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Jefferson College of Health Sciences Faculty and Students Undertake a Community Health Education Mission to Honduras
JCHS Dean for Academic Affairs Lisa Allison-Jones and her husband Bruce are leading a team on a community health education mission to Honduras from May 14-23, 2011. The team left Roanoke on Saturday, May 14.
In addition to Lisa and Bruce, the team is composed of a mix of JCHS students and faculty, as well as employees from Carilion Clinic. Team members include JCHS faculty Michelle Hartman, DeDee Foti and Paula Prince; and JCHS students Heather Jones, Jennifer McPherson, Amanda McAden and Brian Wade. The remainder of the team is Cecilia Gaston, Ronnie Dillon and Chuck Bray.
This year, the group’s mission will be to provide basic education to a group of community health workers from Honduran villages. The JCHS students involved participated in a three-credit course, Transcultural Healthcare, to prepare for the experience and were responsible for preparing the teaching plan and materials for the project.
See below for daily blog entries and photos from the Mission trip!
Daily Blog Updates
Days 1 & 2: May 14-15, 2011
We are an interdisciplinary team of faculty, staff, and friends from Jefferson College of Health Sciences in Roanoke, Virginia. Our mission team has embarked on an adventure that is different from the usual medical missions to the villages. We will be providing basic education to a group of Community Health Workers selected from leaders of 18 villages served by FOBF. The students participated in a 3 credit course over spring semester to prepare the lessons and materials. We also have three team members, Bruce Jones, Ronnie Dillon, and Chuck Bray, who are working on repairs to Alfredo House and the rest of the property. The other team members will be introduced in future entries.
We arrived in Honduras Saturday morning after a thankfully uneventful day of travel. Before arriving at the Barnabas house, we participated in a tour of “Hospital CEMESA,” a modern private hospital in San Pedro Sula. Many of the children that FBOF refers for cardiac surgery are treated there. We were enthralled by the fact every child that was a patient at the hospital had his/her name written on the wall in the waiting room. Once we arrived at Barnabas House, we spent the last half of our day making simple medical kits for the community health workers.
It was a beautiful day at the Barnabas house today. We began our day with a devotion offered by Ronnie. Then we met with the Friends of Barnabas medical staff; this group was very instrumental in providing us with feedback on our community teaching projects scheduled for tomorrow through Wednesday. A highlight of our day included a buffet lunch at a restaurant called Los Glorious. The restaurant is situated on a beautifully landscaped property with a pool and other resort-like amenities.
Our day concluded with a praise and music-led ceremony at the Prince of Peace church in a nearby village and an ice cream break. We are now back home putting the last details of our program for tomorrow together. We are excited and anxious and will let you know how it goes!!
Day 3: Monday, May 16, 2011
It is day #3 in Honduras and we had another exciting day. This morning we gathered in a circle in front of the FOB house for a “Blessing of the Hands” ceremony with our team members, FOB staff and community health promoters. The ceremony was a lovely spiritual way to begin a day that was full of activities.
After the ceremony, the team worked together to prepare a room that would be the center of our teaching for the 8 women and 2 men, each from a different village. They were selected to learn how to improve the health and safety of the people in their villages. One of the women brought her 12 year-old son who sang and played the guitar during our breaks. Our team was astonished by the fact that one of the women traveled by motorcycle 4 hours on a dirt/gravel road just to hear what we had to say. Also in attendance were a local doctor and several other community health educators. Our team was unsure how the women and men would respond to us as we were unfamiliar faces. Additionally, they did not know the men and women who came from the other villages; it must have been a very intimidating environment for them. To our amazement, our guests were very attentive, interactive and seemed to enjoy our presentations and activities. They even shared sad stories of personal experiences of illness and injury.
Today’s presentations were led by team members Heather Jones and Mandy McAden. Heather discussed basic health promotion concepts while Mandy focused her presentation on teaching growth and development of children. Each included interactive activities in an effort to reinforce the information they were learning. Heather led a hand washing activity to the tune of “happy birthday” which led to smiles and laughter. Mandy led an activity that taught them what to do if a child or infant is choking. Each of them practiced the Heimlich Maneuver technique on one another. This activity was reported by many in the group to be one of great value. Of course none of this was possible without our interpreter Cecilia Gaston who made the teaching and learning fun and exciting.
During our time of teaching and learning, team members Bruce Jones and Ronnie Dillon worked on several FOB house maintenance projects. After a full day of teaching, learning, and maintenance projects, our new friends retired to their rooms at the Barnabas house.
