Return to Playa Gigante, Nicaragua

Last August, I led an international service-learning trip as the faculty advisor for the Student Association for Medical Spanish (SAMS) at the University of Texas-Pan American, with the goal of participating in a sustainable development project in the field of health in collaboration with the nonprofit organization Project Wave of Optimism (WOO).  Our initial collaboration with Project WOO was very successful: during our week in Playa Gigante, we achieved our goal of helping the local health center personnel identify patients who suffered from undiagnosed or untreated hypertension through door-to-door screenings so that they could receive follow-up diagnoses and treatment from their physician, and our fundraising efforts helped to support the operations of the centro de salud where the patients would receive treatment.  This May, we had the opportunity to build upon what we learned last year and develop new skills in health outreach and education.

Alimentos saludables and early interventions en la escuela

Just a few weeks prior to our arrival, the health center staff and Project WOO volunteers had begun offering health classes in the Playa Gigante elementary school in collaboration with the local teachers.  Our first project was to incorporate ourselves into the health education team along with our friends Dr. Mariana and Maria from the health center in order to teach classes about healthy eating and food and hygiene for the Kindergarten through 3rd grade students.  For the kindergarteners, we shared a children’s book titled “Adelita y las primas verduritas” and spoke about the importance of eating fruits and vegetables in a balanced diet.  We were fortunate to have classroom sets of copies of the books to distribute to the 1st, 2nd, and 3rd graders as well.  In the 1st and 2nd grade classes, we spoke about healthy food choices and modeled them by doing an activity in which we distributed paper plates to each child with the plate divided into three categories (grow, glow, and go).  We then spoke about the importance of proteins, carbohydrates, and vitamins, and asked the students to paste images of different locally-found foodstuffs into each of the categories.  The students quickly noted that there was nowhere to paste the images of soda and chips and other junk food, so those were pasted on the back of the plate, since they do not belong on a plate that represents a balanced diet.  With the third graders, we spoke about the importance of washing fruits and vegetables before consuming them, and we also taught them a song about the importance of hand washing before eating.

Second graders at the Playa Gigante elementary school with their healthy eating plates

Second graders at the Playa Gigante elementary school with their healthy eating plates

Health, Gender, and Drama

Another health education outreach project we participated in during our stay in Gigante also took place at the elementary school.  We were invited to present during the Mother’s Day celebration assembly that took place on Wednesday.  For the assembly, we wrote and performed in an original play titled “Prevenir el dengue”, a community-development centered drama centered on the plight of the Rivera family, whose young daughter Juanita is taken ill with dengue fever during the rainy season after trash has accumulated near her family home.  In the play, the neighborhood mothers unite to clean up the neighborhood so that no other children have to suffer the effects of this illness.  Dr. Mariana, the town doctor of Playa Gigante, played herself during the presentation and explained the symptoms and treatments for the disease.  In the end, the moms clean up the town and save the day, and little Juanita recovers and finds a clean and healthy neighborhood to play in.  We were supported not only by Dr. Mariana and Maria from the health center in this presentation, but also by all of the students who payed close attention to the action and reacted accordingly (voicing “Oh, no!” when there was bad news, and “¡Sí!” when something positive happened).  This was a fun and unique opportunity to connect with parents, teachers, and children on a topic that is very pertinent as the rainy season is just beginning in Playa Gigante.

 

juego de beisbol

Baseball game with the youth of Playa Gigante

Exercise and Physical Activity

Another element of a healthy lifestyle and preventive measure against chronic illnesses such as hypertension is promotion of exercise and physical activity.  During our week in Playa Gigante, we participated in several activities designed to encourage an active lifestyle.  The Project WOO staff helped us to organize a baseball game with many of the young people from the community on the town’s baseball diamond on Wednesday afternoon.  We also had the opportunity to participate in a yoga class on the beach with our host families.  For many of the attendees, both from Nicaragua and from the Rio Grande Valley, this was the first yoga class they had ever attended; however, it was hopefully the beginning of a healthy habit, since yoga classes are soon going to be offered on a regular basis in the Playa Gigante health center.  Of course, we wouldn’t visit Playa Gigante without participating in the most popular form of exercise in town–surfing!  We attended a surf lesson as well and got a taste of another sport that is important for the town, both for exercise and recreation as well as for tourism and economic development.

feria de salud

Health fair at the Playa Gigante centro de salud

Health Fair and Educational Charlas at the Centro de salud

In addition to our health education efforts in the elementary school, we also did health education outreach at the health center for the patients awaiting their consultations with Dr. Mariana.  While students took turns shadowing Dr. Mariana and learned more about her work and the common health issues in Gigante, others organized educational games for the patients in the form of a health fair, including a “match the bag of sugar with the correct drink” to highlight the added sugars in soda and artificially flavored juices, as well as a craft activity to encourage children to eat fruit rather than packaged junk foods by making a butterfly with watermelon:

Mariposa made of fruit at the health fair

Mariposa made of fruit at the health fair

Homestays and convivencia

While our trip to Playa Gigante was short, we did have a wonderful opportunity to get to know both the town and its people through a home stay experience.  Once again, the generous families of Playa Gigante opened their homes and their lives to us and made us feel a part of their families.  We also had the opportunity to learn more about life in the town by participating in some of the common activities that the residents of Playa Gigante engage in every day for their livelihood–for example, we were able to take a class on how to bake sweet bread in a wood-burning oven with a woman who bakes bread to sell, and we had the chance to go fishing (not with poles for sport like the tourists, but rather with a net, estilo artesanal) with a local fisherman to get an idea of the common types of labor in this small town where fishing is a major industry.

Fishermen tending to their nets in Playa Gigante, Nicaragua

Fishermen tending to their nets in Playa Gigante, Nicaragua

Conclusion: Health is More Than Just Numbers

In our first visit to Gigante it was much easier to quantify our contribution to the health of the individuals in Playa Gigante– we used instruments to measure the blood pressure of 2/3 of the adults in the town.  While we also witnessed an immediate follow-up to that particular intervention by inviting all at-risk individuals we identified to come to the health center to be diagnosed and treated by their physician, Dr. Mariana, we were not able to see the long-term element of follow-up–the health education classes and groups–until our return trip.  This May, we were able to contribute to the prevention projects that target the chronic diseases such as hypertension and diabetes that are a problem both among the patient population in the small rural town of Playa Gigante as well as right back here at home in the Rio Grande Valley.  Both of the projects were satisfying in different ways and complemented one another, with the health education element designed as a way to address the problem with hypertension that we quantified during our first visit.  It is a lesson for us that as important as it is to learn the technical skills that we practiced last year in measuring blood pressure, it is equally important to develop skills that will allow us to communicate important health messages to our patient populations in ways that are creative and easily accessible–even if that means wearing a funny costume and performing a skit about dengue fever–as a part of our professional identity.  These lessons are something we can take back to our own community in order to combat the very same chronic disorders amongst the patients of the Rio Grande Valley.