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Students gain health profession skills in Nicaragua

Dr. Anita Flick, director of health professions advising, had planned to take a group of students to Haiti this summer, but political conditions there prevented the group from making the trip. Yet Flick was able to arrange a trip to Nicaragua, where students and medical professionals offered medical and dental care in a rural community.

Twenty N.C. State students, along with a pediatric dentist and a pediatric emergency specialist, traveled to Nicaragua, where they set up a clinic in Masaya to serve patients for a week.

Flick, who has taken students on health-related trips to Haiti for two years, hopes to expand international opportunities for students with interest in health professions. She would like to offer spring, fall and summer experiences, which would also involve N.C. State alumni working in health care professions.

Her goals are twofold: First, to give students hands-on experience with medicine in developing countries; and second, to bring N.C. State alums back to the Pack.

“I want to help provide opportunities for our current pre-health students not only to experience international cultures and health care, but to foster relationships between our students and our alumni now working in health care professions while hopefully reigniting and building the Wolfpack pride of these alumni,” Flick said.

Flick didn’t attend this summer’s student trip — she had prior commitments to help design a health clinic in Haiti, still struggling to recover from a devastating earthquake in January 2010.

And though the two health professionals who traveled with the group – Dr. Samy Saad and Dr. Dan Howell — weren’t N.C. State alumni, they had terrific feedback about the students they supervised.

Two of those students were Ronnie Shammas of Greenville, a rising junior, and Loren Moles of Asheboro, a rising senior, both studying human biology. Both students had planned to go to Haiti with Flick, but said they had a great experience in Nicaragua.

Ronnie Shammas
Ronnie Shammas, right, is shown with N.C. State junior Ryan Houghton, left, and a patient at a village clinic in Nicaragua.
The first day of their stay, they conducted house visits to assess the community’s health needs and to identify those who needed immediate care. Patients with critical needs received tickets to get them in to the clinic quickly the next day.

Shammas said one of the most critical cases involved a woman with swollen legs, who was diabetic. Her blood sugar level was at a dangerous 587 – far above the level that would require hospitalization in the developed world. Without money for insulin, she had used a homeopathic tea to control blood sugar. The clinic was able to provide a two-week dose of insulin, but physicians felt sure she would return to the tea – and high blood sugar – once the medication was gone.

The lack of access to basic medicines came as a surprise to Shammas. “You hear about the ‘Third World,’ but you don’t really get it until you’re there,” he said.

Moles, who is interested in dentistry, assisted with dental cases in the clinic. Her biggest surprise was that most of her patients’ teeth were in good condition for the most part, with little need for emergency care. “Their dental health was better than what we have here,” she said.

The group’s days in the clinic began around 8:30 or 9 a.m., when they would set up. As patients came in, students would conduct triage, checking vital signs, taking their medical history and conducting health assessments. The clinic would break for lunch, then return to see patients from 1-4 p.m.

“You don’t get that type of experience in the United States,” said Shammas, who has had the opportunity to “shadow” health professionals closer to home.

Students saw a variety of health problem: Scabies, colds, rashes and even evidence of abuse. One young child was found to have a hole in her heart, Shammas said. Physicians will try to treat the condition with medication, hoping the child will be able to have surgery to repair the problem, he said.

“We would see as many patients as we could – they were lined up to be seen,” Moles said. “But people were so grateful to see us there and receive help from the doctors.”

Students took away lessons on what they didn’t want to do in medicine as well. Shammas participated in some dental procedures and learned that, “I never want to do dental.”

That’s also the point of the experience, Flick said. “We want them to really think about why they want to pursue a career in health care and to gain an understanding that it’s not about them – it’s about the people,” she said.

Because the Nicaragua trip was arranged quickly, students in the group didn’t even hold a pre-trip meeting. Yet both Shammas and Moles said they also enjoyed getting to know other students in their academic program, most of whom were new to each other. Yet they worked well together.

“The team was very good; students were poised and well spoken,” Flick said. “The health professionals who went along were just blown away by both the quality of our students and by the way that they worked together and supported their interests in health care.”

-Natalie Hampton