HSC pioneers international interdisciplinary medical service-learning team

February 26, 2010

The poverty and everyday life in Esmeraldas left a distinct impression on the group. It was a stark contrast from the breathtaking backdrop scenery surrounding the town and the slums people lived in.

In Ecuador, alongside the tourism and beautiful landscapes is a poverty stricken population needing medicine and health education. Eager to respond to this need, the Texas A&M Health Science Center (HSC) conducted a weeklong service-learning trip to Esmeraldas this past summer.

Faculty and students from the College of Nursing, Irma Lerma Rangel College of Pharmacy, Baylor College of Dentistry, College of Medicine and School of Rural Public Health represented the HSC.

“It was truly a team effort…”

Faculty and students represented from across the HSC:

  • College of Nursing
  • Irma Lerma Rangel College of Pharmacy
  • Baylor College of Dentistry
  • College of Medicine
  • School of Rural Public Health

A faculty member from the Texas A&M University College of Engineering and the director of the Texas A&M water project in the College of Architecture Center for Housing and Urban Development provided ways to improve quality of life through low-cost ceramic water filters. A teacher from Bryan-College Station assisted in educating children.

“It was truly a team effort that could have not happened without every team member,” says Regina Bentley Ed.D., R.N., associate dean of academic affairs in the HSC College of Nursing.

Making preparations

Traveling to Ecuador was nothing new to Dr. Bentley. When she was hired to teach at the College of Nursing, medical missions to the South American country were already on her heart. “When I talked to the dean (Dr. Sharon Wilkerson), I told her that it was important for me to continue this service if I were hired here,” Dr. Bentley says. “I really would not have taken the job had she not been so supportive.”

Still, planning the trip was no easy task for Dr. Bentley, who started her preparations as early as January. She began by talking to Nancy W. Dickey, M.D., president of the Texas A&M Health Science Center and vice chancellor for health affairs for The Texas A&M University System, and Alicia Dorsey,

Trip Participants

Along with Dr. Bentley, Dr. Dickey and Dr. Dorsey, team members were Dr. Anna Lichorad, Dr. Steve Ramirez, Dr. Raed Ajlouni, Dr. Anna Ratka, Dr. Bryan Boulanger, Avery Ritter, Pat Ehlert, Blake Bentley, Savannah Johnston, Mike Deluna, Lori Muessig, Oscar Munoz, Jody Robinson, Monica Smith, Melissa Scott, Alyson Rainey, Liliana Congelose, Cristina Gonzales, Zahra Kazerani and Norma Munoz.

Ph.D., HSC vice president for program development and community outreach, to get their support and to recruit a true interdisciplinary team of faculty and students for the HSC-wide service-learning opportunity. Group meetings enabled everyone to get to know each other and plan for meeting trip objectives before traveling.

To better prepare for the trip and create opportunities for participating students and faculty to bond, Dr. Bentley organized several meetings throughout the semester as well as a “packing party” a couple of weeks before the trip. Everyone came together to assemble education material, medications and supplies for the people of Esmeraldas.

Each team member was limited to one 50-pound supply box and one piece of personal luggage. Since there were only 23 members, they could only take 23 boxes of supplies. Dr. Bentley’s husband, Blake, made sure everything needed was packed.

“The team get-togethers were very important for team building for the trip,” Dr. Bentley said.

Dr. Bentley’s comprehensive preparations for the trip made it easy and convenient for students to participate. She sent out periodic emails that students found informative and comprehensive.

“She had everything so planned,” says nursing student Savannah Johnston. “It really was a very easy transition from here to there.”

A little education goes a long way

As soon as they arrived in Ecuador, the students and faculty were eager to get started and set up a clinic in an “inner city” church. The clinic featured a triage station, vision screening and dental screening stations, three doctor exam rooms, and a dental exam room. There also were areas to separately teach the adults and children.

“Education is very important to each team,” Dr. Bentley says. “We do not just go in with a band aid but instead provide long-lasting information for the patients to use after we are gone.

