Written by Brandon Spratt, Doctor of Nursing Practice Candidate at the Nell Hodgson Woodruff School of Nursing
Brandon came to Nicaragua in December 2016 with a group of nursing students from Emory University.
As my first true experience outside of the US, Comunidad Connect’s opportunity to volunteer in southern Nicaragua was an escapade I’ll never forget. Then a second-degree student in nursing at Emory University, Comunidad Connect reached out to the School of Nursing to offer students a one-week trip to Nicaragua to invest in opportunities of service within the healthcare systems that aim to increase civic engagement in certain areas. Following my several years of in-country cross-cultural service during my first undergraduate degree, I was ready for such an experience on different soil.
My arrival to Rivas, a southern city of ~40,000 not far from the border to Costa Rica, started with a tour of a local hospital that let me see first-hand the striking difference between the healthcare system here and the one I was used to back in the States. Obviously a lower-resource facility, I was struck at the resilience and versatility that was demanded of the healthcare staff as the nurses were often tasked to 25 patients per nurse. In asking one of the nurses how one could possibly keep up with this demand, she simply smiled and said, “you have to be an octopus to do our job!”.
Our next stop took us to Tola, a smaller community near Rivas that housed a health post for local members to receive basic curative services. It was here that we learned about Nicaragua’s MOSAF healthcare model that capitalizes on community health workers to have an intimate knowledge of the health history of each household in their community to gain insight of the current trends of disease and predict related risk factors. I was impressed at the level of detail that each worker was required to memorize for each household and found this model to be quite intriguing.
While these experiences were quite fascinating and interesting, the most impactful memory I had came from a small, rural community called El Tambo, not far from Tola. It was in this place that I really understood what poverty really is. It is not some tangible idea that can be gleaned from watching videos or reading books, but rather a felt sensation that one only understands when one is in its midst. Dirt floors, tin roofs, and a barren yard were all that many of these villagers owned and while paralyzing at first, I began to see the internal beauty and richness that these people had to offer.
At their request, we gave several presentations about how to understand and address some of the chronic health problems many of their members face. Following this, the villagers did something I will never forget: a great feast. Although our baseline luxuries in America would easily surmount this offering as mediocre in the States, it was obvious that this was no ordinary gala. Out oftheir poverty and of what little they had, their presentation was immaculate. Toiling for days, their cooked chicken, gallo pinto, and juice was displayed before us in banquet-like fashion. Yes, indeed, the food was delicious, but that was not the overarching message that was clear that day. Instead, what was seared into my mind is a life-long lesson that that I will never forget: when poverty-stricken communities come together collectively and harmoniously, it breeds a spirit of generosity.
El Tambo’s generosity is a lesson I will take with me wherever I go and for that I am grateful to have learned such a valuable nugget of truth in the larger arc of life. I hope that others may be able to encounter similar experiences in their lives. I’d like to thank Comunidad Connect for making this possible and hope that they continue the great work they are doing in those communities.
Interview with Lindsey Harbison, Nursing Student at Kennesaw State University
Tell us a little about yourself.
I am currently in my last semester of Nursing School at Kennesaw State University in Kennesaw, Georgia. I moved here from Snowmass Village, Colorado, but am originally from Nashville, Tennessee! I have a background in Baking & Pastry and I ran a bake shop in a hotel in Colorado, before moving here to further pursue Pastry with the Ritz Carlton.. I have always loved Nursing and I come from a family full of medical professionals and health care givers. I decided to switch gears a few years ago and pursue Nursing and here I am about to graduate with my BSN and I feel that life has given me so much more than just another degree. I have been given opportunities, life changing experiences, and friendships that I will always cherish.
What brought you to Nicaragua?
Nicaragua was a study abroad trip through KSU for our Community Health Clinical rotation. The goal was to assess the health beliefs, values, attitudes, and practices of individuals, families, groups, communities, and populations and to provide spiritually and culturally appropriate health care. However what I learned was how the community of Nicaragua are not just individuals, they are families that make up a larger family called community, and each family is a vital source to the well being of their “community family”.
This May, Lindsey traveled with a group of nursing students from KSU to Nicaragua to learn about the health care system and serve in rural communities around Jinotega.
What expectations did you have before coming on your trip?
I expected to see a resource poor country with households inside of rural communities that battle daily struggles with just living. I expected to see homes that were in poor condition, and families with chronic illnesses; Maybe even families that have no drive to help themselves and weren’t thankful for the help they did receive. What I had read, and researched did not present a country with community members that pride themselves on self-sufficiency, resilience, optimism, and hard work. What I was taught was not about how each family and every individual and even the animals are pieces to a bigger picture, and that every animal, individual, and family mattered so that the picture was complete.
What I learned while in Los Robles was that cleanliness, education, and hard work created the foundation for a prosperous life for many families. Being grateful wasn’t just saying the words “thank you,” it was explaining how you have affected their lives for the better, and how you will be kept in their prayers; and whatever the action or the item was that was given to them, how it will help each family member in some way. So I guess one could say I had unrealistic expectations, and thankfully what I expected was not reality.
What observations of the health care system, or health in Nicaragua in general, stood out to you?
Nicaragua sees health and wellness as a lifestyle and not an area in which your life revolves around. They aren’t focused on diets that result in an illness that requires medication management, like diabetes and obesity. They don’t see health problems as a common issues that one just lives with. The people I interacted with spoke of eating healthy, and using herbs and more holistic remedies for ailments. They seemed to be aware what unhealthy lifestyles resulted in and made it a priority to not succumb to that. They are focused on preventing health issues and generally seeking out a lifestyle that keeps them in good health.
What experience had the greatest impact on you?
I assisted with a family interview for the basis of composing a health assessment with recommendations on how to better the family’s overall health. I sat with an older woman who had 5 adult children and numerous grandchildren. She spoke of her son’s health and a tumor on his brain he was receiving treatment for. She told us of how she didn’t have minutes on her phone to even call to see if he had made it through surgery the previous day. She continued and explained that she had faith that God would provide for her and her family, but she also understood that didn’t mean not trying to help herself.
She knew that by working hard and supporting her grandchildren and those in her community, others might support her in her time of need. She was a Brigadista, and gave her community aid when needed and selflessly opened her home for little to no compensation. This to me was true community. Everyone was interconnected, everyone helped each other in their community, and there was such an environment of thankfulness and grateful hearts. They may have a life of less, less material things, but they had more in the way of appreciation and love. That is something that impacted me the most. Coming back to Georgia, I looked around at all the ‘stuff’ I have and how full my pantry was, but yet I wasn’t as grateful as those in Los Robles were for water filters and pilas. Learning to appreciate was something I learned from them, and something I will always cherish.
The students from KSU loved playing with kids in the community and sharing a cultural exchange with families in Los Robles.
What experience(s) brought you closer to the people of Nicaragua?
Being welcomed into the homes of some of the residents of Los Robles allowed for a great cultural immersion. Also while leading charlas for women, I was able to play with their children and got to experience what fun and games they play. Although there was a language barrier, making music out of rocks and bamboo, and playing makeshift volleyball, it was apparent that music and sports speak a universal language.
Check in next week to see how photography played a role in Lindsey’s trip!