Day 4: May 17, 2011
It is day 4 in Honduras and as each day passes we are finding that our work here in Honduras is not only rewarding, it is proving to have a positive impact on our Honduran Friends’ understanding of how to promote better health. We were very fortunate today to have 2 more women join our group. Recall that yesterday JCHS graduate Heather Jones, and JCHS student Mandy McAden presented on the topic of basic health promotion and development of children. Today’s presentations were led by JCHS graduate Jennifer McPherson and JCHS student Brian Wade. Jennifer spent several hours teaching on the topic of women’s health and Brian brought the day to a close with a discussion on dental health and nutrition. Both presentations proved to be very interactive with many questions asked.
Today we incorporated the use of iClickers. The introduction of these small hand held gadgets brought many smiles to many faces as they learned how to use them to answer presentation-related questions. Important was the fact that their answers reflected an understanding of the material presented. To the team’s surprise one of the men quickly answered our questions “before” the iClicker system tallied everyone’s answers! They were equally interested as the women in learning about women’s health. Learning this new technology was just the beginning of their day; little did they know that Dr. Hartman would enter the room as a “pregnant” woman. Our friends giggled and laughed as she pretended to give birth to a synthetic baby. Trust that Team #5 was equally amused and many pictures were taken as “proof”. Dr. Hartman and Ms. McPherson did well to engage our friends with this activity. They even took advantage of the opportunity to practice tying and cutting Dr. Hartman’s baby’s umbilical cord. One of the women shared a story about a time when she was with a woman who gave birth to a baby. She explained that when the baby was born she had no idea what to do with the cord. She expressed great appreciation to the team for teaching her what to do. Many villages do not have access or are many hours away from a hospital or clinic so teaching them what to do before, during and after the birth of a baby was very meaningful to them. It was quite fascinating to hear how their cultural values guide their decisions on before, during, and after childbirth care. For example, women are prohibited to eat eggs, beans, but are permitted to eat cheese with tortillas and indigenous-hen soup. The hen-soup is consumed for 15 consecutive days post-delivery.
Brian presentation on dental health led to many questions, stories and laugher. During one part of his presentation, he provided each of our friends with dental floss, toothpaste, and a tooth brush. They brushed their teeth and then were instructed to chew a purple “disclosing tablet”. This tablet, when chewed, adheres to any plaque or food left on teeth after brushing and flossing. They were given mirrors so that they could see how well they had or had not brushed. This appeared to be a very fun for them, especially entertaining was the presence of many purple tongues. Brian’s closed his presentation with a discussion on nutrition. This was a bit challenging as their diets are guided by their cultural practices and food availability; this clearly exposed the fact that there is a disparity between their diet and a diet that includes foods from the 5 food groups. At one point during Brian’s presentation, he asked what kind of meats they eat. One of the women explained that they eat fish, especially during the time when it “rains fish”. We were all puzzled by this concept. She explained that “yes, it rains fish”. Dr. Moncado explained that sometimes it rains so hard that when the raindrops hit the water the fish are brought to the surface and often become airborne.
As this journal is being written, a few of our team members, Cecelia our interpreter, and Mandy can be heard teaching those who were unable to participate in all of our presentations.
As was yesterday, Bruce Jones, Chuck Bray, and Ronnie Dillion worked steadily on maintenance projects! Oh, let us not forget Berta who prepared 3 wonderful meals today! The fresh mango, pineapple, and papaya in Honduras are so much better than that sold in America.
We are looking forward to another wonderful day tomorrow and look forward to sharing yet another day with you through our journals. Until then….
Day 5: May 18, 2011
Hola Amigos and Amigas!
It’s day 5 for Team 5 here in Honduras and we have more great stories to share with you from our mission trip!
Our morning started with Heather Jones reviewing her “Improving your Health” presentation for our Honduran friends that missed the first day of class. There was one woman who was in nursing school in Honduras, another woman who was a community health promoter, and a man who has been identified as a community leader in his village. Even though they were tired from the previous days of teaching, they were all eager to learn the new information.
Our team members and Honduran participants met in the house for a quick review of health lessons. This was followed by "check offs" - where they demonstrated all of the new skills that they had learned. We distributed toothbrushes, soap, and JCHS tote bags for the participants to carry all of their new health care supplies. At the conclusion of our teaching program the students were provided with an iClicker for an exam. The goal for giving them the exam was to evaluate the effectiveness of our teaching. The results of the exam revealed that students learned the concepts taught and thus our team is pleased to announce that everyone passed with flying colors!
