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Thinking Upstream: Study abroad program gives student nurse a better understanding of public health

Posted: March 13, 2017

"Sign on a wall in Santa Inez: “With vaccines, health and love,
we face life better."

Cecilia (right) with Dulce, a Oaxaca nurse

Group of high school students who worked with Cecilia
(second from right) on a mental health project

Cecilia (right) and her host family

Cecilia Lopez, a senior in The University of Texas at Austin School of Nursing, thought she had a fairly good grasp on how difficult it can be for under-insured and uninsured people to obtain health care in Central Texas. Then she took a study abroad trip to Oaxaca, Mexico, and learned that because of the poverty in the region, many people are unable to get any health care, good or otherwise.

“Every day, I saw the long lines of people snaking out of the public hospital. It really opened my eyes to how much science and hard work needs to go into making a difference in an area like that,” she said. “The nurses in Oaxaca are so careful with medication, making sure to rewrap and save the leftovers so they don’t run out. They still use mercury thermometers, and the hospital rooms are small and completely filled with beds.”

Cecilia was the only nursing student out of twenty UT Austin students, mostly social work and pre-med, who spent six weeks in this vibrant town in southern Mexico, learning about the health care system and getting hands-on opportunities in hospitals and clinics. Brochures describe Oaxaca as “enriched by many indigenous cultures, traditions and history,” and so it is. But alongside the cultural vibrancy are high rates of poverty and poor health care resources. In addition to poverty, racism, gender inequality, and AIDS-related stigmas contribute to barriers to health care access for many in the area.

“What’s needed is more upstream thinking,” she said. “People need to be able to access health care early on when treatment could keep their disease from progressing. For instance, diabetes cases don’t have to progress to amputation cases if treated in a timely way, but in underserved areas they often do. Fixing the problem will require schools, government and health care providers to come together and make changes.”

It’s a topic Cecilia thinks about a lot. As an honors program student, she is researching health disparities for underserved populations and barriers to mental health utilization among depressed minority adolescents. She soon found that in Oaxaca, with its many serious health care issues, mental health isn’t a topic that most of the population have time to think about.

Nevertheless, she discussed it with a group of high school students and asked them to think about what healthy mental health looks like. The students were inspired to take photos of people and places that illustrated sound mental health, and at the end of the six weeks, they presented their photographs at Centro De Esperanza Infantil, a center where students ages 6 to 18 can go after school to receive tutoring, computer classes and a meal. The entire study abroad group attended along with students of the Centro.

“They did a great job and didn’t need my help during the presentation,” Cecilia said. “Our group consisted of two high school freshmen and two seniors. It made me so happy at the end of the project when they told the audience that this presentation made them much more aware of the importance of mental health and that they feel much more comfortable with the topic.”

Back at home, Cecilia is determined to use her newly acquired public health knowledge to give equal care to everyone she treats, regardless of race or ethnicity.

“I came back with a fire to do something. Health disparities occur in the U.S., too, and it’s important for nurses to always treat everyone fairly,” she said. “To do this requires looking at the bigger picture and coming up with ways to bridge the gaps.”


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