Alternative Winter Break: Eleuthera, Bahamas

As you all know, I spent a week in the Bahamas volunteering in clinics and teaching in schools about health, infection control, and other pertinent issues on the island of Eleuthera. During our free time, we toured the most popular spots, relaxed on the beaches, and went out and integrated ourselves within the Eleutheran community. I had promised I would keep you updated, but there was very limited wifi, so I apologize for the delay. Below I have included our assigned journals (some are more specific as to adhere to the required guidelines provided by our professors) as well as pictures from the most meaningful and memorable moments of the trip. Enjoy!



Reflective Journals for Alternative Winter Break: Eleuthera, Bahamas 2015

Journal Day 1
Today I spent the day volunteering at Governor’s Harbor Clinic. It was one of the busiest days of the week because it was one of the only two days the doctor was there. I spent a majority of the morning checking in patients; this involved asking patient information such as their identification, complaint, history, current medications, and taking their vital signs. In the afternoon, I was helping in the pharmacy by filling prescriptions and also shadowing the nurse as she completed tasks such as wound care, pregnancy tests, and vaccinations. It was interesting to see so many people of different age groups, but I enjoyed working with them one on one a lot more than I had expected. 

One of the patients was a mother who said she only fed her 1 year old son juice and junk food, and hadn’t given him milk since he was three months old. The nurse and I explained the importance of milk for development of growth, teeth, and bones and I was surprised that she had no idea she should’ve been giving her child milk. Another patient was an obese, 200 pound, 8-year old complaining of shortness of breath, but the mother would not accept that his obesity was a problem or know what to do about it even after the doctor and nurses all told her that several times before. It really emphasized the importance of education on topics that may not seem like there would be much to teach about. They were all very receptive to the learning. 

One difference I noticed was the limited resources such as gloves and medications. If there were not enough of a certain medication, the pharmacy did not order more; they referred the patient to different clinics. They also did not use gloves for cleaning small things like thermometers because they reserved them for more invasive procedures. There were so many tasks that each staff member completed and so many services offered at one clinic and I learned how much time, effort, and resources go into sustaining a clinic in an area with no hospitals. The nurses on the Island were not only nurses during their shift, but rather, had that as part of their identities on the island 24/7, which is something to aspire to.

Because the island is one long strip with one main road, we spent the day yesterday driving across the entire island; unfortunately, I did not keep a journal, but I just wanted to mention that we did leave time for sightseeing, because all work and no play makes John a dull boy! The downside of the weekend was that our flight was cancelled and there was an overall 24 hour delay. When we finally reached our living quarters in the Church mission house, we discovered there was no wi-fi access or hot water. But, we made the best of our situation and still had an amazing time!



Journal Day 2
Today I spent the morning at Governors Harbor for the second day and final day. I helped do the well-baby assessments before vaccinations and observed the nurses draw labs. In the afternoon, I assisted my classmates with screenings as part of the 40 day health challenge, but only 1 person came in during the time I was there so I spent my time talking with some of the staff and reading the plethora of books and pamphlets on cancer and health in today’s society. 

An especially negative experience today was when I was excited to perform well baby assessments, but everyone had to be sent home and rescheduled because the pharmacy ran out of vaccines. I was surprised to see that the patients were not showing being angry or upset about being sent home despite any inconvenience it probably caused them; however, this may have something to do with healthcare being free in certain cases, and that the people of the island were used to this sort of thing happening regularly (can you imagine if something like that happened at a clinic in the U.S?!)

A positive experience was my interactions with the staff and patients overall. Working with the patients, I was a lot more confident because I knew how the flow worked. In terms of the staff, I was able to talk more openly and ask questions as well as express my opinions. The nurse also felt more comfortable talking with me about politics in healthcare and positive and negative experiences she has had in her 3 years as a nurse. It was interesting to see how similar many of our experiences were as student and new nurses despite being from completely different places and cultures. 



Journal Day 3
Today I spent the day at the Cancer Society performing health screenings for the 40-day health challenge. Although this was a clinic, it involved a lot of teaching about general health and fitness. As patients came in, we assessed their initial weight and measurements, vital signs, and blood sugar levels; we then taught them briefly about healthy eating, exercise, and general wellness. It was inspiring to see so many people wanting to change their lifestyle and turn their health around, and I am happy this process is something I was able to help with.

