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“We are better together”

Global Health Research Team at PSC

Dr. Kate Trout, Nicole McMann, Jessenia Hincapie, Destiny Soto

CREAR public health project in collaboration with Peru State College

Preparing for the trip and leaving Peru, Nebraska

Traveling to Samara

Prior to arriving in Samara, we had worked with CREAR over the past 6 months to design a public health project regarding important community needs and the impact of dengue in Samara. Andrea, the executive director, was extraordinary to work with and helped to identify important community needs. Three years earlier, Dr. Trout had travelled to Samara to meet Andrea, and had seen the influential work that happens at CREAR for Samara and the surrounding communities. Andrea diligently helped us to design a project that focused on two areas: (1) the impact of sugary foods on children’s health outcomes, and (2) factors that impact the incidence of dengue in the community. We worked together to design a demonstration for children outlining the impact of foods with high amounts of refined sugars, and developed a multi-dimensional survey to capture important community needs. Over the months leading up to the trip, we dug into the scientific literature and packed our bags with study materials, instruments to measure health parameters, and art and educational supplies to donate to CREAR, the community, and Samara Pacific School.

On March 6th, we started our journey and left Peru State College’s campus to travel roughly 3,000 miles to a small beach community located in Costa Rica. Two flights later, we landed in Liberia, Costa Rica at 10:30 pm. The first difference we noticed was the beautiful weather. The day we left the high for that day was 26 degrees F (with snow) in Nebraska, and when we stepped off the plane, we were immersed in the humid air of Costa Rica that was about 80 degrees F. The next morning, we set out for Samara.

The two-hour drive from Liberia to Samara had lovely scenery. Our house that we stayed at was beautiful, and iguanas and monkeys would frequently greet us over breakfast. Samara’s beaches were breath-taking. After getting to know Lucy from Asociación CREAR, engaging in activities with the community, and gazing at ocean views, Samara truly did feel like it embodied “Pura Vida.”

Our beautiful walk with our supplies on the way to work with CREAR


Density of Oil and Water Experiment

Day 1: Asociación CREAR

On the day we arrived to Samara, we finally met Lucy from Asociacion CREAR. We were very excited to meet her in-person after many months of preparation. She helped us get settled into our temporary home. On our walk to their new office location, we enjoyed the splendid view of the ocean. Lucy gave us a presentation about how Asociacion CREAR started, the work of the organization, and how far along it has come since the beginning. It was truly great to see that CREAR has their own space, and the progress that they have made in such a short period of time.

After Lucy's presentation, the children started their language lessons as part CREAR’s after school program. CREAR’s after school program is vital to try to extend children’s education hours in order to build stronger skills to enter the workforce and pursue further education. Alongside their afterschool program, we got our supplies ready to do a health and science demonstration. We started by doing chromatography butterflies, where the children were able to learn how capillary action works. Children also go the opportunity to look at feathers, bone, and blood cells through a microscope.

Next, we did a session about density of oil and water with discussion of the composition of cell membranes, and the importance of hydrating our bodies. We finished off with a coloring/activities sheet as a whole class that focused on water, sanitation, and hygiene. The kids were very enthusiastic and friendly, and we had a wonderful time with them. The smiles on their faces were truly priceless, and you can tell that the work done at CREAR will have a life-long impact on their life.

Children engaging in their English lessons at CREAR

Day 2: Visit with EBAIS (health clinic) employees

On day two, we visited the EBAIS (health clinic) employees with Beatrice from CREAR to see what major challenges they face in serving the population. We witnessed the dedication of the healthcare professionals at the clinic, and we were amazed of how they operate with such limited resources on a daily basis. Just to deliver basic care to the most remote populations, they may ride a motor bike as far as they can, and then ride a horse to reach the most remote residence. You can imagine how difficult it is to deliver basic care and preventative healthcare to these populations, let alone critical care in time medical emergencies. They currently do not have an ambulance. It’s our job to try to identify these real operational challenges in healthcare delivery, and try to help find solutions to at least minimize them.

Sugar demonstration during Matapalo Health Clinic

Day 3: Matapalo Health Clinic

On Saturday morning, we got up early and walked the beach to the location of the first public health clinic and to collect our first round of community surveys. We started to set-up our health stations, but we did not prepare for having the clinic at a sandy soccer field. We had to get innovative and think on our toes! We found a use for a nearby broken piece of a surfboard that created a flat surface for the scale, got our stations set-up in the shade, and we were ready to go!

Adults and children from the community came to the health clinic, and many went to get their family members for check-ups. We took their health parameters and provided tailored health education, including height, weight, BMI, blood sugar, blood pressure, and pulse oxygen levels. With Lucy’s help, we set up a display with various treats and drinks to show the sugar content, and did activities with the children. Everyone that saw the sugar display was shocked by how much added sugar is in products, especially the Fanta. It was a great way of putting the sugar content into context in an interactive activity. We finished by enjoying a colorful display of fruita!! The interactions we had with community members were positive and the children who stopped by the health clinic were excited to learn. We wish that we could have stayed longer to serve more community members!

Free health clinic in the community of Matapalo

Day 4: Health Clinic in El Torito

On day 4 we went to the community of El Torito to collect the next round of surveys, and had our second public health clinic at their community center. Like the local population, we utilize public transportation. When we arrived, we set up a coloring station for the many families who brought their children; although, to our surprise, numerous kids took much interest in the blood pressure and BMI stations. The children of El Torito were equally enthusiastic about sugar display. Many kids, and even parents, were shocked at the amount of sugar they consume on a daily basis, and thought twice about what they put into their bodies. It was a great learning experience, not only for the parents and children, but also for our team. We hope that the sugar display can help decrease to the incidence of diabetes in the community, along with future awareness activities. The Caja Costarricense de Seguro Social is concerned with the rising percentage of undiagnosed people living with diabetes, and the complication that arise from the lack of care. An analysis of community needs will be conducted using the surveys, and the results will be shared with CREAR and the community. We hope to use this information for future public health activities with the team at CREAR.

Day 5: La Escuela

On our last day in Samara, we spent the morning at an elementary school in the area called Samara Pacific School. Many of the older students were astounded by the amounts of sugar in their foods. After the display, we overheard students reading their food labels during snack time, and discussing the amounts of sugar in their foods and drinks. Education is empowering! We also conducted a few experiments, such as the water and oil density experiment and the watercolor butterflies. The younger children enjoyed the hands-on learning demonstrations, and the microscope station- they were inquisitive to have a closer look at the natural world. The students were very smart and intuitive, with credit also given to the immense contributions from their teachers. They drew what they saw in the microscope (like true biologist), learned basic cell biology, and got experience using a microscope. We focused on physical health, and taught the children how to find their pulse, how to count their heart rate, and educated about healthy ranges. We demonstrated fluctuations in their heart rate by doing jumping-jacks, running in place, and jump roping. Overall, the students thoroughly enjoyed the activities, and so did we!

The students of Samara Pacific School

We finished the trip by taking a one-day excursion to the Monteverde Cloud Forest Biological Reserve. Peru State College students got to further explore one of the most biodiversity places on the planet.

“Any success in global health is measured by the commitment of your collaborators and the community. To everyone at CREAR and the community, we appreciate the work and dedication that you do to improve Samara and the surrounding communities every day. Thank you for being so welcoming, and we look forward to working with the community in the future!”

From the Global Health Research Team at PSC

Dr. Kate Trout, Nicole McMann, Jessenia Hincapie, Destiny Soto

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