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Mayo Goes to Nicaragua

One of the greatest eye-openers for me has been the realization of how many resources and opportunities are available to us as medical students. Everywhere I turn, I am presented with a new idea to enhance my education and continue to further my personal preparation toward becoming the best physician I can become.

One such opportunity was presented to me the same week of my acceptance phone call earlier this spring: a fully-funded trip to a previously unattended region of Nicaragua with a volunteer medical brigade. It was led by physicians from my institution looking to recruit matriculating first-year medical school class to help lead the trip. Having participated in similar trips in the past, including a two-year mission trip to Brazil from 2011 to 2013, I knew the value that was available to us as medical students in this trip. As word of the opportunity was spread to the incoming class members, ten of us confirmed our commitment to attending the trip, along with more than 30 volunteer physicians, nurses, medical assistants and pre-medical students. The impending excitement for the chance to be mentored in such close proximity to my physician faculty members and my future classmates and colleagues was enough to lengthen my summer break to a near-unbearable stretch. I had never been more thrilled to begin a new journey in my life, knowingly embarking into unexplored territory as a medical brigade for an incredibly underserved community.

“It’s going to be a good day today.” These were the words of encouragement from our physician leader, Dr. Bachman. I distinctly remember standing at the triage station of our clinic, assembled within a local schoolhouse building, gazing in awe at the hundreds of Nicaraguans grasping the fence with desperation in their faces. Our job was to provide the highest quality, patient-centered medical attention to each and every one of them. Feelings of personal desperation began to absorb me, sensing my own inadequacy in this dire situation. After all, what significant difference could an untrained, first-year medical student really contribute to these people in need? How was I going to effectively communicate with them, with a limited capacity to speak their native language? And while communicating with them, how would I be able to convey to them a significant message to better their health and personal well-being?

All of these thoughts seemed to strike me simultaneously as I gathered all of the mental and emotional implications of the task at hand. I glanced at my many teammates around me who were locating medical supplies and assembling the different clinical stations so that we could begin to see patients. We were each divided into various groups to staff different areas of the clinic: the pharmacy, triage unit, several clinical stations for patient encounters, dental clinic, women’s health clinic and an educational station for children and adults to learn more about preventive care. The anxiety quickly dissipated as we pressed forward, relying on the unique talents of each member of our healthcare team. The physicians rotating through the clinical stations were supportive, as they each focused on the specific, unique needs of the patients and their families as they presented. As medical students, we were granted a great deal of autonomy to take a full medical, family and social history for each patient, assess the chief complaints of each person and educate them on how to maintain a healthy lifestyle. We were taught the hands-on aspects of performing a physical exam to help diagnose the conditions of each patient, as well as the recommended medications to prescribe in each unique case. Our goal was to establish a solid foundation for a more stable system of delivering healthcare. This was all in an effort to perpetuate positive change towards a healthier livelihood for those living in these underserved communities of rural Nicaragua.

In addition to providing medical care for over 1,300 patients at the local school building, we were given the opportunity to make special house visits to attend to those in the community who were severely disabled and unable to walk to the clinic. While visiting these patients in their homes, we were able to get a sense of the environment in which they lived, allowing us to provide a more personalized level of care beyond what we could have provided otherwise. Our medical brigade was the very first to provide care in this particular community. Despite the impoverished circumstances in which these individuals live and their oftentimes debilitating physical conditions, these were some of the happiest people I have ever met. The gratitude emanating from the patients and their family members was palpable.

Seeing the reactions from so many individuals in this community enabled me to appreciate the true purposes of this medical brigade. It is often difficult to fully grasp all of the positive effects originating from medical outreach work, and it is not until we are personally involved that we can see all that we have done. The impact of medical treatment and education our group was able to provide in this community in Nicaragua is readily recognizable. However, this medical mission has also opened up tremendous avenues for future development of public health, infrastructure, water treatment, local business and overall well-being for the community members through upcoming outreach efforts. Attending to the medical needs of each individual under the Mayo Model of Care has created the foundational support for the longitudinal and self-sufficient process of change in such communities. I plan to continue to actively organize and participate in many future medical outreach efforts as a medical student and future physician, to better meet the needs of those who have less access to quality health care in their local communities.

As an entering Mayo Medical student, this experience with my fellow classmates and Mayo Clinic physicians in Nicaragua truly set the standard high for the journey ahead. In addition to being trusted by the physicians on our trip to personally conduct full medical interviews and physical exams in Spanish, I had the opportunity to prepare and present a training on Oral Rehydration Therapy to those attending the orientation. The focus of the designed training was to delineate how much each of the trip participants knew about treating those suffering from moderate to severe dehydration prior to our initiating the trip. This included how to recognize the early signs and symptoms of dehydration, as well as how to administer specially-prepared oral rehydration solutions effectively. This training session has been used toward producing a research study on the efficacy of training and simulation experiences prior to international medical mission trips. Along with my classmate, Archna Patel, and Dr. John Bachman (the director of the mission trip), I will be presenting an oral and poster presentation of the study at the Family Medicine Forum at the Mayo Clinic in Rochester this fall. As someone who greatly cherishes my experiences living abroad as a volunteer, this international clinical experience has given me a more focused vision of how I can incorporate my passion for reaching out to the underserved into my future practice as a Mayo-trained physician. I can already sense that this institution values these efforts of outreach, which was a very influential factor in choosing Mayo Medical School for my medical education. I could not have possibly imagined a greater beginning to the next four years of training, being actively engaged in humanitarian outreach work alongside my classmates and clinical instructors, making a tangibly positive impact in a previously isolated community.  I have learned to be patient with myself and to trust in the abilities of others on the healthcare team, which has allowed me to learn so much from each of them — even before we started classes together!

Jeremie Oliver Jeremie Oliver (1 Posts)

Contributing Writer

Mayo Clinic School of Medicine

Jeremie is a first-year Mayo Clinic medical student, originally from the North Shore of O'ahu, Hawai'i. Having lived in Brazil for over two years prior to beginning medical school, he has gained a great interest in incorporating substantial humanitarian work in his future surgical practice. He plans to pursue either Otorhinolaryngology-Head and Neck Surgery, Neurologic Surgery or Plastic Reconstructive Surgery. His favorite extracurricular activities include sky-diving, long-distance running, and swimming in the Pacific Ocean.