In the afternoon, we went to an isolated beach and had a peaceful few moments of mid-trip reflection. We picked shells, saw starfish and other sea creatures, and took a lot of pictures of ourselves and the beautiful sunset. In the evening, we went to the local bar where they played American popular music and we all did karaoke without caring what anyone thought- it was a blast!



Journal Day 4
(I do not have a journal I wrote this day about my experience, so I will try my best to remember what we did). On Thursday, I volunteered at Tarpum Bay Clinic, a small clinic within walking distance from our living quarters. This is when I gained the most independence and felt like I was really making a difference because the only people running the clinic were myself, my classmate, and one nurse. We did the entire process with minimal assistance- registration, assessment, diagnosis, treatment, medication prescribing and filling, education, and discharge- it was busy, but it was the best learning experience of my time in the Bahamas. 

That afternoon, we went to an elementary school to teach fourth grade about infection control and other topics the students could relate to. We asked questions, sang songs while we learned about hand-washing, did jumping jacks to teach about asthma, and initiated discussion about various topics; I was happy to see the students actively participating and all my anxiety about teaching again the next day was replaced with comfort and excitement and motivation to make a difference. We ended the day by visiting miracle cove, named for it’s supposed healing powers for anyone who touches the water.


Journal Day 5
On the final day of the trip, I was happy to be able to go back to Tarpum Bay clinic on my own and feel more confident about my role as a student volunteer nurse. I really feel like I built a connection with the patients and I was continually surprised at the level of trust each patient placed in me. This day really reminded me of why I wanted to become a nurse, and was probably the best day I had. 

In the afternoon, we went to teach fifth and sixth graders about a variety of topics pertinent to their age group. Again, we received a fairly enthusiastic response, at least from fifth grade. The sixth graders were pretty knowledgable about many subjects already, and also seemed a bit bored and ready to go since it was the last class of the day, haha. They were still very polite, participated in every aspect, and thanked us for taking the time to come visit their school.

On our last night, we crossed something major off my lifelong bucket list- we attended a nighttime beach bonfire party with a majority of the island locals, new music and food, and truly felt like we were welcome and belonged to the community. I met so many of my patients from throughout the week, as well as other tourists I had come across outside of the clinics and schools. We were having so much fun, we didn’t want to leave; but, all good things must come to an end, and we went home to pack so we could leave early Saturday morning for our first class flight home!


Other:

During my time at a clinic in Eleuthera, I asked one of the nurses to serve as a key informant and answer questions about the community on the island. She was very excited to speak about the positive and negative aspects about the community, and described it as a very tight-knit community that she is proud to be a part of despite the issues they face. She said that people of this community have a variety of jobs such as those in healthcare, education, food, and travel, and also that many people have jobs that are temporary and do not count towards the statistics of officially employed people on the island.

Many people in Eleuthera do have a car, but many others choose to walk. The nurse did not mention many forms of public transportation, but did place a heavy emphasis on boats because everything on the island is imported from elsewhere. These boats are also used for emergencies to get to a hospital such as when someone is expecting a child. For fun, members of this community have homecomings twice a month for different settlements, but there is not much else that goes on on a day to day basis. The nurse I spoke to specifically did mention the fish fry and karaoke, both of which I got a chance to experience, and stated that she and many people she knows enjoy watching movies and listening to music. 

A majority of the people on the island do not place heavy emphasis on being involved in politics although it is briefly covered in school (the nurse was sure to mention that whatever they learn in school does not cover what actually goes on in the real world). Although the nurse said this, I remember talking to another nurse at a different clinic who was discussing politics with her coworkers, so I am not sure which is correct. Some of the best things about the community is the sense of closeness and that everyone knows everyone; however, this can also be negative when it comes to privacy and individual freedom.

Major issues facing the community include lack of complete education and increased cost of living. We had a long discussion about the “low” salary for nurses and shortage of second jobs, high expenses, and new taxes, but I was surprised to learn that the government does not take out taxes from her pay, gives free healthcare, and also pays her rent that is $800/month! These issues are important for the community to address because acting early on can prevent it from continuing and worsening over time. She ended by saying that in the next few years, she would like to see more education on important issues the community is facing, more opportunities for those who would like a second job, more staff at the clinics (something I would like to see as well!), and continued closeness within the community to face all future problems together.




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