Friday, April 27, 2012

Learning, teaching, doing...

Two days, 6x45 minute classes, vast amounts of knowledge shared.
I did teach, more on the second of those two days (that'd be wed and thurs)... It was such a blur - one group after the next, very different personalities, good questions, great stories, good experiences shared by everyone in the group.  As I said before I have such great respect for the translators!
I helped Arlette most of my first day - she was teaching the labour and delivery day.  She managed after the first class, to get onto youtube and get someones entire delivery on video to show to the group.  That was the impact that we wanted.  A mannequin can only teach so much.  Their faces when that video came up were just priceless - wide eyes, girls cringing in their chairs, strangely tho no giggling! They were very good, hands on with the mannequin was well handed, the steps and the skills were learned well.
 The L&D mannequin atleast gives an idea of what its like... as realistic... as it can be... :)
 Everyone that day became "proud parents" or proud something... :)
Yup... the video had some wide eyes, horrified faces and some grins... like "seriously someone goes through that?!"

I also helped out with backboarding, hot and cold emergencies, and more.  As I said... It was a blurrrr! :D We did as much hands on, practical experience, time to ask questions, think on their feet and give them a place to start from.  We worked on the initial assessments, continued working on interviewing, and it is just the beginning so these skills can only get better.  It was quite the adventure over these two days.

 Backboarding, collars, improvizing.  The boards were made on site - and not too bad really, just need a little tweaking.  We're hoping to send some down by the next trip too, not sure how or if we can, but it'd be so much nicer.
 Thanks to the translators and crayola markers, getting SAMPLE and OPQRST translated into something useable in spanish was an option.  So it became SAMHUE and CODIT, which got the point across and was much easier to understand.
 Ha ha... use your imagination - get them from the car to the backboard... cooperation, communication, speed and patience... ah the easy lessons in life?  They did really pretty well... :D
Tie 'em up and take 'em out! Practicing where they felt they needed to - vital signs, bandaging, while others did splinting, eye injuries and vital signs.  Every group had very different dynamics, and the student in the chair - he was really good, very smart and on the ball, and totally hands on, and very assertive.  

It's interesting though, as I see myself now... I think I am one of those too.  I do my best to just sit back but I am so... bad.  Atleast I have finally noticed that... now I just have to learn a balance... the easy lesson... balance :S

Anyway - those two evenings we did go in to town for icecream, hung out in the square and got away from everything.  Fifo and Ellen took us down, which was so nice of them - not that icecream was a bad reason to go in either.  :)

 Oh my... the stories we told, and the charrades, and the evening of fun and goofing around! Ha ha! Good fun.
We did have our R&R - though not a traditional vacation... :) It was a little bit of refreshment and playing after a long teaching day.

Tuesday, April 24, 2012

ABC's in spanish aren't ABC....

So the next two posts are probably going to be a little blurry because as the teaching days passed, well... they got blurry... moved quickly, people learned, we laughed, we bandaged, we assessed and boy did people laugh.

Our day started with vital signs - pulses, blood pressures, breathing, things that are hard enough to teach in english, but easy enough to make sure they're getting them right because they can be monitored and checked.  But gosh do I ever have a hard time not being able to talk, and be understood.  I know I can talk, but I missed the casual interactions.  So the inevitable - I spewed out words in almost every other language I have learned in the last 15 + years! Haha...  A little almost speaking korean, a lot of trying out french vocabulary which really didn't seem to work as similar-ish as the languages are and I think a couple little italian words came out.  I couldn't help it, I guess that's proof you'll do almost anything to be understood - manipulating peoples hands, gestures, etc.  I think there are different gestures in every culture but I assume I would have known if I had offended anyone!


I realized that morning tho, as we were also going through assessments and interviewing, that our mnemonics don't translate well! We use S.A.M.P.L.E and OPQRST when taking history and assessing patient injury and symptoms, for those who have the background this is pretty self explanatory.  For the others - they are the tools to make sure we get a thorough story of the incident, where you hurt or how bad the symptoms are (trauma or medical complaints) and then SAMPLE your medical history.  So we polled the interpreters and came up with a different mnemonic in spanish! CODIT and SAMHUE.  Granted not really words but a pattern which we wanted to be easier to remember than our english terms.
Much to my luck, I have good printing and a desire to create awesome visual learning tools (well even just visual learning tools, awesome or not... ).  So Ellen had Crayola Markers and some chart paper and I let my inner preschool-teacher come out!

And thus the hands on and visual learning aids were brought out.  I am a nerd... and I dunno why I am laughing but I think it was funny...?

