Fourth year RSO student Raelyn Ottenbreit evaluates patients in Oaxaca, Mexico.

Fourth year RSO student Raelyn Ottenbreit evaluates patients in Oaxaca, Mexico.

By Brance Arnold ’10 MA

One morning in Oaxaca, Mexico, Raelyn Ottenbreit felt overwhelmed while standing outside gazing upon the lineup of patients waiting to be evaluated.

“A lady standing in line came over to me, said many things in Spanish that I did not understand followed by a very heartfelt ‘muchas gracias’ and gave me a long hug and a kiss,” said the fourth year Rosenberg School of Optometry (RSO) student. “We hadn’t even done anything yet.”

Ottenbreit’s experience that day stands as one of many opportunities UIW’s health professional programs provide students for international immersion and engagement; these experiences have a profound and lasting impact, echoing the values of the Sisters of Charity of the Incarnate Word for social justice and human compassion on a global scale.

Many of these opportunities are interprofessional in nature; they involve students and faculty across several of the university’s health care disciplines.

In fact, Ottenbreit’s experience was as part of Los Quijotes Ambassadors of Health’s 2014 annual medical mission trip. Los Quijotes is a team of CHRISTUS Santa Rosa personnel who travel to Oaxaca yearly to provide care. This year, five RSO students, two Feik School of Pharmacy (FSOP) faculty members, and a student from the Honors Program participated.

Dr. Tina Lopez, director of FSOP’s Drug Information Center, who helped organize the trips, said this year over 35 physicians, nurses, pharmacists, physical therapists, psychologists, computer technicians, and friends traveled from the U.S. to Oaxaca to help the underserved community. Though not all of the medications made it through customs, the pharmacy dispensed between 400-600 prescriptions and the optometry team evaluated 150-250 people per day.

“We (UIWRSO) have participated in the medical mission trip to Oaxaca for the last three years,” said Dr. Russell Coates, clinical assistant professor of optometry. “The interns reported that the trip was extremely beneficial to their education, all returning with increased confidence in their optometric skills.”

“This opportunity allows the UIW students to learn and practice in ways that could not be taught in a classroom,” said Lopez.

Lopez said local pharmacist with Carvajal Pharmacy, Jim Stultz, has organized the medications and pharmacy for over 20 years and Dr. Cynthia Nguyen, Carolina Zertuche, and Cynthia Koger served as invaluable members of the pharmacy team.

Tin Nguyen, an Honors Program junior studying biochemistry and religious studies, recalled one of his first encounters with an Oaxaca native was a blind elderly, who fervidly shared with him that he had been waiting every year for this moment of care and referred to the group as “angels.”

Nguyen said that in addition to providing health services, the participants had a chance to travel to many beautiful sites in the area such as Mitla, the local market, and others, as well as taste exotic, authentic cuisine.

Nursing and pharmacy students and faculty members pose at the Great Wall of China in Summer 2012.

Nursing and pharmacy students and faculty members pose at the Great Wall of China in Summer 2012.

Another opportunity, where students learn firsthand about the health care and culture of other countries while fostering interdepartmental collaboration, grew out of Dr. Irene Gilliland’s Fulbright Scholar experience in China.

Gilliland, assistant professor of nursing, said initially the trips included just Ila Faye Miller School of Nursing and Health Professions students, but she reached out to pharmacy three years ago for their interest. The faculty-led summer trips have included China, India, Africa, and recently Ecuador and the Galapagos Islands.

“I have been doing these trips since 2004,” shared Gilliland. “About 150 students have participated over the years; our last trip to China had 35 travelers.”

Dr. Russell Attridge, an assistant professor of pharmacy who has also been involved in the trips, said students take an elective course in the spring to prepare for the trip with a focus on cultural traditions, educational systems, political/social happenings, and health care practices.

“These are health care related students who need to be open to the cultural preferences of patients,” said Gilliland. “We visit schools of nursing and pharmacy to see how professionals are trained in that country. We visit hospitals and, depending on the country, the traditional healing places.”

But the students also learn about the industry of the country, for example, by visiting a silk factory in China or observing how gems are cut in India. Each trip involves moving from place to place to get a flavor of the country. In Africa and India at least two safari days are included and in the Galapagos they live on a boat for five days. Students get to ride local transportation such as a high-speed train, camel, elephant, and even a canoe in the Rain Forest. And of course they visit museums and famous landmarks such as the Great Wall and Taj Mahal.

