Guatemala trip changes global perspectives, lives

Indiana University School of Nursing (IUSON) has a rich history of global programs and experiences. These include partnerships with Kenya, Liberia, China, Taiwan, and Thailand; hosting foreign exchange students and visiting scholars; and study abroad opportunities for students. Ashley Jones, IU Bloomington nursing student in her junior year, and Betsy Kovacik, IU Indianapolis at IUPUI nursing alumna and Board of Advisors member, continued that legacy of international outreach when they travelled to Guatemala with Timmy Global Health to provide medical services to the local population.

Based in Indianapolis, Timmy Global Health is a nonprofit organization that enables students and volunteers to combat serious global health challenges by coordinating healthcare support teams to provide underserved populations abroad with medical services. Timmy Global Health has project sites in Ecuador, Guatemala, Nigeria, The Dominican Republic, and El Salvador and also has “chapters at more than 50 universities and high schools throughout the US.” This deep commitment to serving international populations spoke to Ashley and Betsy, and led them to be a part of that mission.

After attending an in-depth travel preparation course at IU Bloomington, the group of 26 Timmy Global Health volunteers left on March 14 for a weeklong stay in Guatemala. The group included 20 IU Bloomington students from a variety of majors with Ashley as the only nursing student on the trip. The students were accompanied by physicians, licensed pharmacists, and a nurse (Betsy). Betsy and the other medical professionals served as facilitators, organizing and running the medical labs and setting up tests and equipment for the students.

Each day the medical brigade traveled with their equipment to a new location to set up their clinic. They never worked out of hospitals, instead creating private examination “rooms” with tarps or sheets in the buildings in which they were stationed. Each patient’s medical history was carefully entered into Timmy Care – an electronic medical records system. “It was amazing how many adults we talked to who had never been to any sort of provider before, so this was their first experience with health care,” said Ashley.

The patients were then sent through “triage” where the students would check their blood pressure, temperature, pulse, height, and weight. They were then examined by a doctor, one of between four and six American and Guatemalan doctors available each day. Some patients would receive prescriptions that the team would help them fill. Patients also had the option to visit the public health education area for tutorials about washing their hands and brushing their teeth, “They were so interested in attending these sessions. They were asking questions, and trying to demonstrate on themselves and their children. That made me realize how much we take basic health knowledge for granted in the US,” Ashley said. Since the group was not working in a hospital, doctors would refer some of the patients to area hospitals for further care, providing any necessary transportation. During the Timmy Health Global team’s time in Guatemala, they saw close to 400 patients and referred 43 of them to hospitals.

In each of the communities the volunteers visited they found health issues ranging from diabetes to parasites. Malnutrition was rife in the remote mountain towns where the inhabitants are able to grow corn but no other vegetables due to the composition of the soil.

Water was also an issue. The team had to bring their own supply, as the local water was often too contaminated to be used. Betsy noted that even the act of washing one’s hands could not be done with soap and tap water alone; they needed to use a special hand sanitizer to clean their hands after washing them to destroy the bacteria from the water. Showering required great care as well. “Somebody came up with a great idea - take a swig of mouthwash when you’re in the shower, so you can hold it in your mouth and you won’t swallow the water, and when you spit the mouthwash out afterward, you’re cleansing your lips with antiseptic,” Betsy said.

Interpreters helped the team communicate with patients. In the larger towns, Spanish was the predominant language, so the IU Bloomington Spanish majors could help; however, when the Timmy medical brigade visited remote towns in the mountains, the residents spoke an ancient Mayan language. This sparked Ashley’s curiosity. “I started to wonder how many things were being lost in translation. Is there a way to say “pregnant,” or “parasite,” or “diabetes” in that ancient language?” Betsy and Ashley both mentioned that this language barrier led volunteers to find other ways to communicate with their patients, like smiling, laughing, and shaking people’s hands.

The nonverbal communication between patients and care providers also conveyed gratitude. “The biggest thing that I took away from my experience in Guatemala was just how incredibly grateful everyone was for the care we provided. As a nursing student I felt that my ability to help them was limited, but I can’t tell you how many hugs and kisses on the cheek I got from men and women who were just grateful to get their blood pressure taken. To me that was just incredible,” said Ashley.

In addition, the Guatemalan patients welcomed the IU students with open arms, often trying to speak limited English and showing great tolerance to the students’ attempts to speak their language. This warmth and kindness has had a great impact on Ashley. “I have really tried to make it part of my everyday routine to be welcoming and grateful for everything. When I think ahead to my nursing career, I want to do the same thing – make someone who is uncomfortable or is from a different country, as I was, feel more welcome and make sure that they understand the care they are receiving. I may not have realized that if I hadn’t gone on this trip.” These experiences so affected Ashley that upon her return from Guatemala, she applied for and was accepted to be a trip leader for Timmy Global Health Bloomington chapter’s trip next year.

Betsy echoed Ashley’s sentiment of patient gratitude and warmth, adding that the student volunteers themselves were accommodating and willing to communicate with the locals. “The love and acceptance they had for other cultures was eye-opening; it was beautiful. These students showed their patients total respect and acceptance.” She added, “Every nursing school curriculum should offer the opportunity to travel to other countries and experience other ways of life. The students and the patients both benefit from the exchange of knowledge and experiences. That isn’t something that can be learned from a textbook.”