Physicians for Peace recently had the opportunity to have a great impact in Central America by training burn nurses in basic and critical care techniques. The International Infirmary Congress was held this month in Tegucigalpa, Honduras. One of our teams, comprised of volunteers Carolyn Ramwell, Susan Vinge, and Diane Strout, was invited to present at a special two-day, pre-congress event on burn nurse education. The number of nurses in attendance from all over the region made this an excellent opportunity to reach as many health care workers as possible and have far-reaching effects in one of the poorest countries in the western hemisphere.
The team leader, Carolyn Ramwell, then met her second group in San Jose, Costa Rica – Nicole Farrar, Eugenia Lindsey, Briana Morrison, and our own Physicians for Peace staff member, Sharon Gabriel. There they were able to assess the needs of a local pediatric burn unit and bring supplies, training, and asssistance to their staff.
The teams posted the following updates on their experience.
12-06-08 Tegucigalpa, Honduras
Hello,
We arrived safe and sound. Sue is here from team Minnesota and will be fantastic. She is ready to go with the flow. We found out today we are teaching the entire precongress with an audience of 300 nurses. They gave us the schedule and certificates to sign. We will pull together, but what a challenge! We will be giving 10 lectures and then having 2 four hour sessions of hands on wound care. We will pull the cases together from both units (adult and pediatrics) so we can focus on many wound dressing changes and hands on wound care education. Mobility will also be a huge focus. We toured the hospital today, and I did a quick needs assessment. I will flesh it out later in the week, but it is nothing unexpected. This is a good site for PFP. The staff is eager to learn and the improvements for better outcomes can be implemented right away. With the insight from other missions, this is fertile ground to implement our burn program in its entirety. That is it for now. We will pick up Diana tomorrow. This will be a crazy week. Talk about an amazing opportunity to impact clinical practice throughout an entire country! The nurses at the congress are from all over Honduras.
All the best,
Carolyn
12-08-08 Tegucigalpa, Honduras
Hello,
Well today was unbelievable. We gave the precongress talks and then rounded in the burn unit. This is a country in great need of our help. 75 nurses were in attendance. We are all well but tired.
Carolyn
Hello,
It has been another wonderful day here in Tegucigalpa, Honduras. We spent the morning speaking at the pre-congress meeting. Our topics were pain, professional nursing, psychosocial aspects of burn care, and wound care. Again we had about 70 nurses from all over the hospital and many from rural areas and clinics. We also spent time on the peds burn unit rounding with both MD’s and nurses. We were able to help with some smaller dressing changes on the unit, with supplies that were brought from the USA. The nurses and doctors were very excited to receive an O2 sat monitor as a donation from PFP. They were very excited to be able to monitor their patients as they give IV pain meds for dressing changes. The children here are beautiful, and the staff does an amazing job with limited equipment and supplies. We also toured the adult burn unit and the rest of the hospital. During the Christmas season, it is very humbling to be working here in Honduras with people who have so little and still find joy in the little things.
Susan Vinge, Diane Lohrenz, Carolyn Ramwell
12-15-08 San Jose, Costa Rica
Happy Birthday! Feliz Cumpleaños!
It is a rare occurrence on a PFP mission. Two of our five team members are celebrating their birthdays this week – RN and social worker Eugenia “Genie” Lindsey today, and EMT and 3rd year UVA Nursing student, Briana Morrison, tomorrow. Like most of us, and millions of other people around the world, we typically expect to receive gifts on our birthdays. But first-time PFP volunteers Genie and Briana wanted to join a mission trip to celebrate their special days –an opportunity for them to give, not receive—or so they thought.
These volunteers, like so many others, generously give of their time, expertise and knowledge. But they are receiving much, too.
“I thought spending [my birthday] in another country doing what I have a passion for would be better than being home. It is an excellent opportunity as a student,” said Briana. “I get to come on a mission, share what I know and contribute to the mission.” She adds, “But my experience in Costa Rica, with the people, and the other team members has helped me learn a lot, too. And I am treated like an equal among my own team.”
Genie shares, “It is much more meaningful to me to be able to give what I know and help enhance the burn program in Costa Rica. To be with like-minded people who want to serve children and improve their own skills to help heal children is a real gift to me.”
Today, Genie walked into the Burn Unit at the hospital and was greeted by Chief of Medical Staff, Dr. Carlos Siri and his entire team. “Everyone came up and gave me hugs and said, ‘Happy Birthday!’ “ (Or rather, Feliz Cumpleaños, in Spanish.) Genie remarked, “I think this is the best birthday I’ve ever had.”
As the old biblical adage goes, “It is more blessed to give than to receive.” Well, perhaps it is both.
