The International Health Service Collaborative is an interdisciplinary group of medical, pharmacy, physical therapy and public health students. The USF on-campus organization orchestrates an annual spring break trip to Panama. The spring 2015 contingent was made up of about 20 participants, including two faculty members.
The group gathered at Tampa International Airport at 4 a.m. one Wednesday and traveled, ate and slept together for the next week. Because the College of Pharmacy has a different spring break in an adjacent week, the dates were split between the two breaks, Wednesday to Wednesday.
The intrepid public health volunteers stayed in a vacation home in the mountains for four days. Idyllic? Well, with limitations.
“We stayed in one big living room, and a couple of people were in hammocks outside,” said Stacy Assan, who is in her second semester in the MPH program with a concentration in global health practice.
The balance of the week was spent at a hostel in Panama City, where the group visited the Ministry of Health and talked about what they had seen and done in the field.
That field work included daytrips to the remote village of Chica, a community without a regular physician. The group provided medication, physicals and public health education. The latter was mainly about the basics, specifically trips to the schools to teach kids how to wash their hands, brush their teeth and exercise.
“We were there just basically facilitating health education,” Assan said.
The group also conducted needs assessments in focus groups, said Calvin Robinson, a second-year MPH student in public health education.
“The needs assessment was so that, next year, we can tailor our public health education,” Robinson said.
Dermatitis, he said as an example, is a common problem there that, thanks to this year’s needs assessment, next year’s group will be ready-on-arrival to address.
Public health in hard-to-reach places
The group also trekked to a more remote village an hour away that couldn’t be reached without fording two rivers.
“Our bus couldn’t even make it to the site,” Assan said. “We had to get into pickup trucks.”
And it was a good thing those four-by-four pickups could get them there. After all, the village’s people hadn’t seen a physician in a year.
As they had done in Chica, the volunteers gave educational talks on public health. They also delivered vaccines and performed pap smears.
Their point person was Dr. Arturo Rebollón, a licensed physician in Panama who has coordinated the trips since 2009. He provides the necessary medical authority for students to perform their volunteer duties, in addition to covering all logistical bases – insurance, travel, lodging, etc. Formerly with USF-Panama, he recently returned to the Tampa campus and was appointed to be a faculty mentor.
“I was appointed faculty mentor for the organization because I have local knowledge as a physician in Panama,” he said. “I know the health centers. I know those communities. I’ve worked there before.”
Rebollón said that Chica was chosen three years ago as a site USF Health could help based on its various public health needs. A clinic with no regular physician (a rotation of doctors sends one there for one day every two weeks), waste disposal problems and a bacteria-laden water supply are among the village’s more pressing shortfalls. The lack of regular medical care, he said, was particularly evident.
“In two days of clinic,” he said, “we took care of almost 200 people that ranged from school age to very elderly. We were giving all kinds of medications, from basic health control like vitamins to treatments for parasites and chronic diseases like hypertension and diabetes. We made two house visits, one for a kid who couldn’t make it to the clinic. While we were there, there was a motorcycle accident, and I had to take care of it until the people could get referred to a hospital.”
After winning the community’s trust, he said, the team conducted a house-to-house needs assessment.
Panama’s Ministry of Health paid for all the vaccines and medications. Students spent a year holding fundraisers at places as diverse as Raymond James Stadium and Hamburger Mary’s to raise the money for transportation and food. Students had to buy only their plane tickets.
“We also got some help from the USF Health International office. They provided $5,000 to support this trip,” Rebollón said.
From a landfill to a life
Anna Cable and Jessica Castro, both second-year MPH candidates in global health practice, traveled with another group to Cedro Galan, Nicaragua, to work with ForwardHealth Nicaragua, a student-run organization in long-term partnership with a nonprofit called Manna Project International. That partnership is working to bring health care to the nation’s underserved populations. ForwardHealth funds the trips entirely with the proceeds from its own fundraisers.
The COPH connection comes through ForwardHealth’s partnership with the Global Health Student Association, of which Cable and Castro are members. Both also are graduate assistants, Cable in the Department of Global Health, Castro in The Research Administration Improvement Network, or TRAIN.
Cable, Castro and fellow COPH grad student Paige Alitz were among a group of 16 on a mission similar to the one undertaken by the Panama group: public health talks, health education programming, light clinical duties, needs assessment (although it wasn’t a formal component of their visit this time, Castro said).
The group was mostly clinical, she said, comprised of medical students and the three public health students.
They all stayed in a quinta, which Cable described as “one step up from a hostel, but not quite a hotel.”
In the village, the medical contingent held half-days at a clinic run by ForwardHealth and Manna. The public health trio delivered general health education talks in the community and at two middle schools, as well as specific, individual consultations during clinic hours.
“For example, there was a newly diagnosed diabetic woman, so she came over to our table for a nutrition consultation,” Cable said.
She said they also did “some of the easier clinical things,” such as checking vital signs. The predictable language barrier sometimes presented communication challenges, she said, but not insurmountable ones, as some of the medical students more fluent in Spanish would come over to help out.
Spring break was only one portion of Cable’s and Castro’s involvement with Cedro Galan. Cable’s special project is revising and formalizing the girls’ health curriculum. Castro completed her international field experience there last summer.
“Because there are lots of ties year-round, when we got down there, it was like we were already a part of the community,” Cable said. “It was like they already knew us, even though it was my first time there.”
“Our role in the clinic was to bring health education materials to supplement what the doctor and nurse have down there, which isn’t much,” Castro added. “The other days, we worked in a couple of public schools. We provided lessons about nutrition and hygiene for a girls’ health education class and led arts and crafts activities in a kids’ recreation camp.”
The COPH trio also visited the village of Villa Guadalupe, Nicaragua, where the people had lived on a landfill until they were relocated by a collaboration between the governments of Nicaragua and Spain to move them out of the dump and build them modest homes in a cleaner, safer environment. In addition to providing the housing, the Nicaraguan government also built the community a recycling center, which not only provides some jobs but also helps the new community stay cleaner.
“We were there for their child sponsorship program, ‘milk day,’ where enrolled children were given nutritional supplementation packages and their heights and weights were taken,” Castro said.
Let’s go again!
Students are eligible to do multiple spring breaks, and for all the enthusiasm this year’s COPH alternative spring breakers had for their adventures before the fact, they have even more after. So, the natural question is, would they do it again?
“I am, for sure,” said Assan. “I cannot wait! I loved the experience of just being able to see what you learn in class and translate it to real-world experience.”
“I graduate in May, so I wouldn’t be able to go again,” Robinson said, “but if I could, I absolutely would.”
Also graduating next month, Castro voiced the same sentiment.
“I don’t graduate in May, but I finish classes in May,” Cable said. “All I have to finish is my IFE. I’m already committed to Nepal for my IFE, but I have a standing invite to go back to Nicaragua. If anything should fall through, it’s the first place I would go back to.”
Asked whether their experience was better than a regular spring break, the four became a boisterous chorus of yesses in various forms, punctuated by lots of youthful laughter and broad grins that said every one of them meant it.
Story by David Brothers, College of Public Health. Photos courtesy of Dr. Arturo Rebollón, Stacy Assan, Anna Cable, Jessica Castro and Calvin Robinson.
Tags: Anna Cable, Arturo Rebollon, Calvin Robinson, College of Nursing, College of Pharmacy, International Health Service Collaborative, Jessica Castro, mission trip, Morsani College of Medicine, Panama, spring break, Stacy Assan