ARTICLE BY LANE STAFFORD
University of Alabama student Jackson Knappen says some Nicaraguans wake up at 3 in the morning to ride a boat, hop in a taxi and walk for miles just to receive a medical checkup.
Each May, UA students work at the Clínica Alabama- Granada, a public health-care facility serving low-income residents of Granada, Nicaragua, and surrounding towns. They are part of the Nicaragua Clinical Experience, a partnership between UA’s Honors College and FOR (Friends of Rudy) Incorporated, a foundation that supports the clinic and was formed by Birmingham, Ala., physicians.
“I love this program because it gives people the chance to see the practical uses of their Spanish [language] in a medical context,” says Knappen, a senior from Overland Park, Kan., majoring in biology. “It also exposes them first-hand to the problems of global health care and accessibility.”
In the spring semester before traveling to Nicaragua in May, students earn academic credit through UH 120 Nicaragua Clinical Experience. The course equips students with medical Spanish and insight into health-care constraints in low-income countries and provides hands-on medical training from a nurse. While in Nicaragua, students write regular journal entries analyzing and reflecting on their experiences.
Students taking the course are on a health-care profession track, and most have prior Spanish-speaking experience.
Engagement in local culture is an essential element of the trip. Students live with local families during their month in Granada.
Molly Neill, a junior from Decatur, Ala., double majoring in psychology and Spanish, traveled to Nicaragua in 2016 and says the work challenged her in many ways. “Constantly I was placed in situations I had never experienced before, and I had to learn to grow and adapt to those situations,” she says. “I learned to deal with tough conditions like heat and no air conditioning and figured out just how much I could push myself.”
In May of 2016, 12 UA students helped staff the Clínica Alabama-Granada. They worked in daily, small-group rotations to perform four tasks: welcoming and triaging patients; assisting doctors; organizing inventory and operating the clinic’s pharmacy. Students volunteered in the clinic five days a week for an average of five hours per day, treating an average of 40 patients each day.
The most common health problems students help treat are diabetes and hypertension. Many patients’ diets are high in sugar, carbohydrates and salt, which contribute to these conditions.
Triaging tasks include taking blood pressure, checking blood-sugar levels, recording temperature and weight and documenting medical histories. In the pharmacy, students learn about the medications used and prepare them for patients.
Alex Huechteman, a junior from Frisco, Texas, majoring in public health, says her favorite memory from the trip was learning to give an injection. She administered an insulin shot and explained the procedure to the patient in Spanish. “It was a great moment for me to realize what I am learning is paying off, and I am able to use it in the world for the better,” Huechteman says.
Many Nicaraguans cannot afford or access adequate medical care. “The idea and the motivation [for the clinic] came from seeing so much need for help in Nicaragua,” says Dr. Rudy Vargas, a Granada native who founded the Clínica Alabama-Granada. Vargas came to the United States in 1969 for postgraduate medical training and moved to Birmingham in 1973 to complete a fellowship in endocrinology at The University of Alabama at Birmingham. “The poor people of my country don’t have access to specialized medical care due to their precarious economic situation,” he says.
Vargas says some Nicaraguan families live on $100 to $150 a month, leaving little to no funds for proper health care.
Huechteman says the clinic opened her eyes to the medical obstacles people in other parts of the world face and cemented her career goals. “I realized how great the need is for health education, as well as the huge disparity of health-care access,” she says. “It has confirmed my passion to use my education as a physician assistant to improve global health.”
While the partnership provides greatly needed care at no cost to Nicaragua residents, it also expands students’ perspectives and provides training that assists them as they pursue jobs in the medical field.
“I think everyone should do something abroad because the exposure to a different culture makes you appreciate how easy we really have it in the States,” says Alyssia Miller, instructor of the Nicaragua Clinical Experience course.
Vargas says the most rewarding part of volunteering at the clinic is the ability to lessen the misery of another human being. He recalls patients thanking clinic staff with tears in their eyes and seeing a child whom the clinic had helped walk run into staff members’ arms.
“Our patients do for us as much as we do for them,” Vargas says. “One of their smiles is worth more than a million dollars. We can call it an even exchange.”
UH 120 Honors Explorations Nicaragua Clinical Experience is offered in the spring semester and May Interim each year, with applications due the preceding fall. Contact Honors College at 205-348-5500 for more information.