The afternoon broke the gang up into their 5 groups for rotations through the rest of the stations.  We had everything from splinting and spinal management, bandaging, causes of changes in consciousness, medical emergencies (chest pain, asthma, etc), poisoning, and labour and delivery.  I had one group that afternoon but I floated around and helped with other groups for the rest of the day.

I hung out through the afternoon with Brad doing heat and cold emergencies (of course focused on fire and heat emergencies, touching only a bit on hypothermia... the climate is pretty hot and the group aren't so much into swimming in cold water in this area).  
I did loss of consciousness reasons for one rotation, and the group was quiet and just learning the basics, so I kinda hoped I could just get out things simply - how to explain seizures, strokes and diabetes (among other things) is really tricky, without full anatomy/physiology lessons.  But I think it was good.

We finished the afternoon and ya know what - it was very pleasant.  It was rushed, we grazed the surface on everything but they were getting it.  Recovering and reviewing important information, and really enjoying the chance to be back teaching again.

So with that day done and under our belt, we gave ourselves a pat on our backs and called it a day.  There were still 2 more full days! :D

Ooh, but exciting.  One of the medics we came down with is a f/t toronto fire and part-ime peterborough medic, and being a fire fighter has a draw to see what the local fire station is like.  So Fifo humoured us and took us into Jinoteppe (<10 min down the road) to the fire station.  The guys were so accommodating - there are 4 guys on for 48 hours at a time - staying at the station for the overnight periods.  They do both the ambulance and fire calls.  And once a fire fighter always a fire fighter... they are passionate about what they do.  Generally making less than the overall minimum monthly wage, but train together, work well together and make do with what they have.

 The crew... 4 guys were great about explaining their jobs, the most common calls, the high number of traumas - Jinoteppe is right on the Pan-America Highway so lots of transports, vehicles, bikes, horses and carriages, etc travel along the distances.
 Fire truck - not toooo old, donated.  Has extrication equipment - tho it is old and stuff that would have been retired long ago up here.
 Ambulance (obviously) - not new, sometimes has not enough fuel to get further than the gas station but not enough money to fill the tank, and has great wood panelling in the back.
 Pretty new, 4wd rescue vehicles.  During the wet season the crews respond to a lot of mud slides and a lot of the country is pretty rugged - allows for some diversity in the vehicles they take out.
 The Ottawa team showing off the vehicle.  We complain about what we have - we don't know really how good we do have it!
 Helping out with some fundraising (Yup Barry and Red Dog get their own personal copies as thanks for helping out so much with the preparation!)
 Three services represent - and Brian shows off his physique - and nicely shaven legs (he was going on a bike adventure when the rest of us left.
Fire gear...

Again - their generosity, seriousness, passion and interest in sharing and advocating for their jobs and for support were so fantastic.  We did the full tour of the station, and they showed us two special features...

View from the top of the Fire tower - yup we walked up and up and up a very narrow concrete winding set of stairs.  Going up was the easy part...

They also have a 1938 fire truck, that they had donated to them in 1940.  It is in pretty good shape considering it isn't really well protected, but it is a fantastic vehicle.

It was in pretty good shape - although dusty, there is an advantage of not having salty winters.  It'd be quite the collectors item. 


Then we went back, had a rum and coke and went to bed... :)

Monday, April 23, 2012

Amped up, ready to fly... here we go!!

We found out Sunday night that we for sure had 23 participants.  The rest because Sunday was a holiday... transportation was an issue.  So monday morning we were going to finally find out how many participants were going to show up.  Again... we were told that because the Ministry of Health was in charge, and this is the Nicaraguan culture... we'll see who shows up, just be flexible.
While we waited for the final word, there was work to be done! :)

 Every participant was given a basic kit with equipment such as a blood pressure cuff, stethoscope, goggles, some first aid equipment (gauze, bandages, tape, etc), masks, gloves etc.  They can also bring their bags back down for restocking and to show the centre that they have had the chance to use their skills.  Everything seen here was acquired by donation - whether financial or equipment.  All of Skylark operates on private donations - nothing corporate, but all projects depend on us going down to help fund it.  We got as much as we could, and not entirely sure we got it all done but we did our best. :)
 Everything needed to get organized
 everyone was running around as the building heated up... 
 Meanwhile Brad and Kyle get to sit and set all the watches...


The 4 of our Interpreters - Dessi, Alecia, Ryder and Mabel.  I have no idea how they do it going from english to spanish, spanish to english, and they don't just talk they are actually interested, were engaged and learning along with the other participants.  I am sure by the end of the day they are just completely exhausted.  But were they ever awesome.  It was great to have them help out with every step of this adventure.

