GLOBAL HEALTH perspectives allow students to witness how health disparities affect various patient populations. Participating in a health service immersion trip allows students to make a difference while experiencing a new culture firsthand. Studies have found that these experiences can boost students' confidence, self-awareness, cultural competency, and self-efficacy when caring for patients from another culture.1 Health service immersion trips have also been found to help students gain a better understanding and respect for the availability of food and other resources that can lead to cultural norms and traditions.2

Implementing active learning through study abroad and service learning experiences encourages student action and improves cultural awareness and self-reflection as an effective way to address global healthcare concepts in nursing education.3,4 This article explores the cultural competency benefits of a credit-bearing community health educational experience in Peru run through collaborative efforts of The College at Brockport and Sacred Valley Health.

Program specifics

Sacred Valley Health (SVH) is a not-for-profit, nongovernmental, health promotion organization located in Ollantaytambo, Peru. This organization was established in 2012 to create a sustainable health promotion program that partners with community representatives to enhance the overall well-being of the local underserved population. The organization has many community health initiatives involving students from multiple disciplines and geographic locations.

The credit-bearing, educational service trip to Peru provides many opportunities for students to enjoy the immersion experience through host families, volunteer work, structured and nonstructured Spanish classes, and excursions. Students attend a pretrip orientation meeting, where they provide course instructors with information about emergency contacts and pertinent medical conditions, including allergies.

The students are paired with host families who allow them to experience the everyday life of residents in the Peruvian village. In the past, some students had the opportunity to participate in traditional Peruvian celebrations, such as weddings and baptisms, or attend annual cultural events, such as the Choquekillka festivities that occur each May.

Students from The College at Brockport and many nearby colleges and universities apply to take this course. Although most participants are students with a healthcare-related major, a range of other college majors are represented, including political science, biology, performing arts, and math. The diversity of disciplines provides a variety of perspectives and prompts many enriching discussions among group members.

Volunteer experience

During the immersion trip, students spend most of their time volunteering alongside long-term SVH volunteers, who are involved in many ongoing health promotion campaigns. Students also work closely with elected local community health liaisons as part of the Promotoras program. Both partnerships teach students how to deliver healthcare services and healthcare education to residents of rural communities.

The health campaigns take up most of each day, as they're held in rural mountain villages accessible only by narrow dirt roads. Large vans and cattle trucks are used for transportation to and from the remote villages.

Each day starts in the very early morning. Students are prepared with educational posters and a bagged lunch provided by their host families. The students and SVH volunteers hold classes in a school yard, community center, or any flat spot along the dirt road outside of town.

The students develop lesson plans that are used to educate residents of rural villages in the Andes Mountains during clinical days. The students provide information on basic health promotion activities such as hand hygiene, oral hygiene, proper nutrition, and anemia screening during these health initiatives.

The greater challenge for the students is communicating all written and verbal instructions in Spanish. Community members serve as Spanish teachers for the students, which benefits the local community as well as the students by enhancing the exchange of knowledge. Dealing with the language barrier helps nursing students appreciate how a patient experiencing a language barrier in the United States may feel when trying to communicate or learn new information, and it forces them to employ their teaching strategies to overcome this barrier. The students also collaborated with local translators to disseminate their projects in the communities that speak the indigenous language of Quechua.

In addition, each student is responsible for learning about all clinical topics being taught on that campaign. Students rotate clinical stations and support their peers in teaching the programs they developed for the health promotions.

Reflection

Throughout the trip, students were asked to submit reflective journal entries regarding their experiences. Some of the questions they were to consider after the first few days of their visit were as follows.

* What were some of the biggest cultural differences you had to adapt to? Did you find them easy or difficult to adapt to, and why?

* Since meeting your host family, what observations have you made regarding the people of this community?

After the first few community campaigns, the students reflected on the following questions:

* What feelings did you experience meeting the people of these communities?

* What obstacles did you observe to their ability to receive adequate healthcare?

And, just before leaving Peru, the students were asked:

* How has this experience impacted your life?

* How has it impacted your goals for the future?

* How has it impacted your view of nursing as a profession?

All the students reported that the trip was life-changing and that their experiences gave them a broader perspective and deeper appreciation of the Peruvian culture.

Get involved

Overall, student participants in this immersion experience are moved by what they accomplish in such a short period. Some say the experience renews their desire to be nurses.

If you can't participate in a global health experience, try engaging in some cultural immersions a little closer to home. For example, many nursing departments sponsor BP screening events in many different populations that are located only a few hours away, but offer patient diversity. Our recommendation is to spread your wings and immerse yourself in another culture, even if it's only 100 miles away. You don't have to go halfway around the world to become involved.

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