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Nursing in Low Resource Countries

Empowering nurses and nursing students through education and experience to maximize their potential as effective nurse leaders, thus creating positive and sustainable outcomes in their communities and nation.


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Moments of Weakness

Today we want to feature a story that was shared with the MedicalMissions.com community. Anyone can share stories of life on the mission field, medical work being done around the world, or inspiring stories of faith here on MedicalMissions.com - we love to hear from YOU, the people that are dreaming and doing the work of healthcare missions (https://www.medicalmissions.com/stories). 

The story for today was shared by Christian Health Service Corps, and takes place in Honduras. We hope you enjoy it as much as we did!

Andrew and Alisa Geers serve as Christian Health Service Corps missionaries in Honduras. He is a Physician Assistant, and she is a Nurse Practitioner. They shared this story that demonstrates how God's power is made perfect in weakness.

What comes to mind when you see the word “intussusception”?  If you are not at all medically inclined then you may not have even known that it was a thing, let alone how to pronounce it.  For those of you who want to win at jeopardy it’s pronounced  in·tus·sus·cep·tion.  It is a condition whose cause is not well understood but it is always fatal if left untreated within 5 days of its occurrence.  So what exactly is intussusception and why am I spending so much time talking about it?

IntussusceptionTo keep it simple, intussusception is the process by which part of the intestine telescopes within itself and usually occurs where the small intestine meets the colon or large intestine (see photo representation).  This leads to an intestinal obstruction, bowel death and eventual perforation of the intestines.  It is the most common cause of intestinal obstruction in children 5 months to 3 years.  Now that you are an expert on intussusception let me tell you about my 3 month old patient who came in the ER about 2 weeks ago around 10 pm…

The patient had a 2 day history of fever, vomiting and blood in his stools.  He had been seen at a clinic near his home earlier that morning, about 9 hours from our hospital, where he was given fluids and his mother was told they needed to see a specialist.  To this mother, whose father had neck surgery at our hospital some time ago, it made perfect sense that Hospital Loma de Luz would have the “specialists” her son needed to see. In case you were wondering, (and you may not have considered this since I threw a bunch of fancy terms and statistics at you to begin with) I am NOT a specialist in pediatrics.  

I immediately radioed Alisa (cause I have learned that when you don’t know what to do you ask your wife) and ran the patient by her.  It was clear from his distended abdomen and x-ray that this infant had an intestinal obstruction and now we had to determine why (although you can probably guess why if I have not completely lost you with my ramblings).  Usually in the states this child would have had access to a variety of tests and tools to help quickly narrow down the diagnosis, to determine which specialist needed to be consulted and to determine the best approach for treatment.  Here in Honduras we are deficient in our diagnostic testing with our most advanced imaging being x-ray.

IMG_3130
Abdominal x-ray taken just after the patient arrived in our ER showing a belly full of air.

The doctor “on call” with me was none other than our General Surgeon, Dr. Alexander, who does not usually operate on children, let alone 3 month olds.  We admitted the infant, gave him IV antibiotics and had a nasogastric tube placed to try to decompress his stomach but he continued to have fevers and more distention of his abdomen.  We all had been praying for a miraculous healing but it was rapidly becoming apparent that we were losing the battle and needed to use more invasive measures.  Having no experience in this type of pediatric abdominal surgery our general surgeon skyped with the pediatric surgeon back in the states to get his input and to get a crash course on what needed to happen with the surgery.  Lacking onsite experience we were definitely at a disadvantage when it came to attempting surgical intervention.

During the operation we found that part of the small intestine had telescoped into the large intestine and Dr. Alexander worked to meticulously and delicately pull it back out.  We could see evidence that the trapped bowel was beginning to show signs of dying and it would have only been a matter of hours before the damage would have been irreversible.  By the grace of God this child made it through surgery without complications and one week after coming to our hospital he was discharged eating and pooping like a normal 3 month old should.  Our medical staff worked diligently, trusting God to provide the strength and guidance we needed to give the best care possible despite our weaknesses.  And just like the 5 loaves and 2 fish,  God performed a miracle through our limited experiences and resources and all we can say is, to God be the glory!