So by mid morning we found out we have... 50 students.  Super exciting.  We really had almost expected that we would get 20 and it'd be a "thanks for comin out" experience, but to have a full group, this is great.  I believe the age range included those aged 15 to maybe 40 (tops), males, females, from 5+ communities.  They were from small tiny towns, isolated villages and bigger communities that surround Skylark. They all showed up, and you would never guess that these people had all just met.  I think by the end of the first day they could have been all from the same town.  But yeah - most of them had access to facebook - which reminds me I have to ask kevin to get me Larry's facebook info! haha! He took a bunch of pics and videos too on his smart phone.  

Now that we knew the group size we had the chance to get the next 4.5 days planned.  Steve did a fantastic job.  He put together all the scheduling.  And we worked the kinks out and had everything working in no time.

The nice part - I knew only 2 people on this trip, but it is so nice to interact with people in a different environment.  It was a good environment and I think it brought out something I had forgotten, passion, caring and happiness. Now don't get me wrong... we all had our moments of tension, but it didn't hinder anything from getting done.

Our first afternoon was introductions, and then we introduced the primary survey.  Now as lame ol english folk... the whole translation thing didn't even come to mind.  Haha.  But we managed to get the initial stuff taught and understood.  Our interpreters helped us and worked on explaining things when we discussed what the concept was they helped making it understandable and smooth. 

Hands on practice time...
Chatting with the interpreters.


Welcome and thanks for coming! Our group has finally arrived and the week has begun!

So, the first steps went really well.  I mean to have 50 people, different ages, different communities, and unknown education backgrounds, and to have all of these people join together with such interest and passion, it was really freakin cool!  So the momentum had been started and hopefully the speed... wouldn't fizzle out.  

Altering my perspective...

Easter Sunday - overcast.  Part of the group went to Church, and a group of us stayed close to home.  We relaxed, swam, and explored the site.  Talked with Fifo and Ellen (the couple who were more or less running the programming at Skylark.)
Ellen - from Tennesse, has been in Nicaragua for 3 years.  Has worked for various organizations in Nicaragua.  She met Fifo while in Nicaragua and they have become quite the team.
Fifo is originally from Guatemala, totally bilingual, and has great taste in music! He and Ellen are two very generous spirits and so equally matched it is fantastic.
There is gratitude... #whatever by now.  This whole beginning has become... one soul swelling experience... and yeah I am a little sappy about it.

The others returned from church, we gathered and finalized some details.  We then did a tour of Los Madranos, the local community.

 Catholic Church - next door.  Fireworks and singing very loudly Sunday night.
 Boys watching us in the bushes.
 Our neighbours... two energetic and funny boys.
 Benjamin - the famous boy ... my uncle fell in love with this pic.
Our neighbours gave us a great tour - humble but comfortable accommodations.  

It was... how to say this... neat? that doesn't seem to fit... humbling maybe... seeing that people have taken resources, what they can find and they have made their world comfortable, with less and I mean much less money, much less "stuff" and are so happy, welcoming, embracing of all of us who came.  There was this pride to the community (well there are the usual characters, but I think that is expected).  Everyone was pretty friendly, curious, and open to meeting us.  Life was modest, but there were roofs over heads, warm loving large families surrounding each other, food on the table, laundry to be done, laughter and smiles abound.  Maybe that's just my snapshot but you can usually tell by how the whole group works together. 

We ran back to the centre, and grabbed lunch - now let me say... we ate well.  Such good food, lots of it and the gals in the kitchen were outstanding!  I know some of my companions took pics but I just can't do it.  It was a good combination of local and north american flare. :)

Once lunch was done we got back in the van and headed toward Massaya Volcano..

It was fantastically hissy, boiling, growling in the bottom, a huge crater in the earth, that was smokey and smelled like a terrible vat of rotten sulfury eggs.  
 View from parkinglot to lookout - warning maximum stay is 20 minutes and cars must be parked facing the exit - backed in.

Almost to the top - overlooking the volcano.

It was a beautiful view, it was smelly and it was phenomenal.  Not very often you can say that you got a chance to stand at the lip of a live volcano... tho Amanda and Ellen told us that they've never been up there when they could hear it hiss and boil... hahah! Our visit wasn't long...
 They have horse rides up along the volcano - this is the foal of one of the workin ponies.  Pretty timid.
 My attempt at stitching together a bunch of scenery pics from Massaya.
 About 300 years ago... it errupted... and this is what remains...
 on the drive up to the volcano - the lookout.
Looking down into the volcano - can't see much... :)
Team Ottawa!!!! Lookin out over the world.  Kevin Corrigan and myself.