“In the Amazon, we traveled by boat, visited the indigenous people who actually had huts on the edge of the forest, and even witnessed a shaman performing a cleansing ritual,” said fourth year pharmacy student Rebeca Jimenez.

Nursing senior Emily Wortham said traveling to Ecuador and Galapagos provided an interesting perspective in seeing how the health care system works.

“Being a nurse you see a lot of different cultures and you have to tailor their care depending on where the patient is coming from,” said Wortham.

Attridge stressed the collaboration between nursing and pharmacy will help enhance communication for these future pharmacists and nurses when communicating with other professions, which translates to improved patient care.

FSOP P4 student John Chen (center) shares a photo  with Prati-Donaduzzi’s  quality assurance team  in Brazil.

FSOP P4 student John Chen (center) shares a photo
with Prati-Donaduzzi’s
quality assurance team
in Brazil.

An externship program centering on Pharmaceutical industry, is FSOP’s partnership with Brazilian pharmaceutical company Prati-Donaduzzi and Brazilian university Pontificia Universidade Catolica do Parana (PUC-PR).

Since August 2013, the program has provided for four fourth year (P4) FSOP students to travel each fall and spring semester to Brazil for an experiential pharmacy education on regulatory affairs involving the Food and Drug Administration (FDA) and the Brazilian regulatory agency, Agência Nacional de Vigilância Sanitária (ANVISA).

Dr. Marcos Oliveira, coordinator for Pharmacy Latin American Activities and associate professor of pharmaceutical sciences who has been instrumental in establishing and developing the program, said the students engage in a joint course on FDA and ANVISA affairs, followed by a specific project. Upon completion, the students provide a written and oral presentation both at Prati-Donaduzzi and UIW.

For example, P4 student Brian Coffee developed an application to monitor manufacturing processes for a new regulatory facility in Brazil and P4 student John Chen created a brief but accurate and practical regulatory checklist for Prati-Donaduzzi to be used by Prati’s auditors, ensuring manufacturing compliance.

“Pharmacists absolutely have an integral role in the industrial side of pharmacy in the U.S. and it is beneficial to have experience in this area,” said Chen.

In January 2014, four PUC-PR students visited FSOP with a focus on clinical pharmacy where H-E-B helped provide training. Oliveira said FSOP hopes to attract more Brazilian students to participate in the externship program in the future.

And now, the program will include UIW students from other disciplines. Prati-Donaduzzi seeks to involve two pharmacy students, a business student, and a School of Mathematics, Science and Engineering or media and design student, such as computer information systems, said Oliveira.

Overall, Oliveira said the program seeks to achieve “incremental innovation,” small changes that make a real difference in improving patients’ quality of life.

Nursing, pharmacy and optometry are not the only programs providing international opportunities. UIW’s School of Physical Therapy has a fourth year Doctor of Physical Therapy (DPT) student, Katlyn Hannan, on a six week mission trip in Guatemala working with Adonai International Ministries, a medical-aviation ministry whose focus is to serve the Quiché Indians of Guatemala, and DOCS For Hope, a group of seven family medicine doctors, trained in obstetrics, who provide care in the U.S. and abroad. Dr. Susan Smith, assistant professor of physical therapy, and another fourth year DPT student will be joining Hannan for two weeks.

“Providing physical therapy care to the children in the villages in Guatemala has been a known need for a long time,” said Hannan. “I chose this experience because I hoped to help in the creation of a new program to meet the needs of the people and return them to their optimal function in order to be functioning members in their society.”

The PT school also has a student fulfilling a fulltime clinical experience for nine weeks in Italy with Eduglobal Associates at Istituto Prosperius Tiberino, a 111-bed rehab hospital with both ortho and neuro inpatients as well as an outpatient service; and two fourth year DPT students serving as teacher assistants in SRH University Heidelberg in Germany’s baccalaureate physical therapy program for 10 weeks.

Dr. Chad Jackson, assistant professor of physical therapy and director of Professional Practice Education, said the students will go into full-time clinical opportunities at the completion of their time abroad in order to complete their 14 week professional practice experience.

Jackson explained PT will continue to work with UIW’s Ettling Center for Civic Leadership for the development of international opportunities.

“I believe international experiences provide a deeper understanding of global health care along with the needs and disparities,” said Jackson. “Students are demonstrating the Mission or living the Mission in action but from an educational standpoint.”