When is the last time you boasted about your weaknesses?  The word weakness can be more accurately defined by words like disadvantage, defect, deficiency, and imperfection.  We all have weaknesses and yet we usually don’t go around broadcasting them to the rest of the world.  Yet that is what the Apostle Paul encourages followers of Christ to do, to boast to the world about weaknesses.  2 Corinthians 12:9 says, “But he (God) said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me”.  We have seen and testify to the power of Christ working in our weaknesses.  The next time you and I encounter difficult circumstances I pray that we would be reminded of His sufficient grace!


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Christian Thought in Western Science

Over the past few months, we have highlighted a few outstanding sessions, stories, and articles that are featured on MedicalMissions.com. We want to do that again this morning, highlighting one of last year's (2018) breakout sessions. But if you went to this year's conference, and you are anxious to listen to a session you missed, don't worry! The sessions from the 2019 conference will begin releasing on the website (https://www.medicalmissions.com/resources) and the podcast (https://www.medicalmissions.com/podcast) in January.

For now, check out this very interesting session on Christian Thought in the Development of Western Scientific Medicine by Dr. John Patrick


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Responding to Victims of Human Trafficking within the Health Care Setting

Responding to Victims of Human Trafficking within the Health Care Setting

By Jeffrey J. Barrows, DO, MA (Ethics)

Imagine you are staffing the urgent care clinic at your hospital when you encounter a 19-year-old foreign national woman brought in by a family member because of a possible fractured arm. Radiologic studies show a spiral fracture of the radius raising the suspicion of abuse as the etiology of the fracture. As you continue your evaluation of this patient, you begin to notice that she appears cautious and at times fearful of this family member. You’re not sure exactly what’s going on and initially consider domestic violence. However several things remind you of that lecture on human trafficking several months ago. You try to remember the various indicators of trafficking and what you are supposed to do if trafficking is suspected. You wonder if you should try to separate the family member from the patient and whether there is any danger to you and your staff. What if the family member refuses to leave? The more you think about it, the more you realize that you are not prepared to deal with the problem before you and find yourself feeling helpless and frustrated.

As greater numbers of health care professionals become educated about the issue of human trafficking, they are increasingly recognizing patients who might qualify as trafficking victims, but usually within a setting lacking advanced preparation, thus experiencing this frustration and sense of helplessness. 

The answer lies in the development of a response protocol designed specifically for possible human trafficking victims. All hospitals and large clinics should take the time and effort to develop their own response protocol for potential victims of trafficking just as they have already prepared protocols for victims of domestic violence, child abuse, and sexual assault. This will allow them to safely and effectively assist the human trafficking victims regularly coming into their facilities. Fortunately, there is a free toolkit online that describes in detail the steps necessary to develop a response protocol at: https://healtrafficking.org/linkagesresources/protocol-toolkit/

There are multiple factors that complicate our ability as health care professionals to assist these victims, including the issue of trauma bonding, associated criminal activity, and the real danger these victims and their families face. Safely navigating these hazards and difficulties requires advanced preparation and careful consultation with various experts in your location. These experts include those law enforcement officials in your city who focus on the crime of human trafficking, local child protective agencies that have a full understanding of child sex trafficking, and Homeland Security officials who understand and can assist foreign national victims of human trafficking. In addition, local non-profits that focus their efforts to assist victims of human trafficking are critical partners as you encounter the many varied nonmedical needs of these victims.

Perhaps you can be the champion within your health care facility that initiates and facilitates the development of a specialized response protocol for victims of human trafficking, so that you and other health care professionals in your organization don’t experience frustration and helplessness as you encounter these victims, but instead experience the fulfillment that your encounter has truly made a difference in the lives of these suffering victims.


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Resilience and the Missionary

Today we want to highlight a great resource from our annual conference - the audio version of the breakout sessions that are offered each year. These breakout sessions are FREE to members of MedicalMissions.com, and we hope you take advantage of going back and re-listening to your favorite sessions or catching some of the sessions that you missed.

The highlighted session for today deals with resilience. Drawing principles from psychological research and Christian scriptures, this workshop will explore factors of resilience for those working in high risk, high stress cross-cultural work. Listeners will discover what enhances resilience and what contributes to decreased coping. The workshop will introduce practical resources for responding to stress and trauma with resilience, grace, and perseverance.

We hope you enjoy this session!

https://www.medicalmissions.com/events/gmhc-2018/sessions/how-medical-missionaries-can-be-resilient-in-the-midst-of-trauma-and-stress-2

 


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