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The International Nursing Group is fortunate to have so many wonderful speakers and lecturers giving presentations throughout the year. This page is designed to inform all members on the valuable information contained in our past presentations.
This page also contains, "Reports from the Field" information and pictures by students who have traveled abroad and advice for those who hope to follow in their foot steps.
This summer, the Marcia L. Hoy Scholarship helped me fund my trip to Hong Kong, where I studied medical Cantonese. However, I ended up learning much more than just the language -- I learned such things as how Chinese medical beliefs are entwined in each and every meal, and how it's not only the U.S. who is failing to provide adequate health care to the poor and elderly. And the best travels are those that leave you wanting to learn more, which is exactly what this trip did.
Both my mother and stepfather are from Hong Kong, so I have a lot of extended family there. Before my trip, I already had a conversational ability in Cantonese, but I constantly found myself feeling like I knew almost nothing when I'd be at work in the hospital trying to talk to a patient. (How often do you talk to your mom about inserting a catheter?!) In fact, even my mom was sometimes at a loss for words when I'd ask her how to say something, because it had been 30 years since she immigrated and she had forgotten most of her less-commonly-used vocabulary. So I decided to go to Hong Kong and really focus on learning health care vocabulary.
I also learned a lot about how health care works in Hong Kong. It is incredibly common to blend Western and Chinese medicine, as was evidenced when my cousin got several flu-like symptoms: She first went to a Western medical doctor, where she was prescribed a big bag of antibiotics and other pills... And later that day she also went to a Chinese medicine doctor where she received herbs to make teas with. Most of my family doesn't think twice about the two systems of medicine they follow, partly because Chinese health care beliefs are so intertwined in the everyday. I couldn't finish a meal without hearing about how "hot" this or that food was, and why therefore so-and-so had such-and-such ailment. I have grown up immersed in the bits and pieces of Chinese medical beliefs that have passed down through the generations; but whenever I asked "why", I was answered with "because that's what my mom taught me." This just doesn't cut it for a girl who is taught evidence-based nursing! So my trip ended up triggering further studies into Chinese medicine. I'm currently wrapped up in books that finally make sense of why my mom didn't let me eat apples when I had a bloody nose, or why she insists on green tea after a heavy meal.
The scholarship was what really enabled me to get the most out of my Cantonese studies. Because I was in Hong Kong for a relatively short time (one month), because I was not a complete beginner, and because I had specific content I wanted to focus on, affordable group lessons weren't really an option. So the scholarship enabled me to have a private tutor at Berlitz, with whom I met for 1-2 hours a day, 6 days a week. I was very clear about how and what I wanted to learn. (Our meetings were conversation/scenario based, and she would write down the Romanization versions of the new vocabulary for me.) Of course, my general conversational ability also improved through my month of spending time with family and friends. And when I came back to SFGH where I work, suddenly it was so much easier to explain diabetes education and simple procedures to my patients.
Reading the newspaper in Hong Kong also exposed me to the state of health care for the elderly there. People would start lining up outside the public health clinics at 2am in order to be seen by a doctor that day. And for patients being managed for multiple chronic illnesses, that meant that they were doing the 2am wait several times a month. There was a lot of debate over health care reforms, some talking of privatizing the health care system, having family doctors be "gatekeepers" of the hospital system, etc. However, it didn't appear that the situation for the poor and elderly would improve, as seeing a private doctor would be prohibitively expensive.
In terms of my recommendations for other nurses interested in learning Cantonese . . . For an absolute beginner, I would actually recommend a place I had studied at when I first started learning Cantonese. Chinese University of Hong Kong (CUHK) has an excellent 3 month intensive program of 15 hours a week. CUHK professors have written most of the textbooks out there for learning Cantonese, and you get a really good base for differentiating tones and reading the Romanization of the words.
For students who already speak Cantonese, but are lacking in medical vocabulary, I would recommend individual tutoring. I met with instructors at several different language schools in Hong Kong, before committing to one school. After all, you will be spending a great deal of time with this person, so you want to make sure you enjoy their company and that they are flexible to meet your learning needs.
