Photos Courtesy of Nursing Students Without Borders

Rosalind DeLisser teaches health care en Espanol to Red Cross volunteers in San Sebastian, El Salvador.

Nursing student group serves Salvadorans and migrant workers

By Nancy Hurrelbrinck

The residents of San Sebastian, El Salvador, struggle with a host of ailments, such as skin infections, gastrointestinal problems and cervical cancer, that could easily be prevented with a little education about basic hygiene and safe sex.

Eager to provide that education is Nursing Students Without Borders, a group founded last fall by fourth-year nursing student Matthew Walden and some friends, who heard about the village's health care challenges. The U.Va. student-run group has made two of six planned trips to San Sebastian to assess the community's needs, teach basic health care topics and train future health care providers.

Fourth-year nursing student Matthew Walden, who co-founded Nursing Students Without Borders, examines an El Salvadoran man.

NSWB is also launching a program this fall to work with migrant workers in the Charlottesville area.

The two doctors and three nurses who see about 300 patients a day in the government clinic that serves San Sebastian and the surrounding rural communities -- 23,000 people in all -- gladly welcomed NSWB's March and July visits.

In addition to a truckload of medical supplies donated by Charlottesville hospitals through the MERCI project, which was started by U.Va. nurse Helen French, NSWB brought two emergency medical technicians to train Red Cross members. There's a pressing need for EMTs, since the closest hospital is 30 miles away and, with no ambulance in the village, people must take a bus or hitch a ride, Walden said.

The students also researched the treatment of diabetes in the area. "Some people defied all medical logic: they had had diabetes their entire life, but they never thought twice about it," Walden said.

NSWB members are currently working with nursing professor Emily Hauenstein to analyze the information they gathered and create an intervention program to be introduced on a follow-up trip.

Nursing student Esther Miller gives some TLC to a baby named Sofia.

"Education has to be our main focus, because that has the greatest long-term benefit for the community," said Walden. During the 10-day visit in July, he worked alongside 10 Spanish-speaking nursing students and registered nurse Teri Woodard, a 1998 nursing graduate, to train local Red Cross members in peer education.

"I was so impressed by the intensity, intelligence, dedication and motivation of the Red Cross members learning new methods in health care and taking the reins," he said.

In one particularly challenging lesson, two 20-year-old Salvadoran Red Cross members discussed the implications of unprotected sex with a class of teenagers.

The students were dismissive at first, but the Red Cross members got their attention, getting them to take the topic seriously. They played roles, modeling verbal responses women and men could use if being pressured sexually.

Sexually transmitted diseases are common, he said, as are infections caused by polluted water and insufficient hand washing. Town residents are supplied with running water 10 days a month, while those in surrounding areas must haul it from wells, rivers or town. Neither group has electricity, and they live in tile-roofed adobe houses, many of which have dirt floors.

"Being exposed to Third World conditions, especially a lower standard of health care and health promotion, made us realize how lucky we are to live here with all the resources necessary to have long, healthy lives," Walden said.

"The trip made us aware of how important it is to [attend] to the cultural needs of people who come into the health system at U.Va. ... We saw the importance of respecting their spirituality, their family roles, their views of sexuality and reproduction, and their religious beliefs," he said.

NSWB is currently raising funds to provide a multipurpose education center and medical clinic for the Red Cross in San Sebastian. The Albemarle County Rotary Club has promised to donate three times the amount NSWB has raised by Oct.1, 2000. (Anyone wishing to donate items may contact Walden at mlw4d@virginia.edu.)

Local migrant camps

After volunteering for years with a Nelson County rural health outreach program and visiting El Salvador twice with NSWB, Teri Woodard saw the obvious next step: to create a way for the group to serve local Latino migrant workers.

She found Albemarle County to be in particular need of NSWB's services, since the migrant coordinators from the county department of education have ended up addressing health issues, in the absence of a program.

Woodard, NSWB's local action coordinator, and the 20 or so nursing students and community members she has gathered will conduct an orientation for volunteer interpreters and begin working with local migrants this fall.

"We will visit a camp one night a week and do health education, trying to improve their access to health care," she said. "A lot of the illnesses they have are preventable -- dehydration, heat stroke, urinary tract infections," she added. The migrants are mostly men aged 18 to 55, but include some families. Woodard met a woman who was six months pregnant and had received no prenatal care, though her previous infant had died of spina bifida (caused by folic acid deficiency in the mother), she said.

"Follow-up is difficult because they're only in one place for two or three months, based on what crops are in season," she said. "Those with diabetes or tuberculosis may move and run out of their medications."

There are four migrant camps in Albemarle County, but the program will start with one, making weekly visits and assessing how to help the migrants -- from their perspective.

"There are so many health care providers in this town, but so many barriers for the migrant workers," she said. "I want to bridge that gap."

Noting how easy it is not to consider the people whose hard work keeps our food costs down, she said, "It's a great opportunity for students and community members to have this intercultural experience."