prevention, detection, and diagnosis: addressing tuberculosis and leishmaniasis

One of the many things that makes the UAC-CP unique is its emphasis on practical learning. Students in all five major areas of study at the College are required to participate in extension activities that not only provide applicable professional experiences, but also offer important services to marginalized populations.

Third semester UAC-CP Nursing students and Public Health Program Coordinator Angelica Quisbert.

One example of this focus on social service extension activities is a new public health project launched this year in the Nursing Department. “Prevention, Detection, and Diagnosis: Addressing Tuberculosis and Leishmaniasis in Yungas, Bolivia” responds to the needs of people infected with or at risk of being infected with leishmaniasis and tuberculosis. Both leishmaniasis and tuberculosis are relatively common and potentially fatal diseases within the College’s service area.* In addition to preventing and diagnosing the diseases, the project also serves as a model for other regional public health centers and provides UAC-CP Nursing students with practical experience as public health educators.

For the first semester of 2013, 25 students from the UAC-CP Nursing Department worked to implement the first phase of the project, which included a comprehensive public health survey of households in 14 communities, two K-12 schools, and the College (a population of approximately 3,500 people).

Before they could implement the survey, all third semester Nursing students participated in multiple training sessions that covered topics such as: introduction to tuberculosis, leishmaniasis, dengue, and chagas disease; identification of symptoms of leishmaniasis and tuberculosis, collection of sputum samples, surveying, social interaction, etc.

Once they were trained and organized logistically, they went out in groups of two to visit communities and do an “active search” of people with tuberculosis and leishmaniasis. In order to find people at home before they left to work in their fields, students had to start walking at 5am in the morning. (The farthest community was located three hours away.) “With a hand drawn map we walked on narrow trails through what you could call the forest to visit people house by house,” said third semester Nursing student Beto David Mamani.

A UAC-CP Nursing student talks to a local family about proper waste management.

At each household, students gathered information for the public health survey, looked for people with potential signs of tuberculosis and leishmaniasis, took samples of people with obvious symptoms of the diseases, and provided educational talks to promote healthy lifestyles, including ways to prevent and treat tuberculosis and lesihmaniasis.  “Our job is to not only diagnose people, but to educate them and advise them,” Beto said. The students are often the only medical professionals for miles around.

In addition to identifying cases of tuberculosis and leishmaniasis and helping people get the proper treatment, Nursing students also attended to special medical emergencies. “We’ve seen some pretty bad things,” Beto said recalling one particular situation in which students treated a little girl suffering from a dog bite on her face. “The family hadn’t taken the girl to the hospital, so we treated her. We walked to their home three mornings in a row to help the girl’s parents clean the wound and make sure it wasn’t infected,” Beto said. Grateful for their help, the family “paid” Beto and his classmate with bags of homegrown fruit.

Students told me that they were well received by community members. “It was really cool,” said Nursing student Roger Tapia. “We would stay and converse with community members for a long while. Often they would invite us to eat breakfast with them.” Beto agreed. “It has been a beautiful experience to work with the community members.”

The next steps for the project include expanding the active search and public health survey to include other communities within the Municipality of Coroico. Project coordinator Angelica Quisbert said she also wants students to stat processing the samples, rather than sending them to the Coroico Hospital for diagnosis. In order to do that, the College needs a better laboratory with more sophisticated equipment. “I want our students to leave [the UAC-CP] with the experience of working in a lab and processing samples.” If UAC-CP students will be working in understaffed rural clinics some day, they need to have multiple skill sets.  Currently, the only obstacles to growing the program are financial limitations.

Roger said he is grateful to everyone who has made a financial contribution to make this project a reality.  "There are many people in my country who need health care assistance" he said, "and that’s why I’m proud to be part of a project that is making a real difference for people. If we all just give a little, together we can make a big difference. In just five months we are already seeing positive results of our work. Thanks to this project, we are helping to prevent disease and, in some cases, death.”