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Introduction
• A group of students from Yale School of
Nursing and Yale School of Public Health
visited Isla de Mendez, El Salvador from
March 6th‐March 14th, 2009 to contribute to
public health efforts in the village.
Our Activities of the Week
• Health Fairs
• Reproductive health sessions
• Nutrition, hand‐washing, and dental health
education in the public school
• Respiratory Health Survey
• Other activities
Health Fairs
• Held 3 Health Fairs covering
parishes of the 5 churches of
Isla
• Objectives:
– To thank the community for
hosting us
– Educate and inspire children
and adults about sanitation,
hygiene, nutrition
– Encourage stewardship of land
and health
– To provide hypertension
Screenings
Our Program
• Introduction and
welcoming address
• Skits, songs, hand‐
washing demonstrations,
and calesthenic exercise
routines with children and
adults
• Hypertension screenings
of adults conducted by
nursing and medical
students
Outcomes
• Over 250 people, both
young and old, in total
attended the health
fairs.
• Approximately 65 people
were screened for
hypertension.
– Those with high blood
pressure were referred to
the village doctor who
proceeded to provide free
medication and care.
Reproductive Health
Monday
– Three visits to mothers in their homes
– Assessed their comfort level and
familiarity with
• reproductive anatomy
• puberty
• pregnancy prevention
• sexually transmitted infections
• physiology of pregnancy
• communication
– Discussed misconceptions and supplied
accurate information
– Emphasized importance of their
relationship with their children’s
understanding of reproductive health
Reproductive Health
Tuesday
– Met with 22 adolescent girls next to health
clinic
• Theme: getting to know ourselves
– Peer‐to‐peer self‐esteem exercise
• Girls wrote positive descriptors about each
other
– Anatomy and Physiology lesson
• In groups 5‐6 people, girls completed
worksheets identifying anatomical names
of male and female reproductive organs
• Worksheets were reviewed and answers
provided as a large group
– Menstruation explanation
• Each girl was given a handout with
illustrations and descriptions about the
menstrual cycle
• Handouts were explained orally and
information about personal hygiene was
emphasized
Reproductive Health
Tuesday
– Met with 16 adolescent boys
– Discussed definition and importance of self‐
esteem
– Identified individual life goals
– Played “Life Soccer,” where making a soccer goal
was analogous to achieving a life ambition, with
defenders representing challenges and
teammates serving as
resources/support/decisions
– “But I feel like it!” activity
• Everyday feelings and alternative responses
were identified, led to discussion of sexual
desires, hormones, and appropriate reactions
– Completed and reviewed reproductive anatomy
and physiology worksheets
– Identified contraceptive options and
demonstrated correct condom use
Reproductive Health
Wednesday
– Second session with adolescent girls
• Theme: thinking about ourselves in
the future
– 16 returned (73% of previous day
attendees)
– Brainstormed/set goals: who do you
want to be in 2, 5, 10 years?
– Small group activity
• Read scenario and discussed
hypothetical scenario of young
pregnancy
• Discussed components of a healthy
relationship
– Presented contraception methods and
demonstrated condom use
– Wrote letters to future selves
Reproductive Health
Wednesday
– Met with ~ 60 members of a church
youth group
– Facilitated peer‐to‐peer self‐esteem
exercise
– Youth who had participated in our
activities earlier in the week shared their
experiences
– Recorded individual goals for the next
two, five, and ten years
– Shared goals with group and discussed
means and requirements to achieve
them
• A church leader requested that the
youth record their goals so that the
congregation could better know how
to support them and their
aspirations
Reproductive Health
Thursday
– Coordinated a health fair for
approximately 100 high school students
– Groups of 15‐20 students spent 20
minutes at each station
– 2‐3 CORE members staffed five stations
• Myth and facts about reproductive
health
• Reproductive anatomy
• Physiology of pregnancy and
feminine hygiene
• Condom demonstration and
contraception methods
• Sexual responsibility and condom
practice workshop with emphasis
on STI prevention
Reproductive Health
Friday
– Met with ~ 30 mothers inside the local clinic
– Facilitated three activities
• Discussed images in the media, how
young people learn about human
bodies, relationships, and sexuality
• Performed a parody of a dialogue
between a mother and daughter;
whenever the mother in the skit made
an incorrect statement about
reproductive health, the mothers in the
audience booed and made suggestions
for more appropriate responses
• Mothers participated in a role‐play
practicing speaking with and responding
to questions from their children about
reproductive health (e.g. what one
would say when their daughter begins
to menstruate)
Nutrition, Hand Washing, and
Dental Hygiene Education In Isla
de Mendez, CORE ‘09
Adult Nutrition
Children Nutrition
• Discussed the importance of
eating healthy foods with every
class in the primary school
Handwashing
&
Germ Education
• Many villagers burn their garbage
as a method of disposal
• To spur the initiation of a garbage
collection system with data, we
conducted a survey collecting data
about respiratory health of
children between 5 and 11 and
possible risk factors.
• We went door‐to‐door to talk to
parents about their children’s
health. No identifiers were
retained.
Survey Results
• 46 households and 71 children were represented in
our data
• 25.4% of the children in our sample were diagnosed
with asthma
– In comparison, prevalence of asthma in the U.S. is 8.2%
among all ages and prevalence in Mexico in 2004 was
only 3.3%
• The prevalence of any respiratory symptom
including cough, wheeze, shortness of breath, and
chest tightness in the past year was 87.3%
Prevalence of Moderate-Severe Respiratory
Symptoms Among Children ages 5-11 Years
60
50
percentage (%)
40
30
20
10
0
Cough Wheeze Breathing Chest
tightness
Wood combustion for cooking and being female were risk factors for
asthma. Mothers being married and having more than a 3rd grade education
had a protective effect on asthma incidence
% with Moderate-
Adjusted OR (95%
Characteristic N* Severe Respiratory
CI)
Symptoms
Gender (Female) 37 53.8 1.21 (0.40, 3.67)
Disposing garbage by
56 84.6 3.7 (0.90, 15.26)
burning
Asthma diagnosis 18 33.3 4.17 (0.98, 17.66)
Burning garbage and being female were risk factors for moderate to severe
respiratory symptoms.
Other Activities:
‐A school‐wide school field clean‐up
‐An English as Second Language
Session
Thank You!
• If you have any questions or would like to
make a donation to our ongoing efforts,
please email us at:
yalehealthcore@gmail.com