We headed down into Massaya and hit the Market - which was unusually quiet but not surprising being Easter Sunday.  That was okay tho... :) Got a few trinkets, and with my lack of spanish it was a little intimidating.  But fantastic folks helped get me through! And I was very happy to have gone there, but sad because I was interested in doing more shopping... hahah! Once you start... :D Ha ha!  Leslie was a huge help and I don't think I would have bought anything if I didn't have Amanda there.  Note to self - time to learn some spanish... hahaha! :D

Dinner, planning, and relaxation as we get ready for the next day.  Full group, full fun, full Woo Hoo!! :D  The fun was going to begin!  The most fun was that we were all on the same page... and realized that we knew what needed to get done and where to start.  Even though it wasn't going to be the smoothest adventure, but we knew where to start and the rest can only get better! How amazing!
 Gettin ready, getting psyched!
 they grow on trees?!
Blooming - so pretty everywhere!

Sunday, April 22, 2012

Gracias...

This is the time to say what I have learned about Gratitude.
I have been given such gifts - support, encouragement, thanks, laughter, life, culture, dreams, successes... and not all are my own... but the celebration of others.

Today I am going to address this as my most recent experience has drawn to a close and now I have returned to... "normal".

I learned about this opportunity, curiosity took me over, but there was this negative skeptic who had taken up residence in my head over the winter, I knew that I needed to change my persepective before I become a grumpy miser hermit and this opportunity was something that was tugging at me.  It has been a long time since I had the chance to teach and just a vacation was not interesting to me at all.

So about the group - Three Folds Ministries is based out of Parry Sound - established Skylark Retreat Centre.  Their main programming includes Medical clinics with Canadian physicians, nurses, dentists, etc.  ESL, Early Start program, Pre and post natal programs, Christian retreats, and now as of April 2012 First Aid/First Responder training by Canadian Paramedics.   http://www.youtube.com/watch?v=99aL0NkcQDw
The first ever run program was where I was heading, with a group that I really dunno, but having faith that I was ready to jump in, I paid the money.  Getting little bits of info, my mom telling me to make sure I get my return ticket in my hand (all info was there in email, they don't give out tickets, and others excited and surprised since I wasn't exactly advertising beyond Facebook and a few emails, and don't forget the attempt to get Chipin used.

I was so surprised... and happy and grateful... when I had a great collection of family, friends and colleagues (yeah koodos go out to Red Dog here!) all support me financially and cheering me on for the wild experience that I am getting into.  That and finding out I am going with at least a familiar name, one of my colleagues from Ottawa was going on the trip also!  So over the month before going, I collected more than the requested amount, gathered first aid equipment from friends and was surprised at the encouragement I was getting, as I really felt I had no idea what I was getting into, and how right it fit into my life yet.  I just knew something felt better about having the decision made and the opportunity in my grasp.

Fast-forward...
Welcome to San Marcos, Nicaragua, well more accurately... Los Madrenos, Nicaragua about 5 ish minutes outside of San Marcos.
11 individuals - 10 medics and one "deputy chief" arrived in Toronto to travel together to Managua, and get driven the 45-ish minutes to Skylark Retreat Centre.  Lets just say... Customs was interesting... especially when the non-elgish speaking customs guy starts sorting through all of our bags of stuff, opening and looking at what was in there then gets to one carrying one of the teaching mannequins... well when the little baby feet kicked out to see him and the fake lady parts flashed him, his face turned red and he stopped right there.  Sent us on our way - so yes the birthing mannequin was invaluable for saving us hours at customs.

The drive was smooth, got everyone from the airport to Skylark.  Managua was quiet - being Easter weekend, and everyone has the week off and would be most often at the beach, but the garbage was quite abundant - but apparently normal - their homes are like their palace but the rest of the surrounding area is free for all - but sometimes people will collect the trash, pile it and then burn it.  A little gross... but a different perspective to our world.  
Our welcome at the airport - $1 please... no... $5 please! 

Our first day was orientation, discuss the programming, unpack and prepare everything for the incoming group.  We had no idea how many were coming, who was coming, what their education level was.  We had been given the idea that we'll have to be flexible, they'll come and go when they want, they won't learn as we expect them to, etc.  So we were just gathering our ideas, thoughts and the points we want to hit and got ready.  And really this was the introduction to the group - amazingly we had 11 people all on the same page.  How fantastic! And we were flexible, we had ideas and shared and listened, we had stuff to offer.  This was the day that I just suddenly felt all the craziness and chaos let go.