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Oaxaca - Summer 2013

ESTUDIANTES DE ENFERMERIA EN OAXACA

Seven students, APNs Amanda Markusson and Samantha Tangchaiburana and MECNs Natalie Sanaee, Kristen Roman, Scarlet Lee, Tony Ingoglia and Jennifer Han spent a week on Oaxaca, Mexico where they got a firsthand look at how the healthcare community used both Traditional and western health practices to provide care for the community. 

A DAY WITH THE MADRINA

From the Student Clinical logs came these stories:

"The madrina was there, a woman who goes into the community and (searches) sees the high-risk pregnant women to make sure they're educated on the danger signs and symptoms, appointments, and the importance of having a birth plan.  We walked for almost 3 hours...Dedication does not adequately describe what this woman is...The homes were made from just about any non-permeable material, flattened jumex cans, mattress springs with palm fronds splayed out on top, etc.  The 2 women we did speak with were very educated.  They knew the symptoms of pre-eclampsia, one of the largest concerns in this population, they all had a birth plan which included social support and care for their children.  They all had jobs. They all had Seguro Popular (an insurance/program)...This was so far my favorite portion of the trip."

"We walked all throughout the village and knocked on patients doors to check up on their pregnancies and make sure that they were taking their prenatal vitamins, were receiving checkups, and had adequate social support...Many roads are extremely steep and inaccessible to cars... Many women have delivered babies in the roads because they were not able to make it up the hill according to the Madrina...the houses sometimes have found objects that cover their roofs.  Buckets are used as trashcans.  Milk crates are used as tables.  Buckets are used as chairs, etc... I am really glad I got to do an extensive walk through in the village and enter the homes of the people because it allows me to empathize with patients throughout my career who living in poverty and to understand the difficulty in accessing the health system in the first place.   Today reinforced that the real world is complicated and requires diligence, patience, and good intentions towards those in the greatest need of care.

VISITING THE HOSPITAL CIVIL AND A RURAL CLINIC

Students spent 2 days alongside Mexican nurses in the Urgent Care/Emergency, Pediatric Urgent Care, Medical Surgical, and Maternity wards at Hospital Civil. 

"It's the second day in urgent care at Oaxaca's main hospital... The trauma patient had a central line, triple lumen. Little did I know, there is a specific nurse whose only task is to do central line dressing changes... When the RN was informed NP's could insert central lines, she was so excited. She brought me to the catheter room. I saw all the catheters which they use, including PICCs, Hiccmans, triple lumens and different dialysis catheters, much like the ones we use at home. It seems like nurses in Mexico also have different opportunities as far as practicing nursing, much like the states."

Then, students spent 1 day in a rural clinic, with the "community Nurse" and physician in the 1 clinic that serves a population of almost 600 Sapotec indigenous families. The RN functions as a primary care/public health nurse provider, along with multiple complex responsibilities, as she canvasses the neighborhood for public health risks, advocates for health and policy changes, along with providing clinic and home care, and monitoring the environment for health risks.

"We drove out to Santa Ines to visit the main clinic and do a "sweep" of the community with Letty, the enfermera in charge.I noticed the importance of preventative medicine and equal opportunity when visiting the Santa Ines site. "Sweeping" the community made me incredibly appreciative of what nurses, such as Letty, do.  Letty pointed out many of the stagnant water pools in the walking path, stating that they are reservoirs of mosquitoes and dengue fever...We visited one household where a patient with renal failure was refusing peritoneal dialysis because it "made her feel worse than when [she] doesn't do dialysis."... It saddened me to think that many, predominantly the Zapotec, have to live among such harsh conditions. I only wished I could do more to help them."

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