Dartmouth College and Geisel School of Medicine: Nicaragua CCESP -
Cross Cultural and Educational Service Program

Other participating professional schools:

Dartmouth College, Geisel School of Medicine

Faculty and staffing:

Dartmouth Professor Douglas Moody instructs the undergraduate course and leads the program in partnership with Bridges to
Community staff and two undergraduate leaders. In Nicaragua, the Community Development (CD) team is overseen by two BTC staff, Professor Moody, and student leaders. The Clinical Health (CH) team likewise benefits from BTC leadership (two staff) and oversight from several health care providers (MDs, NPs, PAs).

Application process:

Due to conflicting college and medical school calendars, year four Geisel students have traditionally been the ones able to participate.

There will be an orientation meeting (date to be determined).
It is suggested that students planning to apply for the Service Trip
a. Have some facility in speaking Spanish. (This will be a huge asset to the group).
b. Be available on campus for the two weeks before the trip to develop educational materials, prepare medical supplies, and build teams with the faculty and undergraduates.
(Elective credit should be requested for the Trip Preparation and Service Trip weeks)
c. Be available on campus for some of October and November to participate in the educational programs and trip preparation.
d. Be prepared to provide a post trip report and presentation.

TO APPLY: Please email Shawn O'Leary with your CV (resume) including your qualifications, the enclosed CCESP application, and a 1-2 page description of why you want to go and how it will fit into your plans.

Program elements:

Geisel students will participate in public health projects, teach local health care workers, mentor undergraduate students, and provide direct patient care under supervision when appropriate.

Prior to departure - The CH/CD teams hold several meetings including a large group orientation/day retreat, a CH skills session, and a meeting between the medical students, healthcare professionals, and student leaders to finalize plans for the clinic e.g. discuss setup, roles, and workflow of daily clinic, illnesses common or unique to the region, address questions/concerns, medical kit/packing needs.

Undergraduate course during the fall term - medical students are welcome to attend lectures and access course materials, though neither are required.

In Nicaragua - Arrival and overnight in Managua, travel by regional airline to Siuna, travel by bus from Siuna to CD/CH sites.

On site - Ideally, the group meets with local physician/staff then sets up clinic in preparation to see patients the next day.

BTC coordinates with community health leaders in the local and surrounding communities to determine how many/which patients would benefit from being seen and are able to make the journey to clinic. Each day, a local community is scheduled to send its patients to the CH site. BTC triages patients who arrive each day, provides a set number of ‘tickets’ to be seen (~50-70), though additional patients may be seen if urgent care is needed.

When a patient’s number is called, they go to see the provider, who evaluates, diagnoses, offers treatment recommendations, and advises patients. If a prescription is given, patients may pick this up a the clinic ‘pharmacy’. They may also be directed to the ‘Glasses’ station, where they can be evaluated for and receive reading glasses.

Clinic generally begins at 8pm, followed by a ~12pm lunch break, and ends ~5pm, depending on the day.

*Patients’ encounters with ‘visiting’ healthcare providers serves as an opportunity to engage these patients in their local health systems. During patient visits, providers reinforce the accessibility and competence of local health care providers and encourage appropriate follow-up.

Outside of clinic - BTC provides a hearty breakfast, lunch, and dinner. The group meets for nightly reflection and enjoys free time together exploring the area, playing pickup sports, cards, etc. There is plenty of time for ‘alone’ time as well for reading, writing, and resting.

Financial support:

Dartmouth College provides significant financial support, asking a $200 contribution from medical students towards the total cost of the program

Faculty time allotted:

n/a

Administrative support:

Administrative staff - Theresa Ellis and Sarah Caputo