Project Spotlight: Medical and Public Health Mission in Nicaragua

In 2015, the PA Foundation awarded Arcadia University a Robert K. Pedersen Global Outreach Grant for its project “A Medical and Public Health Mission in Nicaragua.” The project was developed in collaboration with Global Brigades, the world’s largest student-led health and sustainable development organization. Through the organization’s Medical Brigades program, which places volunteers alongside local licensed medical professionals to provide comprehensive health services in rural areas, Arcadia University sends PA students to volunteer in a partner country during their didactic year. The “Student Brigadiers” triage patients and assist physicians and mid-level providers in patient evaluation, diagnosis, assessment, and treatment. They also complete health informatics data entry and assist the in-country pharmacist in dispensing prescribed medications.

The 2016 Arcadia Medical Brigade – an interdisciplinary team of 65 individuals including 51 PA students and 14 PA faculty and other healthcare professionals – embarked on a six-day trip to Nicaragua in early March to improve healthcare in several communities. With the funds they raised, including a $14,660 Global Outreach Grant from the PA Foundation, the team purchased two medical brigade boxes that supplied medication to treat 1,712 patients in the communities of El Coyolito and Sabana Grande—far exceeding their initial goal of treating 1,000 patients.

Key components of the brigade’s patient care model included triage, consult, “charla” (Spanish for “chat”), and pharmacology. Triage involved small groups of 2-5 students and 1-2 clinicians who checked vital signs, performed heart and lung exams, and conducted urinalyses, pregnancy tests, and glucose tests. The next step was the consult, which also involved small groups of students and clinicians who conducted pertinent physical exams, made diagnoses, and led patient education efforts. Gynecological and dental services were provided to patients as needed. The “charla” component was targeted to children aged 2-12 and aimed to provide education on health topics critical to the community (but largely overlooked), including dental and hand hygiene. The team provided resources such as toothbrushes and fluoride treatments and taught correct hygiene methods. Finally, the pharmacy managed the filling of prescriptions and distribution of multivitamins and hygiene packs to every patient.

The brigadiers utilized the medical supplies and medications they purchased to treat chronic conditions such as asthma, hypertension, and diabetes, as well as infectious diseases and conditions distinct to Nicaragua. In both El Coyolito and Sabana Grande, the team witnessed a high prevalence of gastrointestinal conditions such as parasites in addition to chronic conditions. They also saw a significant number of musculoskeletal disorders, a result of the type of physical labor performed in the communities for income.

In addition to directly treating patients, the brigade implemented a public health project that involved laying six concrete floors for six different families. Concrete floors help prevent and control many of the parasitic diseases that are common in this environment, particularly in children. Chagas disease, for example, is a potentially fatal disease that is spread through insects that burrow in the ground. Team members also focused on public health education, with the goal of teaching residents about the impact of certain behaviors on their health and encouraging positive practices that complement preventive measures and minimize illness and death.

PA students involved in the project had an opportunity to apply the skills they acquired during the didactic phase of their Arcadia curriculum by assisting clinicians in providing hands-on medical care and patient education. Of the experience, one PA student said, “For the first time in my education, I learned what it feels like to make a difference in someone else’s life through medicine. There is no classroom lecture, assignment, or test that is capable of teaching me how to compassionately care for an individual as I did and words can’t explain how thankful I am for that experience.”

The PA Foundation is proud to support this influential project that has proven to advance healthcare for communities in need and serve as a growth and leadership experience for future PA leaders.

The 2016 brigade team was led by Arcadia Global Brigades Chapter President Michael Huber, MMS, PA-C, DFAAPA, along with PA faculty Melissa Justice, PA-C, Jami Smith, PA-C, and staff member Kathy McGovern, CRNP. Also accompanying the team were Arcadia alumni Renee Langstaff, PA-C, and Dustin Marley, PA-C.