doctor set. The smile on her face was so breathtaking.”

Davis special moment with the little girl, Carmen, is a small reflection of the experiences many of the other students had that day.

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Davis playing with a bowling set and a young girl during the community give back day in the village of Chocoyera. Photo by Allison Fluker.

The study abroad to Nicaragua was brief. The health professions team flew out of Austin, Texas, on Jan. 2 only to return on Jan 13. In that time, the students traveled to small villages outside Masaya, a nursing home and to a children’s home. Throughout their time abroad, they performed hundreds of focused assessments and impacted many lives.

“We’re walking into a place where people didn’t choose that lifestyle,” said Davis. “It’s important to count your blessings because you don’t know what that person is going through.”

Davis went on the trip not knowing what was going to happen but she returned home with a bigger understanding of the world, healthcare and the knowledge that she made an impact in so many people’s lives.

“It is impressive to see the locals have so much joy in them even though their situation might not be the best,” said Davis.

An immersive study abroad program in the School of Journalism & Mass Communication