January 2nd, 2015:
Today marked the very beginning of our journey in Nicaragua. Our group consisted of nursing students from both Fairfield University and San Diego State University who arrived in Managua, Nicaragua around 8:45 PM local time.
After taking a roll call and collecting our bags, we were on our way from the airport to a house owned by the university, where we would be spending our time in Managua.
January 3rd, 2015:
To start the day, all of the students collected their medical supplies they brought from home and separated them into suitcases that would be used at different times throughout our stay in Santa Maura. As a group we were able to gather a number of supplies that included gloves, tooth brushes, floss, toothpaste, sterile gauze, sutures, antibacterial ointment, glucometers, urine dip sticks, lancets, band aids, among other supplies that would be required to screen the volume of workers we expected the next day.
After we were all done packing our supplies we loaded them onto the bus and headed to Masaya, where we were scheduled to visit one of Nicaragua’s active volcanoes. On arrival, we were able to walk through the museum at the base of the volcano. The museum provided us an opportunity to learn about the ecosystem, some of the history, as well as the geography of the volcano and its surrounding area.
After spending time at the volcano we ate lunch at a restaurant that overlooked the lake. The view was beautiful and it was a great time to start to get to know the other students on the trip.
After lunch we had the opportunity to visit a family who has made pottery for three generations. This was one of the most memorable experiences because the group of students got to see how much work goes into making a single piece of pottery. The amount of detail that is put into each piece of pottery makes them all true works of art. After the demonstration the students had the opportunity to purchase some of the pottery the family made, and we all went home smiling.
January 4th, 2015
Today marked the day in which we left Managua and headed to the coffee farm in Santa Maura. The bus ride took around 4 hours, but transcended a number of different and beautiful sights along the way.
Upon arrival, we were greeted by the staff of the biological station and assigned rooms in which we would stay. After the students got settled in to their new environment, some were able to explore the surrounding flower stations near the main house. After talking to all of the students on this first night, it sounded as if we were all very happy to be in such a beautiful and scenic area of the world.
Before going to bed, the group met in the main house the night before our first day of actual screening and practiced the skills that would be required to take the blood pressures and blood sugars of the coffee farm workers. Below Dr. Planas explains how the next day will go, how to accurately perform a manual blood pressure, and the proper technique in acquiring a patients blood sugar to the group of nursing students!
January 5th, 2015
This was our first day of screening the coffee farm workers. When we arrived most of the workers were already working in the fields, however there was a line of women and children waiting to be checked out by the nurses and doctors.
Our group of nursing students was not the only medical team who were in charge of screening the workers. There was a medical brigade that obtained the patients vital signs, performed dental screening, and had a pediatrician, obstetrician, and internal medicine doctor available to examine anyone who may need additional care.
Both medical groups had different forms that needed to be filled out for each other’s respective research, which caused some disorganization. This was a big learning experience for us, because the next day we changed the flow and structure of how patients were to be screened, which made the whole process easier to navigate for everyone involved.
Despite the minor bumps in the road, the first day was a tremendous success. The student’s expressed nothing but positive attitudes in the work we had done that day. It was great to see all of us come together in a way that allowed everything to get done in a timely manner.
January 6th, 2015
Our second day on the Santa Maura coffee farm was another great day. The decision was made to make some corrections to how patients would be screened with the hope of decreasing the amount of confusion and time it took at each station. Our group of students discontinued filling out our original medical questionnaire forum, and focused on recording data for the patient’s personal use.
In changing the process, it was easy to see how much smoother the whole operation became. People who wished to be screened were seen quickly, and it was easier to direct patients on what station to attend next.
Much like the first day, students were kept extremely busy, especially as the workers got off work for the day.
After the screening winded down, the students got to experience a tour of the entire coffee farm. On this tour we witnessed the facilities in which both permanent and temporary workers lived, the cafeteria where the workers would eat their three daily meals, as well as see the coffee bean processing plant. Being able to go on this tour showed all of the students the different standards of working and living the workers faced in Nicaragua compared to that of the United States. It was explained to the students that the 300 permanent workers of the farm stayed in individual houses, and the remaining 600 workers lived in a dorm style area that contained 8 beds per room. The workers were supplied three meals a day, and also had access to a small kitchen if they needed more food for their families and themselves. Later in the tour it was explained to the students that Santa Maura is an extremely eco-conscious coffee farm that is really one of a kind in Nicaragua. The owners are very adamant about recycling water, using left over coffee skins as fertilizer, and minimizing contaminated water getting into their crops. It was interesting to see how these workers lived and the attitudes they had regarding their surroundings, which left many of the students feeling a sense of deeper appreciation for their working conditions.