One of the most compelling moments of the day was when Modesto, one of the participants, and Dr, Moncado stood up to express their gratitude for all of the knowledge and skills we had provided them. He proceeded to share a story of how this knowledge has already helped him and his family. He explained that after the day where we taught the Heimlich maneuver, he had gone to church in his village and a young child choked on a piece of hard candy. Modesto was able to use his new knowledge and skills to perform the Heimlich maneuver and dislodge the candy from the child’s throat! His story left many of us very emotional which helped us to realize the significant impact our teaching has had on at least one village in Honduras.
To conclude our health promotion teaching initiative, we held a “graduation ceremony” for all of the participants. All of the people who attended the health promotion sessions were presented with a certificate recognizing their completion of the course. We were also given cross necklaces created with Honduran wood by our own Bruce Jones. The graduation ceremony opened with Melvin leading the Honduran participants in singing “This is the Day” in Spanish; this was his gift to us. At the conclusion of the ceremony our team sang the same song in English, this was our gift to them!
Once all of the participants had departed, our team packed into the bus for a mini-fieldtrip. We went sightseeing around waterfalls and mountains where we all hiked and were able to see some of the beautiful nature that exists here in Honduras!
We ended the night with a birthday celebration for De-Dee Foti and an anniversary celebration for Bruce Jones and Lisa Allison-Jones. We celebrated with a Honduran cake that cannot be described as anything but delicious! Tonight we are heading to bed early, as we have to leave by 7:00am to travel to a rural village where our team will assist Pasquela in providing health teaching and disease prevention for local teenagers.
Day 6: May 19, 2011
It is day 6 in Honduras and our day was filled with many adventures.
Today we started with a wonderful breakfast and then a 2 hour bus drive on a dirt gravel road to a village in Santa Barbara. The village is a central location for Honduran families that live in underdeveloped areas. Approximately 27 children came from many different villages to learn about family planning, health promotion and sex education. Children approximately 12 years of age were awaiting our arrival and wore their best clothes in anticipation. Ms. Pasquela led an interactive teaching lesson mixed with moments of singing and clapping. But before the teaching began, Pasquela, Melvin, and the children sang and clapped to 2 songs in Spanish, one of the songs is called “This is the Day.” Our team then sang the same song back to them, but only in English. This was truly a wonderful moment for most of us.
As the day continued, the children seemed to remain quite interested in what they were being taught. A wonderful part of the experience occurred during the time when the children got to use their iClickers to answer questions about the information they were taught. They laughed and giggled and were so engaged the entire day. At the end of the day, the team members handed out soap, toothbrushes, toothpaste and floss. Brian Wade demonstrated the proper technique for brushing teeth in an effort to promote good dental health.
After saying our goodbyes to the children, teachers and community leaders we all piled into the bus for a 2 hour drive back to the Barnabas house. About half way back to the Barnabas house, we came upon a truck that had gone off the road’s edge. Fortunately no one was hurt, but we left in amazement that no injuries occurred with such a serious accident. As we closely approached the Barnabas House, Bruce Jones verbalized a great “let’s stop for some ice-cream.” Our driver Elmer obliged and took us to a local tourist attraction that had a butterfly garden and a 3-story tree house overlooking a fabulous view of a lake. Most of us purchased an ice-cream bar for 23 Lempiras, the equivalent of 1 dollar and 21 cents in American money.
The evening came to a close with another nice meal from Ms. Berta and a surprise from Ronnie. Ronnie is a team leader for medical mission trips and comes to the Barnabas House frequently to make repairs to the house. While we made our trip to the village, Ronnie stayed at the house to work on dressers for some of the bedrooms. Ronnie is quite entertaining and out of nowhere entered the room in a pirate’s costume; this surprised and scared many of us, but we laughed hysterically afterwards.
We are exhausted from a long rewarding day and most of us have retired to our bedrooms to catch up on some rest for tomorrow’s day. We plan to continue our teaching and our expecting approximately 20 midwives to arrive at the Barnabas house at 9 a.m.
To be continued……
Day 7: May 20, 2011
It is day 7 in Honduras and it has been both an exciting and emotional day for many.
Today we met with 13 midwives from different villages to teach them about the importance of vital signs. Some of the women have been practicing midwifery for over 40 years, but do not possess the skill of taking a temperature or counting a pulse and respirations. A challenge arose when we discovered that several of them did not know how to count against the second hand of a clock. The fact that many either forgot or did not own eye glasses also presented somewhat of a challenge. While initially this appeared as a barrier to our teaching efforts we quickly realized that their willingness to learn was superseded the barriers.
Dr. Moncada spent a fair amount of time presenting a lecture on vital signs. Mandy, Brian and Heather followed her presentation with a practice experience for each midwife. The theory portion of the teaching helped assure that everyone had a basic understanding of vital signs prior to engaging in a hands-on experience.