–Sharon Gabriel, Costa Rica mission team member and PFP Director of Events
12-17-08 San Jose, Costa Rica
We have just finished our first official day of teaching here in Costa Rica, our third day in the Burn Unit. I am very impressed with this team in Costa Rica. I use the term team because I think it is such an important part of burn care. Back home in Arizona, our approach to burn care is multidisciplinary: clinicians, nurses, therapists, nutrition, social workers, all working together; and I see this unit here working to achieve a similar goal. The staff is so friendly and inviting to us and very open to our suggestions on how to improve their unit. They are so motivated to do what is best for their patients they are working on finding appropriate materials to start making their own compression garments, and have a dedicated workspace for that endeavor.
Yesterday I was able to spend the day with them while they did wound care, which by many standards is very innovative. All patients had their wound care under anesthesia, including tub debridements. I was able to discuss different wound care options with the physicians and made suggestions about how to improve mobility.
This morning I brought an entire suitcase of donated compression garments with me, along with a few other gifts for the staff, to which the physiatrist responded, “It’s like Christmas!” I was so happy to be able to share those resources with them.
Today we also began a 24 hour seminar for the hospital and others in the surrounding area about the care of burn patients. I gave a lecture on the initial care of burns and fluid management and shock. Unfortunately, my espanol es no bueno. So, the burn unit was nice enough to arrange for me to have a translator. My lectures went really well, and luckily some of the nurses in the room spoke English and could help out the translator with some of the technical terms like “hemodynamic” and “compartment syndrome.”
So far, this has been an incredible experience, and I have been very well received, although, it is a little difficult to explain what a Physician Assistant is exactly. I have been treated with respect by the staff, and my experience with burn patients appreciated. I hope this to be my first to many missions.
Thank you for this opportunity!
Nicole Farrar
12-18-08 San Jose, Costa Rica
Burn Nurse Seminar at Children’s Hospital in San Jose, Costa Rica
Fifteen nurses from various provinces and hospitals around Costa Rica attended a two-day workshop at Hospital Nacional de Niños, presented this week by a PFP volunteer burn team. Dr. Carlos Siri Adema, Burn Consortium member and Chief of the Burn Unit at Hospital Nacional de Niños, invited the PFP team to increase the number of burn nurses and burn knowledge in Costa Rica. He was instrumental in developing the curriculum presented. The program itself was hosted in partnership with hospital Educational Coordinator, Sra. Lorena Gomez Alpizar and APANQ Foundation President and Burn Consortium member, Sra. Nayra Gaspar.
Led by team leader Carolyn Ramwell (RN,MSN,PNP), the classes were taught by team members Physician Assistant Nicole Farrar (MMS, MBS,PA-C) from Arizona Burn Center, nurse and social worker Eugenia “Genie” Lindsey (RN,BSN,LCSW) from Virginia, and EMT and 3rdyear UVA nursing student Briana Morrison from New Jersey.
Briana taught a session on Pre-Hospital Burn Emergency Care so the nurses could instruct their lay communities on guidelines for handling burn traumas prior to getting victims to a hospital. The nurses also received teaching/advocacy materials such as posters and pamphlets on prevention from the APANQ Foundation.
Nicole led an in-depth clinical session and lively professional exchange on Initial Burn Management, giving an overview on the types of burns including scalds, which make up 60% of the burn injuries in Costa Rica. Her sessions also covered Fluids and Shock, and how these can affect different organ systems in the body.
“These classes are important because there are different ways to approach the patients; it has been very interesting to learn different protocols and the different technologies for burn care,” said Angelina, an Intensive Care Unit Nurse from Hospital Nacional de Niños.”
Genie taught about the psychological issues related to post-traumatic stress disorders as well as non-accidental trauma and how to recognize the signs of child abuse. She gave practical demonstrations of child-centered therapy interventions, such as puppet therapy with ChaCha the Cat, color visualization therapy, story-telling, play therapy and sand-tray therapy – all designed to help heal the soul and spirit of a victim.
In addition to the educational lectures and materials, the nurses were given CDs of the presentations to take back with them. Equipped with additional knowledge, new ideas and friendships, and practical tools, these indigenous healthcare providers can leverage the seminar with Physicians for Peace to exponentially further burn education within their communities.
Sra. Gomez was very excited about the seminar and bridge-building that occurred, as well as the participation and cooperative efforts between the organizations. “They [Physicians for Peace volunteer educators] have caught the attention of the audience with the topics and material presented. It was both professional and fun at the same time.”
She added, “It doesn’t matter what country you are from, it matters more what kind of heart you have for the people. And you can tell what kinds of hearts people have – that’s why I am so glad to have met you.”
–Sharon Gabriel, Costa Rica mission team member and PFP Director of Events
