TAMHSC provides care, education to remote Bolivian village

October 5, 2010

Buried in the Andes Mountains of Bolivia is an impoverished village – a people so removed and outcast that they were not considered humans by the country’s government until the 1960s.

In a united effort to provide basic health care, supplies and education to the indigenous Quechua Indians of Quesimpuco, Bolivia, nearly two dozen faculty and students from the Texas A&M Health Science Center (TAMHSC) participated in a weeklong service-learning trip in mid-June.

Joining Nancy W. Dickey, M.D., HSC president and vice chancellor for health affairs for The Texas A&M University System, were 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. A similar service trip occurred last August in Ecuador, and both were directed by Regina Bentley Ed.D., R.N., associate dean of academic affairs in the TAMHSC-College of Nursing.

Prep time

Quesimpuco is near and dear to Dr. Bentley. On her first trip in 2000 that included a groundbreaking for a new church, she met Blake Bentley. They were together a year later when the church was dedicated, and on a return trip in 2002, they married in the church.

Bolivians hold festival

Villagers welcome the health science center team with a festival.

“After all these years, I still want to go back there whenever I can,” Dr. Bentley says. “After you go to such a remote place, there’s really nothing here at home that you can complain about. It puts things in perspective.”

To prepare for the Quesimpuco trip and allow the students and faculty to bond, Dr. Bentley organized meetings throughout the semester along with a “packing party” before the trip. Everyone assembled education material, medications and supplies for the Bolivians.

Each team member was limited to one 50-pound supply box and one piece of personal luggage. With 24 members, they could only take 24 boxes of supplies. They also had to pack heavier clothes, as it was winter there.

Faculty and students took clothes that were versatile and could be worn for several days, such as jeans. As with the previous trips, Blake Bentley made sure everything needed was packed, including ample food.

“Every box was within ounces of the 50-pound maximum,” says nursing student Briana Newton. “Blake even weighed each of our bags before we left College Station, and if you managed to be even a pound underweight, you might find yourself transporting a block of cheddar cheese or some extra antibiotics or pipe cleaners for the kids’ art activities in your personal bag.

Dr. Bentley’s comprehensive preparations for the trip made it easy and convenient for students to participate. She also made sure they knew how remote a part of the world they were visiting.

“I thought it was a great opportunity to be given to us here at the health science center,” says nursing student Lindsay Okle. “I was real excited from the beginning, but the closer and closer it got, the more anxious I got. It was a bit tricky to know what to pack and if I had packed the right stuff.”

Hitting the ground running

Part of the adventure was the travel itself. Getting to and from Quesimpuco took a day each way. There was a 2.5-hour flight to Miami from Houston, then a 6.5-hour flight to La Paz, Bolivia. Once on the ground, six Jeeps awaited for the nearly 11-hour drive to the village in the Potosi Province.

After arriving in Quesimpuco, there was a quick adjustment period to the 12,000-foot-high altitude (College Station is about 300 feet above sea level), as well as a hearty welcoming ceremony from the locals. The students and faculty then established a clinic with a triage station, a pharmacy, and doctor and dental exam rooms.

“I learned a lot in this trip about the different disciplines in the TAMHSC system and how important each of them is to one another,” says

Bolivian having number written

College of Nursing student Briana Newton writes a patient number on a woman's hand.

third-year pharmacy student Anne Cecile Mingle. “I learned how together, we all play a vital role in providing quality health care.”

Over the next four days, the group saw about 400 patients ranging from babies to the elderly. Many of the elderly were complaining of back and knee pain, sore joints and headaches.

“These people work hard in the fields all day bending and lifting,” Dr. Bentley says. “They don’t have a bed to sleep on but just sleep on a hard surface. It takes a toll.”

Most students rotated through each station to give them a wide range of experiences. They were excited to interact with and learn from the different health care professionals while helping with patients.

“My medical day, I was with interim College of Medicine Dean (Edward) Sherwood,” Okle says. “I was in charge of diagnosing and helping treat the patients. He was very complimentary of me for being persistent and thorough, and it was a big confidence booster. The whole time, all of us were equal. I was very comfortable walking up to anyone and asking questions.”

“Everyone had a spirit of volunteerism, a great work ethic and most importantly, a ready laugh,” Newton says. “We may have major problems with our health care system here, but we are so lucky to have the options we do. People were grateful and appreciative of the little we could do for them, and it was really great to see everyone working together across all the disciplines.”

Like many villages, Quesimpuco also has its own language, similar to but different from Spanish. Fortunately, there was a unique solution to the potential communication barrier.

“It was uplifting to see the young boys that came every day to help translate from Spanish to Quechuan,” Newton says. “They did a great job, took their task seriously, and were so eager and happy to help. I do not know many 15-year-olds that would be so enthusiastic about explaining how to take vitamins, antiparasitic and other medications 100 times a day. But they did with a smile and even learned to ask the patient to repeat the instructions back to ensure clear understanding.”

As was the case in Ecuador, the biggest problem was parasites. Fortunately, the group had enough medicine for everyone to resolve the issue, at least temporarily. As a preventative tool, Oscar Munoz from Texas A&M University worked with villagers 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.