By the end of the day they all were very grateful for what they we taught them and our team was grateful for the opportunity to provide them with such valuable information. We took pictures group pictures and hugged each of them goodbye. After our goodbye’s, the team, Dr. Moncada, and Pasquela gathered to discuss the strengths and weaknesses of our teaching project. This teaching program we developed is a pilot project and sharing feedback was extremely important. Overall, we all believed the teaching project to be a huge success. This proved to be an emotional experience as the direction of our conversation moved from a discussion of the project to how we all equally cherished our time together; it was a unanimous feeling that they touched our hearts and we touched theirs. Many of the team members shed tears when Pasquela said, "This isn't goodbye...this is only an until next time." She also thanked us for helping her and told us that given her busy schedule, she would not have any friends if it weren't for FOBF and the teams they send. Pasquela is so passionate about healthcare and helping the people of her country.
As a token of thanks, Pasquela gave each team member a hand woven bracelet with different colors to symbolize our team's efforts in their country. She also gave the team the choice of several other items as a token of her gratitude. Dr. Moncada called each member by name giving each a hug along with a “gracious.” She has been so instrumental in the delivery and success of our teaching project.
Elmer interrupted our goodbye’s to tell us that we HAD to go if we wanted to buy bags of coffee. Elmer took us to the coffee processing plant where they grind and BAG coffee. After the tour of the coffee plant, Elmer took us to his home to visit with his family. He has a lovely wife and 3 children. His son Emerson aspires to be a preacher when he grows up. Upon Elmer’s request, Emerson very timidly recited the Lord's Prayer for us and it sounded like it was delivered half in Spanish and half in English. Karen, his older sister, wants to be a pediatrician and we are hoping that she will make it to the states to make that happen.
We concluded our day with dinner at the Barnabas house. Berta made us HOMEMADE salsa that was fantastic.
Remember Ronnie, our pirate? Well, once again he shocked us; not with another costume, but with a bat he caught in the hallway!
Tomorrow we will travel to San Pedro Sula to visit a public hospital and shop at the market. We need to be at the airport by 5 a.m. Sunday morning so there may only be only one more journal coming your way. I am sure tomorrow will prove to be another eventful day in Honduras.
Day 8: May 21, 2011
Day 8 in Honduras was an eventful, yet tough day!
Six a.m. came early and we packed up all our belongings and headed off to San Pedro Sula for a visit to a public hospital. A physician gave us a tour of the maternity section of the hospital, which proved to be an enlightening experience. Upon entrance into the maternity triage (waiting room) section of the hospital, we found many laboring adolescent girls sitting in plastic chairs. Male counterparts and any other loved ones are not permitted to be present during the labor and delivery process. From the waiting room, we proceeded to the maternity floor where women were in active labor or had recently delivered their babies. The room has two sections, one wall for adolescents and the other wall for adults. Unlike the United States, there are no baby cribs or any other amenities we take for granted in this room; babies and mothers lay in the same bed. We were surprised to see women in their beds in complete silence (stoic-like) during labor and post surgery. Hard to grasp was the fact that women do not get pain medication during their labor, only if they have surgery. In addition, if they have an uncomplicated delivery, new moms are discharged in 6 hours. If they do have surgery, they are discharged in 48 hours.
After the tour of the maternity unit, we enjoyed a wonderful lunch at a nearby restaurant. After eating, Elmer took all of us to the market, a large flea market with an unbelievable amount of items to purchase, such as hammocks, sombreros, jewelry, machetes, etc… We indulged ourselves for 2 hours!
After shopping, we carried many bags stuffed with Honduran goods to the Metrotel, a hotel close to the airport. This day warranted a nap! That evening the team participated in a communion, service led by Melvin followed. Melvin explained that Christians in the United States say that Christ is the “bread” of life, but in Honduras, Christians call Christ the “Tortilla” of life and he was not kidding as our bread was a tortilla. After our communion, we enjoyed dinner at “Lawsons.” Four a.m. came quickly Sunday morning and we were off to the airport. We departed San Pedro Sula at about 6:30 a.m. and landed in Miami about one hour later. Customs in Miami is quite a memorable experience. We had a layover of 7 hours before boarding our plane to Greensboro. After arriving in Greensboro, we loaded our luggage in a van and headed home through a rainstorm. After many hugs we parted ways and headed home.
A long, exhausting and rewarding trip ended after 9 days. I feel certain all of us parted ways processing everything that we did and saw during our time in Honduras. What a blessing to have been given the opportunity to serve the people in this country.