When Robin Kramme ‘22OT decided to be part of Salus University’s recent mission trip to Guatemala, Brianna Brim, MOT, OTR/L, CPAM, CLIPP, assistant professor and the University’s director of the Occupational Therapy Institute (OTI), took her shopping for supplies that Kramme could use while creating interventions and modifying equipment for patients in Guatemala.
 
PA student and childAmong the items they picked up was a Velcro toy set patients could use when working on elbow extension and bilateral hand use. And, sure enough, there was a young girl in Guatemala who benefitted from the toy during her OT activities. In fact, the toy was so helpful and the girl enjoyed it so much that Kramme left it with the family so she could practice her OT activities at home.
 
That’s just one success story from the University’s Guatemala mission trip, the first such excursion since the start of the pandemic.
 
Nine students from the Physician Assistant (PA) Studies program and Kramme from the OT program, along with two PA faculty members, Cara Orr, MS, MMS, PA-C, interim director of Didactic Education and assistant professsor, and Jeanne-Marie Pennington, MSPAS, PA-C, PA, clinical coordinator and assistant professor, were in Guatemala from Aug. 21 through Aug. 29. As it has in the past, the Salus contingent worked with Hearts in Motion, a non-profit organization that provides access to quality healthcare and assists in the development of social programs to improve health, education and welfare for people in the United States and Central and South America.
 
Extra precautions were taken and preparations were made by Hearts in Motion and by the Salus group in advance of the trip to make sure it was safe for everyone involved. The COVID-19 vaccination rate in Guatemala is quite low, and many of the people there don’t have easy and affordable access to quality healthcare. Consequently, many of the patients the Salus group would be seeing were likely unvaccinated.
 
PA students examining childrenThe Salus students and faculty were all vaccinated against and tested for COVID-19 before leaving and all wore N95 masks with surgical masks along with eye protection when seeing patients in Guatemala. In addition, Hearts in Motion officials made sure that unlike past trips, where patients would line up for hours waiting to be seen without a need for social distancing, patients this time were required to sign up in advance for an appointment, which helped keep lines short and flowing smoothly. In total, the Salus group saw approximately 550 patients over five days of medical and OT/PT clinics.
 
Conner Thomson ‘22PA said the team brought along a significant amount of vitamins, pain relieving medication, medicines for abdominal discomfort and other anti-acid agents, antibiotics for gastrointestinal, respiratory, and urinary infections, and some anti-parasitic medicines.
 
“We provided a lot of patient education as we noticed many of the problems could be prevented with lifestyle changes, such as proper hydration,” he said.
 
According to Kramme, one of the challenging aspects of the trip for her was utilizing different and unique materials in order to create therapy sessions with clients. On the first day, for example, the group set up a clinic in a small, concrete classroom, pushing a picnic bench and children's table together to use as a treatment table for clients. Other days, Kramme would use old ping pong balls, graduated cylinders, broken stools, old shoes, water bottles and duct tape to complete therapy sessions.
 
PA students examining children“I used the materials I brought down for multiple purposes in order to maximize their use and to be the most effective in the clinic,” said Kramme. “I was forced to think outside of the box every single day. On the flip side, it was very exciting to apply what I learned in the classroom in a treatment session. While I had limited materials, I was able to utilize what I brought down in order to help people and change lives.”
 
But perhaps the most challenging aspect of the trip was the inability to get patients the type of specialty care they required whether it was ophthalmology or orthopedics, according to Thomson.
 
“These doctors were in the city and it was difficult for families to travel there and fund it,” he said. “There was only so much we could do and unfortunately many specialty medical groups have been cancelling their mission trips due to COVID-19, so these patients are unable to receive necessary care.”
 
While that is frustrating, Thomson admitted another difficulty of the trip was the language barrier. “While it did help to have several fluent people on the trip, we at times struggled,” he said. “We were supposed to have translators for the entire week, but that fell through. Nonetheless, we persevered as a group.”
 
PA student and childThe experience was a little different for Lizmeidy Hernandez ‘22PA. Originally from the Dominican Republic, she had seen first-hand as a child what poverty looked like. Now as an adult, she was able to help people. She’s also fluent in Spanish, so the trip allowed her to connect with patients in their native tongue.
 
“Trips like this give students a glimpse of the reality of how people live on other sides of the world. It teaches students an immense sense of humbleness,” said Hernandez. “It builds courage as trips like these immerse students into a foreign environment where a lot of self-growth can be made.”
 
One of those self-growth issues Hernandez learned on this trip was what she called “the art of listening.” “I’m a talker, I admit it, and so the Guatemala mission trip taught me to get full stories from patients,” she said. “There is always more to the story if you’re willing to listen. Many of my patients seemed relieved that we took the time to address every single one of their concerns.”
 
According to Orr, the big takeaway from the trip was that despite a global pandemic, healthcare providers can still serve people in need in a safe and effective manner. All those that went on the trip from Salus were tested three to five days after arriving back in the U.S. and all tested negative and remain healthy.
 
In addition to treating patients face-to-face, Orr said among the other learning aspects of the trip for the students was actually seeing the disparity that exists in global healthcare and the importance of patient education. She added that a trip like this during these times requires the students to exhibit a large degree of flexibility because of all the uncertainty of what they may find in the communities.
 
“Our goal for the students was to have as much hands-on experience as they could get with the patients,” said Orr. “We wanted them to be involved from the beginning with collecting the histories, doing the physical exams and formulating an assessment and plan and then educating the patients about that. Within that framework, it worked out very well. It was a fantastic experience.”
PA students group photo in Guatemala