It’s Impossible to Say “No” to an Abuela

By: Sarah Ng, OMS-II

This past July, a team of NYCOM and NYIT students and faculty travelled to El Salvador to participate in fieldwork as part of the Center for Global Health Program. The team was led by Dr. Zehra Ahmed, Dr. Michael Passafaro, and Dr. Deborah Lardner, and included Hau Chieng (’15), Ryan Denley (’15), Dane Masuda (P.A. ’14), Michael Nickas (’15), Sarah Ng (’15), Jasmine Beria (’14 Academic Scholar), and Jon Giordiano (’14 Academic Scholar).  During our three weeks there, we were able to shadow doctors and health promoters, successfully carry out a clinical study on Chagas disease, run health fairs for students of all ages, practice new clinical skills, enjoy breathtaking scenery, learn about a new culture and history, and much more!  Each of us took turns blogging about our experiences while we were in El Salvador, which was posted on the NYIT homepage during our time there. (http://www.nyit.edu/global_health/el_salvador_2012/)  We thought we would share a few excepts and photos from the blog here.

Today was an extremely full day. We woke up at 5:30 a.m. so that we could head over to the community of Los Cimientos, which was a three to four-hour drive – you lose track of time on these types of trips. We spent the first hour in our regular blue van, but the majority of the time, we sat in the back of a mid-size Toyota pickup truck. We had to travel up to the top of the mountain to reach the community. Even though the seating was uncomfortable for most of us, the sights never got old. We passed children playing soccer, dogs laying in the middle of the road, cows herded up the mountain, farmers taking work breaks in the shade, and beautiful, cloud-perched mountains sitting in the distance.

In the span of fifteen patients, we paid witness to a sixteen-year-old discovering she was pregnant for the first time, a woman who lost her pregnancy while recovering from toxoplasmosis — a rare disease in the United States, but more common in Central America,  a five-day-old baby boy who was extremely good-tempered despite his abdominal hernia, a slew of complicated and uncomplicated upper respiratory infections in children—a major concern in this region, and an elderly man with multiple chronic illnesses driving him into frailty.

Helen, the local Peace Corps worker, was able to organize a Pap smear clinic for us in the morning. The women in El Salvador tend to be nervous and embarrassed about the procedure—not unlike us. However, as a result, they will rarely volunteer for the test; we learned that last year, during an attempt to run a similar clinic, only a couple of women were willing to receive one.

This year, it so happened that a non-profit organization donated 25 solar lamps to the community. Helen was unsure of how she would distribute this finite and popular resource, but then she had an idea: she could offer a solar lamp to each woman who agreed to receive a Pap smear exam. And so, 25 lucky women left the clinic with both an environmentally-friendly light source as well as a helpful preventative measure for cervical cancer!

Dr. Ahmed, Michael, Helen—the Peace Corps volunteer that we met in Los Cimientos— and I followed médico promotor Marvin and his colleague to a local school where they spoke to a class of ninth graders about Chagas prevention. The presentation was remarkable, as it precisely tackled all the critical points about the disease. It also motivated the children to participate and ask questions. At the end of the session, Dr. Ahmed  gave the students a quick lesson on the purpose of our using an EKG in our Chagas study, and also on how to obtain an EKG exam for themselves. She thanked the class for having us.

Our last visit today took our group up a mountainside to visit the lone house on that particular trail.  I can’t even talk about the scary and steep drop-offs or the number of times I slipped or sunk into the mud because I know doing so will only upset me, but we’d heard the old abeula we were visiting was capable of making the trip without any difficulty at all.

On arrival, to my sight and to anyone else’s who’d graced that mountain home today, I saw an alert woman working hard by her indoor wood-burning stove.

After I asked her permission, she allowed me to take a picture of her methodically rolling out tortillas.  She was a very generous host to Dane, Sarah, and me, and happy to have us in her home.  She insisted on serving us some of her food.

Obviously, it’s impossible to say ‘no’ to an abeula.

We ate our tortillas with beans and some cheese taken from a bowl of mountain water.  It was delicious and we left nothing behind.

After assessing her normal blood pressure and asking some basic health questions, we checked her water basin—or pila—for contamination and left her home with a smile and an embrace.

Today was a big day for the five of us who are now second-year students, both D.O. and P.A. alike. We ran a health fair for a school in Yamabal; the fair has been over a month in the making. With the coordination of Peace Corps volunteers Alex and Elsa—Alex teaches at a local elementary school—we educated 40 fifth and sixth graders on nutrition, exercise, the lungs, the heart, and oral hygiene.

…To give the children some perspective on what happens when a person develops high blood pressure, he organized a “human” blood vessel, where NYIT students and faculty served the roles of vessel walls and children played the roles of red blood cells.  NYIT members stood opposite each other an arm’s length away from their neighbors– fortifying vessel walls just wide enough to let our eager red blood cells pass through two-by-two.  We asked the children to repeat the trip, but this time the NYIT members bottlenecked the end of the vessel to simulate a narrowing of the arteries and an increase in blood pressure.  Then, the illustrious Dr. Lardner played the role of a lifetime as arterial plaque impeding our red blood cells’ clear passage through the vessel.

…The constant integration of new lessons with ones we discussed earlier in the day was central to the success of our health fair. Teaching the interconnectedness of healthy choices and their effects on all the systems of the body was our primary objective. The enthusiasm and energy these young children exhibited for nearly three hours can only be a sign that today’s health fair will have a positive impact on their lives. This day showed me that even with obstacles like a language barrier, the right attitude and preparation will lead children to pay attention to your every move and learn from you–even if your Spanish sounds a little funny.

Before I go into anything else, let me be the first to tell everyone that we reached our goal of 300 patients today! Some of us thought it would take two full weeks, while others thought getting 300 patients in our three weeks here was going to be too tall a task; no one anticipated that we would be able to complete electrocardiograms (EKG’s) and venous blood draws on 308 locals in just three days.

So congratulations are in order for Jasmine and Dr. Passafaro, as well as for everyone else who helped them along the way.  This study has been more than half a year in the making. We believe it is going to be a significant stepping-stone in the screening for Chagas, no matter which way the results fall.

I hope you two remember us little guys on your way to stardom.