Students rotated through each station in order to give them a wide range of experiences. The students got excited to interact with and learn from health care professionals while helping with patients.

“I’ve done this so many times, but the excitement never really wears off,” says Dr. Bentley. “We stayed really busy every day. We saw a total of 421 children and 95 adults in four days.”

The surprising thing for everyone was the number of women and children who didn’t understand how to eat healthy. The group quickly adapted to the needs of the patients and used local foods such as rice and plantains to educate them on how eating better can lead to a healthier lifestyle.

Nursing student Monica Smith didn’t know what to expect. “I thought we might see a lot of obesity,” says Smith. “However, what we saw was a lot of children that were malnourished.”

As expected, the biggest problem was parasites. Fortunately, the group had enough medicine for everyone to resolve the issue, at least temporarily. As a preventative measure against these parasites, Dr. Bryan Boulanger and Oscar Munoz from Texas A&M University worked with local church leaders to teach them how to make low-cost ceramic water filters out of supplies in their community. These ceramic filters can be used to provide households clean drinking water for the first time.

Different way of life

For all the students, the experience was an eye opener. “It was a culture shock for me,” Johnston says. “To see the children was heartbreaking.”

Despite these conditions, the people of Esmeraldas had high spirits. The children valued every paper hat, every sticker and every educational experience as if it were the most exciting thing they had ever done. The women served team members lunch every day and were so genuinely happy to do so.

Monica Smith says, “The people were happy with what they had because it was all they knew. You wouldn’t really know that they were sick.”

A great attitude

Part of the group’s success can be attributed to the excitement from participants. The right people can truly change the dynamics of a mission trip, and so was the case in this trip to Ecuador.

“The many beautiful and happy smiles we have shared this week with the children of Esmeraldas and Quito prove that we can make a positive difference in the lives of others when we work together,” wrote Dr. Boulanger, assistant professor in environmental engineering at Texas A&M, in the trip journal.

All faculty members were impressed and encouraged by the selfless and joyful attitudes the students had. It was enjoyable for everyone to see each other outside an academic environment and really get to know these people they interact with on a daily basis.

“Our students have been simply remarkable,” Dr. Dickey says. “They work hard and laugh readily. Everyone leaps to a job to be done without any query to whose job it is or attention to where they came from.”

Anna Ratka, Ph.D., Pharm.D., professor and chair of pharmaceutical sciences at the Rangel College of Pharmacy, echoed Dr. Dickey’s sentiments.

“The students showed genuine compassion, care and dedication,” says Dr. Ratka, who lead the pharmacy team. “They were truly outstanding as members of the multidisciplinary team of health care professionals.”

Avery Ritter, one of four third-year pharmacy students on the trip, says, “I would jump at the chance to do this type of service learning again. I think the most valuable lesson I learned was that no matter the language, no matter the country, we are all more alike than unalike.”

Both Smith and Johnston were examples of the servant attitudes of the students. Smith’s favorite moment was the story of a mother that received education on how to nurse her baby properly.

“She hadn’t fed her baby after three hours,” Smith says. “So, we worked together to discreetly communicate to the doctors and tried to get her to feed the baby, and she was so receptive to what they had to say. She came back down the stairs, and she had her baby nursing. She even had a smile on her face.”

Johnston reflected on a little girl in the dental exam room. Her primary job there was to assist the dentist when the children wouldn’t cooperate.

“She wouldn’t let the dentist touch her unless I was holding her hand,” Johnston says. “She put that much trust in me. Of course, I was never going to walk away. We’re nurses, and that’s what nurses do.

Future plans

Esmeraldas was the first interdisciplinary medical service-learning team incorporating multiple Texas A&M Health Science Center and Texas A&M colleges. All the students enjoyed the interaction with new people across the campus as well as across the state.

In fact, the trip opened doors for future trips through the health science center. Plans are under way to visit Bolivia in June, followed by a return to Ecuador in 2011.

“It’s just a wonderful feeling to see it all come together,” Dr. Bentley says. “When you have good people helping you, you never feel like it’s a chore.”

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