Friday, January 16, 2009

San Juan.. Post 2

Giving injections at the baby clinic:
After the teaching session at the barangay preschool
Very smart children!! Placing food items on the food pyramid:
Our Jeepny for the week! Don't you want to ride?
At a health clinic with some of the University of the Philippines students:



Hello again from San Juan, Batangas! As usual we have been kept very busy by our extremely hospitable hosts here in the Philippines. Tuesday we started the day by attending a preschool where 3 nursing students were doing health teaching with the students with the help from 4 volunteer Barangay health workers. Barangay health workers are individuals in the community who volunteer their time to learn how to do basic assessment skills, such taking vital signs of the individuals in the Barangay. The preschool health teaching consisted of teaching the children basic health promoting activities. The nursing students began the session by reading a storybook that they created on proper cough and sneeze etiquette. They then involved the children in their teaching session about the food pyramid by giving them stickers and getting them to place it in the appropriate place on the pyramid. It was amazing that they knew the food pyramid so well that they were able to place the foods in the correct category! This is something we would never see in Canada at that age. They have done a really good job here of educating the children at a very young age of the principles of the pyramid (or food guide in Canada).
The last health teaching they did with the children was proper hand washing and the nursing students used a song to accompany the proper technique, and used return demonstration which we have learned to be an effective teaching strategy with young children, along with visual and kinesthetic aids. Following the children learning the song, they each had a chance to wash their hands in front of the Barangay health workers to ensure they had the correct technique. I found that the nursing students really know their target audience, and in this case they taught the technique by using buckets of water because many of these children may not have running water at home.
In the afternoon we took the Jeepny to a more remote barangay, which took about an hour to get to. Many of the roads in the remote areas aren’t really roads at all, they are very similar to hiking trails in northern Sask, only with tropical growth instead of forest. We reached the house where 3 nursing students were doing family education on cough, colds, and pneumonia, and found the area to be very peaceful compared to the other areas of the Philippines we have been to. The nursing students then did a one and a half hour education session with the barangay members who attended on the above topic, using many of the principles of adult learning that we learned back in the second year of our program. They involved the participants a lot, kept the session relatively short (in the past these session used to be 4 hours in length!), and they used many visual aids. The students explained to us that this topic is important for this barangay because they don’t access health care workers as readily since they are remote, and because many of them self-prescribe antibiotics (a problem in Canada as well). The session taught them about basic signs and symptoms of coughs, colds, and of pneumonia, as well as when they should be seeking medical attention. They also taught them the importance of not self-medicating. At the end of the session they give each participant a certificate for the completion of the course, which gives them a sense of accomplishment and helps to increase self-confidence and empowerment.
Following the family teaching session, we were served with the local coffee (which was very sweet and kind of fruity) and caramelized plantain. We have found that the Filipino people are very hospitable and everywhere we go we are served with either drinks or food or both! So don’t worry moms and dads, we are being very well fed!! While we were socializing with the families and children who attended the session, some men from the community began getting some coconuts down from the palm trees using very long tools that looked like bamboo poles. So we had the chance to drink from very young coconuts (not the kind you drink from on the beaches of Hawaii, or so we are told by Susan), and we tasted the coconut “flesh”. It was different… :) Some of us liked it, some we indifferent towards it. Susan says that more mature coconuts are much tastier.
Wednesday was another busy day as well! In the morning we were split up into two groups, one (Chelsea, Lindsay & Troy) went to a health clinic that was hosting a baby clinic where all the babies in the barangay were being immunized, while group two (Kristinn, Morgan, & Jenny) were supposed to go to a different health clinic for the same thing but no one showed up. So group two ended up going to a farm where they held newborn pigs instead of babies! The baby clinic was very interesting to be at, I have never seen so many babies in one room at one time! They all ranged from 2 weeks of age up to 9 months. We had the chance to actually give the immunizations for the time we were there in the morning, which was a really great experience for those of us who haven’t had a lot of experience giving injections, especially on infants. Following the baby clinic we had to check out of the place we had been staying at for the first three nights here in San Juan, pack all of our bags into the bag of the jeepny, pack ourselves in there too (it was a tight squeeze!), and take the hour drive over to the Kabayan resort, on the ocean, where we are currently staying until we return to Manila on Friday before flying to Iloilo City on Saturday.
After a quick break and lunch we headed back into the center of San Juan where we attended a community teaching session held by two of the fourth year nursing students on hypertension. I was once again blown away by their ease of public speaking and educating groups. They clearly have a lot of practice in the area, and I can truly see how intelligent these student are (especially considering the University of the Philippines is the top choice for all applicants, therefore these are the top 70 nursing students in the entire country!). They are so good at interacting with the community members, getting them involved, and they work very hard on empowering the entire community. From the little I have seen, I can tell that they are making a tremendous impact on the city of San Juan.
We also learn a few interesting facts about the cities and barangays that we visit each day, and today we learned that the alcoholic drink of choice in the particular barangay we were in today is one that is made by fermenting coconut juice, and is 90% proof!! Even more amazing is that they drink it straight up like they were drinking wine. This is something the nursing students are trying to discourage (among many other bad habits) in order to decrease the incidence of hypertension in the barangay.
The days here are long, but we have been learning so much here and we are also learning many community nursing techniques that we feel could really benefit communities back in Canada that we hope to one day put into practice.

Lindsay, the Philippines nursing crew

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