Philippines 2013 1
2 Philippines 2013 By Sara Pugh and Kayla Stirr Kayla, Brandy, Sara, & Lindsey
3 Lindsey, Kayla, Sara, Brandy, September, 2012 Lindsey Rask, Brandy Rousson, and the authors of this Blog (Kayla Stirr, and Sara Pugh) were fortunate to be chosen to participate in the International Study Abroad Program and have our final nursing practicum in the Philippines. We all embarked on this great adventure on the morning of January 3 rd, and after an extremely long trip over, arrived in the Philippines on the evening of January 4 th. Since our clinical experience did not begin until January 14 th, we were able to do some traveling around the Philippines before hand. It allowed us to adjust to the culture we would be emerged in for the next five weeks. We were able to see some amazing sights, but before we knew it our vacation was over and it was time for our final practicum to begin.
4 We flew into Manila on January 13 th, and were greeted at the airport by Joy Molo, who would be our community preceptor, and Belinda Capistrano, our hospital preceptor. After an hour and a half drive to Antipolo we arrived at our home away from home for the next three weeks, Saint Michaels Retreat House.
5 Immacula da Building, our new home for the next three weeks Monday January 14 th T he first day of clinical was nerve racking for all of us because we were not sure what to expect. The day began by being introduced to our partners, which were fourth year Filipino nursing students from the University of the East Ramon Magsaysay (UERM). The girls, Hannah, CD, Kim and Marian were all very nice, and we immediately got along with them.
6 The four Canadian nursing students with the Filipino nursing students From left to right: Kayla, Hannah, Sara, CD, Lindsey, Marian, Brandy, and Kim Immediately after being introduced, we went to the main City Hall in Barangay Dela Paz to meet the city and health officials. A Barangay is a small unit or division of society. Every Monday the city officials, health officials, senior citizens, and volunteers from each Barangay in Antipolo meet at city hall for a meeting and flag ceremony. We were required to meet the city officials in order to gain entry in the community where we would be working over the next three weeks. Everyone was expecting our arrival and was very pleasant to talk to, but the language barrier became a problem earlier then we expected.
7 Town meeting at City Hall While at City Hall we met the Captain of the Barangay named Hon. Serafin M. Alvaran. We asked him a lot of questions about the community and health found in the surrounding areas.
8 Us with the Captain of the Barangay, Hon. Serafin M. Alvaran After City Hall, we went to the local health clinic. T he clinic is much like a walk in clinic at home, where people can visit to receive free services. There they were doing immunizations, vital signs, medication administration, T uberculosis diagnosis and treatment, animal bite treatment, Dengue fever treatment, and health teaching all in a confined space. A nurse named Mary Anne gave us a tour and told us about what happens in the clinic as well as introduced us to other health care workers, dieticians and nurses.
9 (Permission granted to take picture) Mary Anne providing us with tour of local clinic We then had time to ask them about major health conditions in the Antipolo population and any statistics they could share. We learnt that a lot of their main conditions and mortality rates were due to the same conditions as Canada. For example, prostate cancer is the most prominent cancer in men, and breast cancer the most prominent in women. We also learnt that malnutrition in kids under six years old is a major problem in the Philippines. We were told that Antipolo is number two in the Philippines for having the most malnutrition.
Picture with staff at local clinic 10
11 Antipolo Church exterior Following the clinic, Joy wanted to show us a historical place within Antipolo. T his place was the Antipolo Church. It was incredibly big, and inside contained beautiful stained glass windows. It was definitely worth seeing, and became a landmark for us to know when traveling out on our own time.
12 Antipolo Church interior After leaving the church, Joy had us come back to St. Michaels to get to know each other better. They had us try fried bananas, which is a traditional Filipino snack.
The four of us tasting fried banana snack, with the Filipino nursing students and our Preceptor Joy 13
14 Blog #1 part 2 Tuesday January 15th The second day was the day of orientation. We got picked up earlier than the usual set time because we had to go to Manila to spend the day at the University of East Ramon Magsaysay. Sign welcoming us to the UERM When arriving at the University everyone was so pleased to meet us. We got introduced to the Dean Carmelita Divinagracia and her husband Romeo Divinagracia who is the President of UERM. Both were very kind and many pictures were taken with them.
15 Meeting Dean Carmelita Divinagracia, and President Romeo Divinagracia at UERM We were honored to meet the Vice Chairman of the University named Wilson Young. This man is the second highest up in ranking at the university, so we felt very special to have had the opportunity to meet him.