“There’s so little water available,” Dr. Bentley says. “Some only drink a cup of water a day. And they really protect their animals’ water supply more than they protect their own.”

Outside the clinic, students and faculty took a morning to hike up a hill and watch a beautiful sunrise over the mountains at the base of an old shrine. On an afternoon hike, they went high above the town and saw scattered remnants of ancient Incan pottery, then stopped to hear from a villager about the history of the region and its local fauna and geology. The last day included a large festival, with participants joining in the traditional dances.

“I was surprised how little health care the people of Quesimpuco had access to,” says Maria San Andreas, a fourth-year medical student. “The nearest hospital was a few hours away, and even then, that hospital was not equipped to handle every case. In spite of those circumstances, the people were so nice and thanked us many times for coming to help them.”

HSC student with Bolivian baby

College of Nursing graduate Monica Smith holds a baby from the local village.

This trip, like others before it, has made a permanent impact in many ways. Local health care providers have received training to improve the health and quality of life of the local people, and hopefully, the infant mortality rate will be reduced.

There also has been tremendous physical growth in the past 15 years with construction of a community center, health center, church, school and dormitory, library, and even a hospitality facility for visitors and mission teams. A bridge was built across the Tigres River to allow better access for hundreds of people in villages throughout the region.

The students were impacted permanently as well. Each has a memorable story that will stick with them forever.

For nursing student Stephanie Swindell, it was aiding a young girl who had excess fluid in her mouth from not changing her gauze dressing after having teeth pulled. For Okle and Newton, it was the appreciation from the village leader for helping save a 6-year-old boy with a persistent posterior nose bleed who would have died without their care. For fellow nursing student Laura Haag, it was being a calm presence to a child having a molar removed.

“I took off my mask and made sure she maintained eye contact with me while they were working on her mouth,” Haag says. “It was a life-changing experience to try to communicate with someone whose language you can’t speak.”

Good spirits

All the TAMHSC administrators and faculty members were impressed and bolstered by the selfless, happy attitudes the students had. The trip gave a rare opportunity to collaborate outside an academic environment and really get to know those whom they interact with on an almost daily basis.

“Students spent time in a variety of disciplines besides their own developing appreciation for the demands placed upon other members of the health care team,” Dr. Dickey says. “Learning opportunities ranged from hands-on skills like auscultation and manipulation to profound appreciation for the role of technology in all our disciplines as practiced in the United States. Of course, one of the skills practiced was simply performing as a team throughout 10 days of travel, close quarters and foreign culture.”

Bolivians gather in clinic

Local villagers await their turn for treatment at the clinic.

“I was so impressed with our students’ attitude and hard work even when they didn’t feel well,” Dr. Sherwood says. “The team really banded together to help each other and the residents of Quesimpuco.”

The students taught the Quesimpuco villagers about health care, and the villagers taught the students about their culture. The close quarters also provided a chance for participants to develop strong bonds that last even now back home through text messages and get-togethers.

Of course, text messages and modern technology were nonexistent during the trip. The only communication with the outside world was a single satellite phone.

But like the rest of the trip, everyone adapted.

“I thought I was going to die without a phone or the Internet,” Okle says. “Now, I don’t always answer my phone or keep it by my side all the time. It’s nice not to be worried if someone is trying to contact me. It’s made me more relaxed.”

Future plans

Now, plans are beginning for the next trip to Bolivia.

“I’ve already emailed Dr. Dickey to talk about planning,” Dr. Bentley says. “You get out of the trips what you put into them. You can change people’s lives, and the memories will always remain.”

For Haag, ministry is in her family and a personal calling. She wants to experience firsthand the ongoing changes in Quesimpuco over the next several years.

Swindell is also ready to return.

“The first night we got back home here, we were all exhausted and trying to catch up on sleep,” Swindell says. “Was I worthless at that time in bed? Yes. But was the trip worth it? Definitely. I recommend going on a trip at least once in your life. Even if you go on a medical mission trip and you’re not in the medical field, there’s still so much you can do.”

Pharmacy student Mingle agrees that everyone should embark on at least one mission trip in their lifetime. She also has advice for those that go.

“Keep an open mind and be prepared for the unexpected,” Mingle says. “In this situation, as in life, things do not always go according to plan, but it is the journey and not so much the destination that matters. Enjoy the ride, because before you know it, it has all but ended.”

Trip Participants

Along with Dr. Bentley, her husband Blake, and Dr. Dickey, Texas A&M Health Science Center team members were College of Nursing students Lindsey Okle, Laura Haag, Briana Newton, Stephanie Swindell and Monica Smith; interim College of Medicine Dean Dr. Edward Sherwood and his wife Shirley, assistant professor Dr. Anna Lichorad, and students Ramish Kumar, Amit Sharma, Ryan Alvares and Maria San Andres; Irma Lerma Rangel College of Pharmacy assistant professor Dr. Joseph Rinka and student Anne Cecile Mingle; Baylor College of Dentistry associate professor Dr. Michael Ellis, assistant professor Dr. Kim Self, and students Benjamin Cozod and Jonathan Oudin; and School of Rural Public Health student Craig Peek.

Oscar Munoz of 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. He was joined by his wife, Norma Munoz.

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