January 7th, 2015
This was our last day on the Santa Maura farm. Much like the past two days, the students were able to screen many more workers, women, and their children. The group decided to keep a similar layout as to what we had the previous day.
Some of the factors that many of the students believed contributed to the success of our clinic was each persons ability to communicate effectively, have a sense of humor, and put other people before themselves. Our group dynamic really offered a level of care that surpassed many of the patient’s expectations. If anyone had a question or concern related to what we were doing, the UCA translators consulted with the nursing student or instructors to qualm any fears the patient may have had.
The ability to communicate with others is something all nurses must learn to do. Having the opportunity to see how translators interact with patients is a great way to observe the result of interdisciplinary communication that is all so important to becoming a competent nurse.
As our time on the Santa Maura came to a close, David the nurse of the farm organized a piñata in which students of both groups had a chance to participate in the festivities. This was a great way to end our time on Santa Maura, especially knowing how many lives we touched, and how our impact will be remembered for years to come as evidenced by the newly painted school rooms and nursery.
January 8th, 2015
This morning our group headed to a different coffee farm in order to increase access to health screening to as many people as possible. The farm, La Trampa, was located about 30 minutes away from where we were originally stationed in Santa Maura. This farm was a cool experience because we got to talk to the owner of the farm, and hear the story of how he started the farm with some of his family members. The owner also explained who buys his coffee, how much each coffee bag is sold for, the different levels of coffee and what environmental factors influence the final product.
As lunchtime came around, we decided to split up into groups. One group was going to stay at our original spot and continue to screen any workers that came. The other group was in charge of going out to where the workers were eating lunch and screening as many people in this time as possible.
I volunteered to go out with the lunch truck and take the blood sugars of the workers as they took their break. Personally, this was one of the most eye-opening experiences of the trip because I was able to go into where the workers would pick the coffee beans and see the conditions that they worked in every day. It was amazing to think that these people could even keep their footing on such a steep and muddy hill, much less pick coffee beans and carry them for hours in a big basket tied around their neck. It really made me appreciate how hard some people in this world work just so we can have something as simple as coffee.
We were able to screen a good amount of workers on this short trip away from La Trampa, and many of the workers we screened really appreciated what we were doing.After we were done screening the workers who were on their lunch break it was time to head back to Santa Maura.
When we got back to the biology station, students were given the opportunity to go on a hike through the jungle and up into the hills around the coffee farm. The hike was very challenging considering the first stretch of it went straight through the forest through vines and fallen trees. The rainy conditions the night before also made it very muddy and easy to fall. Fortunately, everyone made it safely through the forest and was able to continue on the portion of the hike that for the most part took place on the road.
A word of caution for future students who might choose to do this hike: it is very muddy, and a very hard hike. On our last stretch of the trail one of the students lost her footing in the mud and dislocated her elbow. Proper footwear should be worn at all times on this hike, and everyone should realize that at certain spots of the hike there are absolutely no trails. This hike should not be taken lightly and there is a chance of getting hurt if you fall related to the extreme conditions.
January 9th, 2015
This was our first day back in Managua after being on the coffee farm for the last couple of days. The students were able to go on a tour of Managua, and see the amount of expansion that occurred after the earthquake destroyed most of the city. On this tour we were able to see the old presidential house, the national palace, a cathedral that was destroyed in the earthquake, among other historical landmarks. The tour ended by the lake with a walk through a life sized model of the city of Managua before the earthquake. It was interesting to learn how the political climate at the time of the earthquake really set the rate of development back in Managua. Instead of investing the money the government got in foreign aid to rebuild the city, much of that money was placed in off shore accounts owned by the corrupt political officials. It is almost impossible to think how much different Managua, as well as the country of Nicaragua, would be if this was not the case.
January 10th, 2015
For our last full day in Nicaragua, the students traveled to Granada. During our time in Granada the students had the opportunity to take a tour of the city via horse drawn carriage, see many of the cathedrals that have been in the city for decades, as well as take boats on a tour of the lake and see where some of the richest families of Nicaragua lived. Granada is a beautiful city; the students not only got to see the pre-colonial styled buildings, but also learned some of the city’s history including William Walkers impact on Granada.
Every one of the students enjoyed their time in the city, and many were sad to leave at the end of the evening. Many of the students left that night having a newfound respect for the country of Nicaragua and reported future wishes in returning to this country.
Many of the operations that we performed as a group would not have been possible without the numerous donations we received. We would like to thank every single individual who donated medical and school supplies for their contributions. We know that increasing access to health care is an important first step in ensuring the health of people all over the world – and your donations made a real impact on the lives of others.