16 Meeting with Vice Chairman Wilson Young After our tour around the university, we were fortunate to have Pizza Hut waiting for us before beginning our orientation.
17 During our clinical orientation we learnt about the activities we will be partaking in for our clinical experience. For the community portion of our practicum we will be working directly with families in the community, in a health clinic, elementary school, and geriatric center. For the hospital portion of our rotation we will be working in pairs on two separate units, the Critical Care Unit and the Operating Room, for one week each.
18 Blog #1, Part 3 Wednesday January 16th T he third day started with T eam building Activities. T hese activities consisted of challenges in order to utilize each other to accomplish end goals, build trust, and help us learn to work together. T he first team building activity was a game called spoons, which involved a tiny circular object being passed from one spoon to another, except the spoons were held in our mouths. Therefore we had to get very close and personal early on in the day. Lindsey and Kim during team building activity Secondly we had a race called T he Caterpillar. T his game was physically draining, as you had to get very close and sit on the knees of person behind you and walk around a huge bay. Our legs definitely took a hit with that activity, but it did teach us how to
19 work together with our group. Next we had to construct a tower with clay and toothpicks, the only catch was that two of our partners were blindfolded and the other two had their hands tied up so could only use one hand. This meant as partners we had to direct the people blindfolded on how to build the tower. Building tower during team building activity T he last activity made trust the main component. Each of us was paired with our Filipino partner and we had to do various activities under their direction while being blindfolded. This activity allowed us to believe our partner wouldn t put us in any danger and we could trust their word. After the team building activities, it was visible that we all seemed closer. This was a good beginning as we were about to head into the community where we would be working with our designated partner.
20 Guiding our partners during the last team building activity We arrived at the community in Antipolo where we will be working for the next couple weeks. We visited the health center, as well as made some home visits to families we would be working with during our community rotation. All of us are paired with a Filipino nursing student, and will be working with three families in the community each. Joy assigned us each families who are a part o the 4 P s program implemented by the Philippine government. 4 P s stands for the Pantawid Panilyang Pilipino Program, and was developed in order to address the issue of poverty in the Philippines. The poorest of the poor families are selected to participate in the program in order to make them more stable.
21 Blog #1, Part 3.5 In order to be a part of this 4 P s program certain criteria had to be met such as: a low income, children below a certain age, and they need to abide to the program by ensuring their children go to school and seek health services when due. Health Center in community we will be working in
Community we will be working in 22
23 Barangay Health Center We were able to meet the families we will be working with, and they were all incredibly nice, but unfortunately could not speak any English. This was a challenge for us as we could not speak directly to the families in the community. We are fortunate to have our Filipino nursing student there to translate and ease communication. Being in the community was a real eye opening experience, as we had never been exposed to that level of poverty before. We now have more insight on how people in the community live, and look forward to being in the community more.
24 Thursday January 17th The fourth day we were excited because we were able to do physical nursing skills. Although minor, they gave us a good review of things we haven t done in a long time. In the clinic we got to do prenatal care, therefore we got to do the weights, blood pressures, and Leopold s maneuvers for the pregnant women. We also got to do some health teaching on the proper foods to eat, vitamins to take and answer any questions the pregnant women had. Once again, our Filipino partners had to take charge since the women in this community struggled with their English. Luckily the nursing principles were for the most part the same. After the work was completed in the clinic, we then returned to the community to complete our assessments. We started first with an oral interview to decide what the main priority focus should be, and then physically assessed those priorities. Being in the community, interacting with the families, and experiencing more of the culture of the Philippines has been great. We can t wait to work more with the individuals in the community! Friday January 18th Today was the last day of our first week working in the Philippines. First thing in the morning we visited the main health clinic and assisted with taking the heights and weights of school children in the community.
25 (Permission granted to take picture) Sara taking the weight of a school child in the community In the afternoon we went back out to the community to perform further assessment. We then combined all of our information in order to make a program plan. When assessing the information gathered, we found that malnutrition seemed to be the greatest health concern of the community due to the poor income of the families. Based on this information we created the idea of gathering
26 cheap foods and creating a soup kitchen with the mothers of the family so they could learn the recipe and make it again for their families. T his will be implemented next week. Overall, our first week working in the Philippines has been amazing. We have met so many great people, and been able to experience so much. We can t wait to see what the rest of the practicum will bring. By Sara Pugh and Kayla Stirr Nursing students in the Philippines January 2013 NEPS, University of Saskatchewan