Nursing Students Carry Mission Abroad

The Notre Dame College nursing program’s mission is “to prepare a professional nurse who is responsive to the health needs of a diverse global society.” Three NDC nursing students and two faculty members recently had the chance to actualize this mission through a unique international service opportunity offered by the Foundation for International Medical Relief of Children (FIMRC).

On May 11, the quintet embarked on a journey to western Nicaragua to volunteer at the Roberto Clemente Rancho Santana Clinic as part of FIMRC’s “Project Limon.” Their mission: eradicating the problem of head lice.

FIMRC is a global health volunteer program that provides access to medical care for underprivileged and medically underserved children around the world. Its “Project Limon” brings medical care to children living in remote areas of rural western Nicaragua. This area has one of the region’s highest child illness and mortality rates. Preventable conditions such as respiratory diseases, diarrhea and malnutrition are the main causes of death for children under the age of five here.

FIMRC regularly assigns medical volunteers to the Roberto Clemente Rancho Santana Clinic. The clinic serves more than 10,000 patients a year and is staffed by just one doctor and two nurses. Student volunteers have the opportunity to assist with physicals, deliver acute care and provide patient education.Heads Up: Head lice are a common childhood ailment throughout the world.

Recently, local health ministers uncovered a lice epidemic affecting over 50 percent of children in a local elementary school. Under the supervision of FIMRC and the Roberto Clemente Rancho Santana Clinic, nursing faculty and students have initiated a comprehensive lice eradication program.

Head lice are a common childhood ailment that is widespread throughout the world. Contrary to popular beliefs, head lice are not exclusively associated with school children of low socioeconomic status. Nevertheless, the stigma associated with head lice creates challenges for any group initiating a lice eradication program.

NDC nursing professors Dr. Joan Mallick and Dr. Colleen Sweeney, as well as students Marissa Lundgren, Adrienne Nadvornik and Nick Gotschall took up this challenge. Together, they organized a sustainable approach to the management of head lice. By developing education posters for members of the local health brigade, the students empowered community health leaders to carry out the detection, cure and follow-up treatment. They worked with parents to eradicate myths about head lice.

“The most rewarding part of this trip was the experience and culture shock,” said Gotschall. “I have now seen firsthand how others live in developing countries. Citizens of Nicaragua are some of the happiest people I have met. This was interesting to me because of how little they actually had.”

“It is easy to read about how families have to travel by foot for miles to get to the clinic, but when you see the actual distance, it becomes tangible,” Lundgren said. “You see the trials and tribulations these people go through. While you can never know how they feel, you can see the difficulty.”

Fighting Head Lice with Education and Compassion

The students’ first step in helping the locals eradicate head lice was to meet with parents of infected children to inform them about the project plan, solicit support and schedule house visits to treat the home and infected family members. The students offered parents plastic bags for clothes and bedding, provided lice shampoo and demonstrated how to use insecticide spray to treat their children’s beds and furniture. While some parents were reluctant to let the students treat them, they agreed to take the bags and shampoo to use for themselves.

“Most patients were very receptive to receiving care. We did not meet resistance until we spoke with the children's parents. It was the adults that did not want to change their ways,” Gotschall said. “The only way a resolution can be accomplished is through community teaching.”Epidemic: Half of the students at this elementary school were plagued by head lice.

Following the parental education class, the students helped initiate a month-long treatment for child head lice. Equipped with lice shampoo, shower caps, garbage bags, buckets, gloves, nit remover gel, hair conditioner and metal combs, the students visited Limon I elementary school. They identified the affected children and treated them appropriately.

They also trained the teachers in lice identification and encouraged them to discreetly change seating arrangements to separate infected children from non-infected ones. The students distributed educational pamphlets and gave teachers an opportunity to demonstrate proper techniques for lice identification.

After the month-long treatment FIMRC reported a decrease in the number of head lice cases and an increase in the number of previously diagnosed students now being lice free. The report was a validation for the Notre Dame students and faculty, who said they were profoundly changed by their experience in Nicaragua.

“It was such a giant task that seemed impossible to start, maintain and finish,” Lundgren said. “Receiving the report a few weeks after our trip, and seeing the decrease in students with lice, really helped to show that our initiation of this big campaign made a difference.”

But the group from NDC was not only responsive to the health needs of a remote Nicaraguan village. Faculty and students also learned a lot about themselves and their profession. One Nicaraguan public health nurse in particular, Marta Romero, provided an enormous amount of inspiration for the group.

Romero’s commitment to her community provided many valuable lessons to the nursing students. She worked tirelessly to address the whole range of health needs in the community from malnutrition and anemia to infectious diseases. Romero’s commitment did not end when she went home at night—she was always available to her community.From Left: Afrienne Nadvornik, Dr. Joan Mallick, Dr. Colleen Sweeney, Marta Romero, Marissa Lundgren and Nick Gotschall.

“If the U.S. thinks we have a nursing shortage, try having one nurse for multiple communities. Marta was the only nurse for five communities,” Lundgren said. “She sacrificed her family time, her personal time and her off time all for the community. She is a true hero.”

“The experience has shown me how much a nurse can truly touch someone's life. How much you can impact another is up to you,” Gotschall said. “I learned about myself that I do have a drive to help others. Often I find myself helping even before I have much time to think about what I am doing.”

The NDC quintet returned from the trip with a greater appreciation of the enormous global health challenges that lie ahead. Through the example of Romero, they realized one nurse can change a community. They also believe their experience brought them closer to FIMRC’s vision: “A world in which all children have an equal opportunity to benefit from modern medicine.”

Dr. Colleen Sweeney is an assistant professor of nursing at Notre Dame College.

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E.g., 06/22/19