Global Health Education

in GuatemalaODU Health Sciences

Spring Break Study Abroad 2014

ODU Health Sciences & Global Health“Building Happy, Healthy Lives”

Overview Trip Summary Global Health Discussion

ChallengesRisk Factors in

GuatemalaNon-Communicable/

Communicable Diseases

GuatemalaEnvironmentCultural PracticesOccupationGender RolesEducation

Nutrition Healthcare

BarriersWorkersEducation

Service WorkCorazon de los Niño’sExperiences and

Observations

Extracurricular Fun!

Trip Summary: Service Work La Corazon de los Niño's

“We are an organization that generates economic, material and human resources, promoting continuous staff training, and developing programs for health and education.”

Project HEART: serving 10 communities around Antigua and over 12,000 people.

Taught hand and dental hygiene to schoolchildren

Delivered fruits and vegetables to a poor community

Provided assessments, diagnoses and provision of medicine to the people of vulnerable communities

Trip Summary: Extra Activities

La Union Spanish School: 2 hour Spanish lessons with personal instructors

Salsa and Marangue lessons

Tour of a Hospital in Antigua

Attended lectures on health in

Guatemala

Visited a Coffee Plantation

Hiked Volcan Pacaya

Weekend at Lake Atitlan: touring, boat ride and zip lining!

Introduction to Global Health Improved quality, quantity, and overall

health in the last 50 years worldwide.

Extended life expectancy: 20 year increase

Reduction of child mortality due to vaccines, access to safer water, and improved sanitation

Purification systems for water, hand washing, and access to safe water have reduced the sanitation crisis

HIV and AIDs innovations due to preventative measures

Global Health Challenges Poverty

Global health action is dependent upon a country’s development, security, and public health availability.

Infectious disease: Accountable for approximately 19% of global deaths

Access to health care

Inadequate transportation

Poor medical staff availability

Health Risk Factors in Guatemala Pneumonia

Influenza

Chronic Obstructive

Pulmonary Disorder

Urinary Tract Infections

Malnutrition

Non-Communicable Diseases According to WHO, 80% of deaths related to non-

communicable diseases occur in low to middle income countries

Risk factors for Guatemala:

Tobacco smoking

Physical inactivity

Indoor cooking

Hypertension

High blood sugar and cholesterol

Obesity

Communicable Diseases There is a high risk for infectious disease in

Guatemala

The highest risks: (especially for travellers)

Bacterial Diarrhea

Hepatitis A

Typhoid Fever

Dengue Fever

Malaria

Environment Guatemala is a very

ruggedly beautiful country.

Volcan Pacaya

Lake Atitlan

Guatemala’s mountainous terrain makes it hard to grow crops for produce purposes, contributing to the people’s malnutrition.

Some of the villages are very remote, making access to healthcare difficult.

Cultural Practices

Dancing: Salsa and Meringue

Music: Marumba

Futball

Celebration of Holy Week: Easter parade through the streets of Antigua .

Guatemalan dress rooted in their Mayan culture

Huipil: blouse

Cortex: skirt

Tzute: shawl and for carrying children or objects

Occupation Tourism was the main

occupation we experienced

Tiendas (stores) on every corner

Men, women, and children involved

Our tourism experiences first hand:

Coffee plantation

Zip-lining

Shopping and Tasting

Injuries of the locals all seem to present the same, it was some form of a strain, either it was in the wrist, hands, shoulders, and even back

Many people work in large factories.

Gender Roles Women:

Primary Role as Caregiver: cook, clean and maintain the family.

Less education and salary

Men

Work and provide for the family

Alcoholism is a huge issue.

Education Mandatory and free Primary

School for ages 7-13

4/10 will complete primary school: Lowest primary school completion rate in Central America

Optional and free Secondary School for 3-5 years

College attendance is rare because most children must work to contribute to the family due to poor economics

Nutrition The Guatemalan diet is

based on corn and beans.

We enjoyed sampling the different styles of local cuisine.

Service Work:

We delivered vegetables to women and children in a poor village.

They had to attend a presentation on nutritional eating in order to receive the vegetables.

Barriers to Healthcare Only 2.5% of Guatemalan’s

Gross Domestic Profit (GDP) is spent on healthcare

Lack of education and preventative medicine

Lack of access to healthcare and facilities

1 doctor for every 10,000 people

45 hospitals in Guatemala. There should be 300 hospitals to

account for the population

Healthcare Workers

Guatemalan health care workers here are religious, institutional, and program based.

Community focused and skills are passed from generation to generation.

The main focus is to

educate the matriarchs due to their role in the family.

Healthcare Education Education is important

to improve healthcare in many local villages.

Licensed medical professionals teach local women about basic first aid, nutrition, and hygiene.

