Nursing students help underserved in Peru

First-ever school-sponsored outreach trip gives nursing students study abroad experience

By California State University, Bakersfield

September 1^st, 2022

When nursing student Leslie Lopez-Mendoza signed up for a nursing outreach trip to Peru, she didn’t know what exactly she had gotten herself into. Not only would it be her first time using her newly acquired nursing skills outside of the clinical setting, but the trip was also the first-ever study abroad opportunity for California State University, Bakersfield’s nursing students. With no peers who had previously gone on the trip to ask what it would be like, her decision to go was an act of faith.

“I really didn’t know what to expect; I knew we were going to go and help the community, but I just wasn’t sure exactly how,” said Lopez-Mendoza, a senior. “I was in between going or not, and I just decided to go because I was like, ‘Why not, it’s not going to hurt.’ But I’m just so happy I did decide to go. It was one of the best experiences of my life.”

In early July, 21 CSUB nursing students and their professor traveled to Cuzco, Peru for a 10-day trip focused on providing health services to those in the town and its outlying communities. At each location, students would admit patients, conduct screenings for blood pressure and glucose levels, give head-to-toe assessments, administer a fluoride dental treatment and work with a doctor onsite to get them started on any necessary medications.

“When we’re here in town and in the hospital, everything is so driven by computerized charting and making sure that they are following all the policies and procedures, and I think so much of caring for the patient gets lost in that shuffle,” said nursing professor Krystal Ball, who organized the trip. “When you’re doing outreach, it’s just about you and the patient and what you’re providing for them. It’s a very powerful situation where they really can key into what drives their passion to want to be a nurse.”

Nursing students don’t really have the time to do traditional study abroad programs, Ball explained, because the program requires that all nursing classes are taken on campus and in a certain order. But she knew the impact an experience like this could have on students, so she worked with Dean Mark Novak in Extended Education and Global Outreach and Yuri Sakamaki from the CSUB study abroad office to make a school-sponsored outreach trip a reality. They connected her with Maximo Nivel, a study abroad organization based in Peru.

“I think traveling out of our country is important for every single person but especially health care providers,” Ball said. “It’s important for them to understand and be appreciative of what we have in this country and focus on health care disparities and how to help them, which is really important here in town as well."

Myka Norton listens to a patient's lungs.

Gabriel Rodriguez does a blood sugar finger stick.

Jaspinder (Jesse) Khaira and Gabriel Rodriguez

Leslie Lopez-Mendoza and Annika Gonzalez pose with dental education for the kids.

Professor Krystal Ball and student Jourdan Thompson

All 21 students stayed in a four-story house with a host family, along with Ball and consulting nurse Kristi Libby. Living quarters were a bit cozy, and warm water for showers didn’t last long with such a large group, but the students didn’t mind; they were there to help, and eager to do so.

For the first four days, the group would go to a different part of the region to provide health services. The lines of patients were long, with many walking several hours to get there. As the students learned, the nearest hospital in these communities was hours away and even basic check-ups were rare for the residents.

“When I learned about that, I was so surprised,” said Ravnit Sran, a nursing student in his junior year. “On our first day, people actually came from faraway places just to be seen for a little bit of medication. They were so appreciative.”

While many Peruvians speak Spanish, some speak the traditional language of the Incans of Quechua, so even students who spoke Spanish had to learn how to give care in a language they don’t speak. Lopez-Mendoza recalled a time she was struggling to talk with a patient who spoke Quechua when a woman waiting in line to be treated came up to help her translate.

“That really stuck with me,” Lopez-Mendoza said. “They’re there to get help and they’re helping us as well. That community is really tight-knit, and they’re so grateful for the services we were providing. Although it may not be a lot for us, it was a lot for them.”

From their host house, the students had to travel anywhere from 20 minutes to 3 hours each way to get to the neighboring communities. The roads were bumpy, and Lopez-Mendoza was one of a handful in the group who would get motion sickness from the journey.

“The people made the trip worth it,” she said. “Once I got there, I was just ready to go ahead and help, all that sickness was just gone. They’re really, really great people.”

Though they enjoyed the experience of helping people in need, students faced a culture shock upon realizing the disparity in health care. At the end of each long day, they would take time to go over what they had seen and how to make sense of it.

“It’s very important to do debriefing because they are going to see things that are very impactful that they don’t know what to do with,” Ball explained. “It’s different knowing there are poor people versus seeing and interacting with poor people.”

Even in America, nurses will see a similar disparity in health care among certain communities, so grasping the importance of culturally competent care was just as vital a part of the trip as getting practical experience was.

“I feel like this experience will impact my nursing career because this trip really made me become even more of an advocate for patients,” Lopez-Mendoza said. “This brought out a side of me I didn’t really know I had. I’m usually a little quiet, but there I had to use my voice and speak up and make sure that patients are getting appropriate care.”

For Sran, the experience was essential in confirming he was on the right career path.

“I just went into nursing because everyone was doing it and my family was kind of pushing me,” Sran said. “But now after seeing that, all the difference we made doing little things like giving them vitamins or checking their temperature, I definitely want to do this. Now I have a purpose of what I want to do and what kind of nurse I want to be.”

Jaipreen Kahlon checks pharmacy prescriptions.

Sarah Prounh, Jaipreen Kahlon, Arianna Flores and Samantha Parks

Sarah Prounh and Jaipreen Kahlon fill bags with vitamins for patients.

Daisy Carillo listens to her patient's lungs.

Maximo Nivel staff plus Justin Rodriguez, Jovenrey Arcangel, Kira Swope, Nurse consultant Kristy Libby, Megan Koenig, Samantha Parks, Sarah Prounh, Daisy Carillo, Jaipreen Kahlon, Arianna Flores and Ravnit (Ravi) Sran

The group set a goal of seeing 500 patients and ended up exceeding, with a final count of 509. As a reward for their hard work, students got a few days off to take in the sights of Peru. On their first day, they toured the town of Cuzco, learning about its history and seeing its markets and town square. After their outreach work was done, the group spent the remainder of their trip visiting Rainbow Mountain, Sacred Valley and Machu Pichu. They also enjoyed food like alpaca burgers, guinea pig and Chicha Morada, a purple corn drink.

“I’m very proud of the students who did this inaugural trip,” Ball said. “They really represented CSUB well and our nursing department well. I couldn’t have asked for a better first trip and a better first group. They’re excited to share with the other students to encourage the other group to go next year.”

Lopez-Mendoza and Sran said they would both recommend the trip to students thinking about going in the future.

“It takes you out of your comfort zone,” Lopez-Mendoza said. “I would do it all over again. You’re meeting new people and learning new things, and it’s fun. You’re not bored, you’re always busy, and it’s really an amazing experience. We’re just nursing students so there’s only so much we can do, but we did a lot.”

To support future trips, the nursing department created the Global Nursing Outreach Fund to accept donations. The first trip was paid for in part by grants from the California Department of Health Care Access and Information, some of the $6-million funding secured by Assemblymember Rudy Salas and private donations, but the department would like to establish a robust fund so they don’t have to rely on grants in the future.

“The goal is to make our nurses who we’re graduating, most of whom stay in town, better at providing care for our community’s patients,” Ball said. “It’s important for students to see cultures other than their own.”

To support future outreach trips, visit the NSME donation page and select "Nursing Student Global Outreach Fund" in the "I want to support" drop-down menu. The next nursing outreach trip is scheduled for June to Guatemala.