And for any nurse looking to better serve their Chinese patients, I would also recommend picking up a book on Chinese medicine. "East-West Healing" by May Loo is a good book about integrating Chinese and Western medicine. "The Complete Book of Chinese Health and Healing" by Daniel Reid is also very comprehensive.
This summer I had an amazing opportunity to travel to La Paz, Bolivia through the Child Family Health International. Their mission is to build and strengthen sustainable healthcare services for underserved communities worldwide. Although this non-profit organization has program sites all over the world, I chose the location in Bolivia because of its unique pediatric focus. I was also fortunate to receive funding from the Marcia Hoy scholarship, which covered about half the cost of the program.
My four-week trip, beginning on August 1st and ending on August 31st, consisted of volunteering at a local clinic, two pediatric hospitals, and several shelters for street children. I also enrolled in Spanish language classes that were included in the program. The clinic at Hospital Materno Infantil Los Andes served the indigenous community of El Alto. The population consisted primarily of Aymara and Quechua Indians. Some of the common problems I assessed were malnutrition, infection, syphilis (contracted from the mom during delivery), a variety of respiratory problems, and hip dysplasia.
Hospital Boliviano Holandes and Hospital del Nino were distinctly different medical facilities that offered a wide range of services to the children in El Alto and La Paz. I assessed and assisted with the treatment of patients with diarrhea, metabolic acidosis, and respiratory problems including bronchiolitis, bronchopneumonia, and asthma. I also assessed children with rare and debilitating conditions such as prune belly syndrome, cysticercosis, and Leishmania’s disease.
The children's shelters were founded by Alalay, an organization dedicated to removing children from the streets and providing them with a place to live along with consistent medical care. I volunteered at three shelters in La Paz and one in Santa Cruz de la Sierra, which provided a home for a total of 500 children and adolescence. I assisted the only medical doctor employed by this organization in providing primary care for the residents. Some of the conditions we saw were various respiratory infections as well as an outbreak of impetigo, which was exacerbated by the crowded living situations. In addition, many of the children presented with multiple and ongoing somatic complaints. Despite their illnesses and poor living environment, the children were energetic, happy, and eager to play. There was a cohesive "family" feel in each of the shelters and I felt privileged to be a part of it.
This experience as a whole was life altering. My scope of nursing has broadened to a degree that I did not believe was possible during a brief, albeit intense, 4 week period. I learned a great deal about the disparity of health related resources between countries and within. The disparity between health care professionals, specifically doctors and nurses, within the Bolivian hospitals and clinics is staggering. The hierarchical system within these facilities is omnipotent and an extension of the "machismo" culture. I learned that the country's political strife and the well being of the children are tied so closely together, they are almost inseparable.
As a health care provider, I learned the meaning of "conservation." Many of the exam rooms lacked basic necessities such as paper towels, antibacterial cleaners, gloves, and warm running water. Despite the lack of resources, we were able to perform our jobs by making the most out of the little we had. I also learned the importance of teaching preventative concepts such as eating all major food groups to prevent malnutrition and hand washing before eating and after going to the bathroom to prevent the spread of infection. In addition, it was essential to teach the value of prenatal care to protect the health of the mom and the baby, and appropriate swaddling techniques to prevent hip dysplasia. I took advantage of every opportunity to educate and consult even if I had to use hand gestures and exaggerated facial expressions to get my point across.
I would recommend this program for those who are interested in seeing as much as they can in a one month period. It was a great introduction to the country’s health care system, however I only spent one week at any given location. This program is also geared towards students, therefore there is an emphasis on "observation" rather than "hands-on" care. However, you can always jump in and provide more care if you feel comfortable. I was aware of this before I went and felt that this program was a good fit because I was a very new nurse and I had never volunteered in a third world country before. Although it may not necessary, it is highly beneficial to be familiar with the native language and customs before the trip. I would even suggest taking a course, at the very minimum, to learn medical terms. The more you are familiar with the language, the more rewarding and satisfying the experience will be. Lastly, I would also keep in mind that funding is available if you plan in advance and depending on the nature of the program, you may be able to use the experience for credit once you return.
I hope this summary was helpful and I wish you the best of luck!!!
--Laura Montafi
September 30, 2005
Revised: Nov. 2005
Contact:
intlnursinggroup@ucsf.edu
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