GUATEMALA EXPERIENCE HAS IMPACT By Mike Field Nine students from the schools of Medicine, Nursing and Public Health gained a new perspective on health care in America recently. They traveled all the way to Guatemala to get it. As part of an innovative student-run program called Project Impact, the students spent 15 days visiting indigenous Mayan populations in remote communities decimated by decades of civil war. There, they saw medical problems_and some solutions_they say will affect the course of their future professional careers. "Our purpose was to try to look at health care issues from an international perspective," said project organizer Paul Chan, a fourth-year student in the School of Medicine. "In situations where the community has been at war, access to clinics and hospitals is very limited. You tend to see the same ailments--mostly infectious diseases--over and over again. The trip gave us a sense of how health care is best promoted under the most difficult circumstances." For some of the students, the Mayan community, though remote and culturally removed from their own background, held surprising parallels to contemporary American society. "In Tennessee, where I come from, certain segments of the African-American community have health indices similar to third world countries'," said Monica Peek, a fourth-year student in the MD/MPH program. "I found the Mayan community similar, in some ways, to what I have experienced there and here in East Baltimore." Peek, who hopes to pursue a career focused on global African outreach, said her participation in the Guatemala trip has led her to think seriously about planning a similar venture to Africa next year. "What I found most interesting in this trip was that despite the oppression they had experienced, the Mayan community was very optimistic about the future. There was a great sense of self-determination, which is crucial to any community struggling to survive." The Guatemala trip was just one of a dozen different programs that have been organized through Project Impact in the past year. Some--such as the Sports Clinic and the Turtle Derby, both sponsored by the first-year medical school class- -are annual events now placed beneath the Project Impact umbrella. Most, however, are new programs that have been created by students eager to participate in community service, advocacy and public education programs. "This is part of being a physician," said Catherine DeAngelis, senior associate dean for academic and faculty affairs in the School of Medicine. "Project Impact fits perfectly with the new School of Medicine curriculum; it's the kind of responsibility we expect physicians to feel. This goes beyond taking care of sick people. It means going into the neighborhood and making people feel better." Project Impact was organized three years ago, when members of the incoming School of Medicine class informally arranged new opportunities for community outreach. "A number of us wanted to look for different outlets to integrate personal caring into our basic training," Chan said. With an initial grant of $900 from the Medical School's alumni association, Chan and a handful of other students were able to organize a number of different community outreach programs, including work in homeless shelters and with the city's mobile health van. Since then, the number of sponsored projects has grown to a dozen, including the trip to Guatemala and a similar trip to the Appalachian mountains of Kentucky. The Medical School's alumni association has continued to support the program. Chan estimates Project Impact has filled 500 volunteer slots in the past three years. "I think students in all the health professions are interested in more than just their studies," he said. "We're seeing more and more students with humanities backgrounds, creating a diverse and broadly based group. I think students are very interested in doing more than just, for instance, becoming a urologist. They may still become urologists, but they will do other things along the way." Initially, Project Impact was composed entirely of School of Medicine students. In recent years, however, it has expanded to include students from other health professional schools as well. Working with students in nursing and public health introduces medical students to community health and public health issues they're not exposed to, and vice versa. It gives people another side of medicine," Peek said. "Our goals, ultimately, are the same, but we come from different perspectives," said Leslie Wirth, a second-year bachelor's candidate in the School of Nursing. A former Peace Corps volunteer, Wirth was one of two nursing students on the Guatemala trip. "Many nursing students at Hopkins already have degrees and experience and our training occurs in a very similar fashion to medical students'," she said. "One of the goals of the trip was to bring medical and nursing students together to learn about each other's training and experiences. There needs to be a greater integration of all students in the health care professions." Wirth and fellow nursing student Barbara Blanchard went to Guatemala with the assistance of a grant made by a School of Nursing alumna. "Part of our purpose there was to research a presentation we'll be making as part of the Context of Nursing course this fall," Blanchard said. "Using slides we took and our own personal recollections, we'll be examining how nursing care can be delivered in extreme situations. "The Guatemalan Indians have nothing--no water, no electricity--and yet they manage to survive," Blanchard said. "The trip illustrated that you have to consider a person's cultures and beliefs before you attempt to deliver care. That's something that will always be a part of my nursing as a result." In the coming year Project Impact members say they hope to organize further volunteer opportunities for all students and faculty members on the East Baltimore campus including, possibly, a return trip to Guatemala. Their first trip--an odyssey through some of the worst living conditions in the Western Hemisphere--increased, rather than diminished, their resolve. "We all went into the Guatemala trip expecting a lot of sorrow, a lot of emotional upheaval," Peek said. "But what we found was a lot of strength, a lot of love and a lot of happiness. It was inspiring to see how people could struggle to overcome even the worst situations. If there were tears, they were of happiness, not sorrow. We weren't sad while we were there."
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