Teaching is focused towards the women/mother’s of families as they are the primary caregivers

Corazon de los Niño's Non profit organization founded in 1991 using

human, physical, material and legal resources to help achieve goals through health and education programs

Resources offered Nutritional Education

Early stimulation

Preschool Education

Health and Health Promotion

Basic health services such as medical attention,

dental, psych, laboratory and pharmacy

Targeted Population Women for empowerment Children and adolescence

Corazon de los Niño’s Headquarters: Limited Resources with only

necessities

1 Doctor, 1 Lab Technician, 1 Pharmacist, 1 Dentist, 1 Pharmacologist

Farming Technique Education

Mobile Clinic:

Truck: 3 assessment tables in the back of a truck with poor privacy and limited space

Community Center assessment rooms were dirty

Our gowns and caps were saved for both days, gloves were cleaned with alcohol. All other supplies were personally owned.

Antigua Hospital Local Hospital:

Donation run

Nurse/Patient Ration 7:1

OR facility, mental health services and long term care

Majority of supplies not disposable

Observed nurses folding laundry and cleaning

Service Work Nutrition teaching and vegetable distribution

Educated women in a local village on health benefits of vegetables

Allows for women empowerment

Improve diet and nourishment of children and families

Health Promotion teaching: Taught basic hand hygiene and dental hygiene at a local elementary school

Prevent infection

Mobile clinic to surrounding villages

Check for lice

Blood Pressure checks and teaching

Address pressing health concerns

Pharmacy

Health Care Service Work We provided mobile clinics to two poorer villages

Vital Signs, Weight, Head to Toe Assessments

Prescribed medications, gave education for medication administration and free medications.

Health and the Guatemalan Culture

Respiratory Issues: Cook indoors

over open fires and pollution

Nutrition:

Corn tortillas considered

nutritious because they provide

the feeling of fullness for a low cost.

Acidic diet leading to gastric reflux

Breastfeeding: Common and culturally acceptable

Issue of proper maternal

nutrition

Health and Guatemalan Culture

Personal Hygiene:

Lice

Poor water and sewage system

Knowledge and Resource Deficit

Mother of sick toddler giving him coffee for dehydration

Dental Hygiene in Guatemala Severe decay to where the crown of the tooth

has fallen out and patient reports pain

Periodontal disease with tooth mobility

Baby bottle tooth decay

Global Health Research Review Background: Pneumonia causes more child deaths than any other disease. Smoke

from household solid fuel affects half the world’s children.

Methods: Parallel randomized controlled trial of 534 households in Guatemala in a population using open indoor wood fires for cooking. Half received a woodstove w/chimney (n=269) and half remained as controls using open wood fires (n=265). The homes were visited every week until children reached 18 months to record health statuses. Primary outcome was physician-diagnosed pneumonia.

Findings: Over 29,125 weeks, there were 149 cases of child pneumonia in intervention households & 180 cases in controls. The chimney stove reduced exposure by 50%.

Interpretation: Physician-diagnosed pneumonia for children below 18 months was not reduced significantly, but the reduction of a third in severe pneumonia could have implications for reduction of child mortality. The significant exposure-response associations contribute to causal interference and suggest that stove or fuel interventions producing lower exposures than these chimney stoves are needed to substantially reduce pneumonia in these populations.

Global Health Research Review In Guatemala, we got to visit people in their

homes and see their indoor wood fires in use.

Women and children had the worst respiratory ailments; wheezing could be heard from several feet away.

A similar study would absolutely benefit the health of the Guatemalan people.

Giving Fruits and Vegetables

“I have always wanted to make a difference in others lives by

traveling to those less fortunate, but I never realized how much this experience would make a

difference in my own life.”

-- Tara Liske

“It humbled my opinions on poverty by getting to be a part of their lives for even such a short

time... Despite all of their struggles they are some of the

happiest and most upbeat people I’ve ever met.” –Lindsey Northup

Mobile Clinics

“It was the most life changing experience I have

ever been a part of. Yes because I got to do once in

a lifetime things, like zip line, but most importantly because I was able to see

the reality of the world and help those less fortunate.

All of the faces I saw and all of the warm hands I

touched will forever hold a special place in my heart.

-- Amanda Frederick

“My experiences with working in the local clinics with residents

from the different villages have truly influenced my perspective

on global health. This experience has ultimately

taught me the importance of confidence, compassion, and flexibility in the nursing field.”

“Life-changing and fun!The ultimate community service experience.”

--Soonja Heber

“Too often we underestimate the power of a touch, a smile, a kind word, a listening ear, an honest compliment, or the

smallest act of caring, all of which have the potential to turn a life around.”

- Leo Buscaglia

Hand Hygiene Education

Dental Hygiene Teaching

“Going to Guatemala and participating in this study abroad program opened my eyes to several world issues that I would have never

been exposed to if I had not made the decision to go on this trip. My experience in Guatemala was a humbling, learning experience that I

will never forget and will forever cherish.”

--Katie Babb

“The purpose of life is not to be happy. It is to be useful, to be honorable, to be compassionate, to have it make some difference that you have lived

and lived well.”

-- Ralph Waldo Emerson

Lake Atitlan!

Ziplining!

Salsa Lessons!

Volcan Pacaya

Thank you!

Extra…..

Video 3:36

Mobile clinic working day in Guatemala http://youtu.be/kOpY3qO1Jc8

Video 0:33

Mrs. Hawkins zip-lining in beautifully scenic Atitlan http://youtu.be/NQgLG6vjM5E