Wednesday, June 23, 2016

Today was definitely the most exhausting yet rewarding day of my internship here thus far.

In the morning, I led my second health education workshop or charla for a pregnant adolescent support group I recently started up at a local urban health post for girls aged fifteen to twenty years old. This time I worked with a new set of girls from two different residential regions in Masaya. The topic of the charla was diet and physical activity for pregnant women, and we went over what they should and should not do in order to maintain a healthy lifestyle while pregnant. I was extremely impressed by the level of engagement and interest of the participants this time. The workshop took on an interactive split lecture and discussion-based format, allowing me to present the informative PowerPoint I had previously prepared while still incorporating time for the women to discuss amongst themselves and ask the attending doctor and me several questions.

Though the room was dead silent when we first began, it was buzzing with conversation by the end. After discovering that none of the girls knew each other, I started off the workshop with introductions and an icebreaker game. I gave each girl a pink post-it note with an object or celebrity name to place on her forehead. With the help of verbal hints from the surrounding girls, a great deal of laughter, and many failed attempts, the girls finally each guessed their own word.

With a bit more cheer and energy in the air, I then began presenting my PowerPoint, starting it off by questioning them paying attention to one’s diet during pregnancy is important. I then asked them a couple of more questions to spark discussion, asking if any of them knew the recommended amount of weight they should expect to gain during the course of their pregnancy. No one could answer. After I told them they should expect to gain between 25-35 pounds over the course of their pregnancy – around 1-5 pounds during their first trimester, and about one pound per week during their second and third trimesters –, they were surprised and began started furiously taking notes in the little notebooks I provided them.

The charla covered many sub-topics, discussing what should be included in a well-balanced diet as well as emphasizing the specific vitamins and foods pregnant women need to prevent birth defects, ecclampsia, and delivery complications. The girls shared me what their typical meals – breakfast, lunch, and dinner – include, and we discussed ways slightly modify their way of eating in order to improve the health of themselves and their babies. We also discussed many of the foods and activities they should avoid to keep healthy, and they posed many questions to the doctor and me about things they had heard from family members and friends. One participant asked if it was okay for pregnant women to have a beer from time to time; she said that her family and friends always tell her that one beer would not hurt her. Another asked if it was recommended that they take a nine-hour airplane flight while pregnant. The doctor and I addressed these questions, and many more.

I was extremely pleased with the participation of the doctor all throughout the charla. He shared very valuable information with the girls, providing medical advice that I had not been aware of beforehand, and sharing some of his own experiences working with mothers with birth complications and babies with birth defects resultant from at-risk pregnancies. Since he is part of their community himself, he has observed many risky practices of pregnant women and was familiar with what local myths about pregnancies to address. He discussed how while locals may say eggs and beans are dangerous to eat during pregnancy, they actually are not and carry very important nutrients. He also brought up how it is very common here to see pregnant women riding horses or mounting motorcycles, and subsequently emphasized how both of these practices can be extremely dangerous. Something that I particularly liked was how he emphasized the importance of family planning for future pregnancies, throwing in information about how taking folic acid four months before you become pregnant can greatly reduce the risks of having a baby with birth defects.

All throughout the charla, the doctor interjected with advice and answers to the participants’ questions and was an amazing help. Though the original plan was for the charla to end after one hour, it continued for almost two hours because of the fantastic dynamic between the doctor and the patients. I hope to be able to leave this project in his hands for him to continue after I finish my internship.

I was also very happy with the girls’ interaction throughout the session. It was evident they were interested in learning this information by how they were taking meticulous notes and asking several fantastic questions. I enjoyed listening to them discuss practices they had seen in their community, and street myths about pregnancy diets that they themselves have heard or been told. One thing that both the doctor and I consistently underscored to the girls was how integral it is for them to take what they had learned that morning and spread it amongst their families, friends, neighbors, etc. From the interest and motivation I saw in the girls this morning, I have confidence that this group of girls will take what they learned today and use it in some manner or another to help themselves and others in their community.

The second half of my day consisted of working with the 33 female students in Chicas Poderosas, the new girls’ leadership club in the Modelo Monimbo secondary school that I helped start up a few weeks ago. The girls have been hard at work on an environmental health project. After participating in a week’s worth of my workshops, they have been subsequently discussing ways to make change in their community. They have decided to work on an educational campaign for primary school students to teach them about the dangers of littering and plastic as well as how to prevent the spread of Chikunguya, dengue, and Zika in their homes. We dedicated today to making the posters that they will use to present.

I was proud to see the girls working so hard on their posters- discussing ideas amongst themselves, sketching drafts in their notebooks, excitedly scavenging around outside for a few pieces of trash to place on their poster for demonstration pieces, and looking in their school workbooks for related images to cut-out. It was wonderful to see how the members within each group divided up tasks and worked together to create really wonderful posters.

 

 

 

 

 

What truly made my day was when one group brought up a draft of their poster that they had been working on as a team outside of school, in their free time! I brought out the posters for the girls last week during our Tuesday workshop, but unfortunately we were not able to get to work on them until today. I thought I collected back all of the posters, but I must have missed one. Unbeknownst to me, a few girls took this poster with them, and worked on sketching these beautifully detailed to illustrate what actions people should take in their daily lives to avoid getting mosquito-transmitted diseases like dengue, Chikunguya, and Zika. The final product was lovely and made me very proud.

With the passing of every session, I am more and more impressed to see how these girls and the patients I saw in the morning are exercising leadership over their projects and the material they are learning and demonstrating genuine motivation and interest in helping their community. These girls are my inspiration, and the reason why I absolutely love my work here!