To Javi with LOVE

It is very important for myself and the students at UMass Lowellwho traveled to Chile to thank Javier Cifuentes. He is the son of Manuel Cifuentes who works for UMass Lowell.

Javier is a student at BU and a previous resident of Chile before moving to the United States at age nine. He is fluent in Spanish and knows Chile. This young man took upon the huge responsibility of being our liaison and translator. He willingly gave up his own semester break to travel with us and listened to our many questions such as “what does this mean,” “can you tell me how to ask the patient (bus driver, waiter, banker etc.)” and a million other questions.
He is a kind, generous and joyful person to travel with. This trip challenged him as well as us and we thank him for his invaluable assistance.
Thanks Javi!
View aphoto galleryfrom the trip.
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Adios Chile


Today is our last full day in Santiago. Many of the students are tired and I am sure would like to sleep in.I have decided to go to Valparaiso and have invited anyone who would like to come with me.I am pleasantly surprised that instead of hanging around the pool today they are willing to go to a historical site.

Javier overlooking the port of Valparaiso.JPG
I have done some reading on this city that used to be a bustling stop for cruise ships and other shipping prior to opening of the Panama Canal,as the ships would have to pass by here before rounding Cape Horn. For the last century there has been some decline in this port city and it has only been recently that it was declared a UNESCO site and there has been much attention given to it.

Many areas are being renovated while preserving the artistic and architectural elements. There are old buildings and 1940’s era electric cable cars juxtaposed with sleek buildings and gas-powered city buses that crowd the streets. It is like San Francisco in some respects and can best be visited by foot (and we certainly did a lot of walking yesterday).

After visiting other cities affected by the earthquake, we wonder how this city fared in 2010. The precarious buildings and location of homes on the steep hills would seem to be a recipe for disaster.

Many photos are taken (see our gallery for some great pictures) and after 3 hours of climbing roads of cobblestone and riding up one of the 15 funiculars (ascensores) that are scattered throughout the city, we are ready to find our way back to the bus terminal.

We have become a well trained travel pack as we make our way through crowded streets and city buses. Despite the crowded conditions, the people of Chile are not rude and pushy.I am impressed with how many people use the city buses and actually respect and follow the rules of crosswalk signs. We know that this would not be the case in many urban cities in the USA.

Our time is short so we do not have time for a real meal before we take the bus back to Santiago. We have become pros at visiting the local Lider (food market) and find some food.It must be a subsidiary of Walmart because we see these stores all over Chile and they carry the same Walmart private label “Equate” and other familiar products from USA. I guess Walmart has moved into every city even beyond the borders of America.

The energy level of the students is obviously waning as they think about home and the approaching start of school. The seniors are anxious about pending placements for their Precepted Practicums and the upcoming HESI exams. The juniors have new clinical rotations starting and a big drug calculation exam in the first few weeks of the semester. Our one Sophomore has learned a lot about what to expect in the next two years and is very excited about finally taking some nursing courses. She (Sarah) is very fluent in Spanish and has been so valuable during our trip. The people of Chile are drawn to her as she often stops to chat with taxi drivers, hotel staff and others.

Many of us are very hindered by our lack of Spanish fluency. We are all trying very hard to work on our vocabulary, but it is frustrating when sightseeing and also when trying to communicate with patients. We are developing a keen awareness of how it must feel for our patientsat home who are not fluent in English. On this trip we struggle to determine if we are ordering shrimp (camarones) or by mistake we are getting clams (prawns).It makes a big difference if you hate clams but love shrimp (believe me…I made this mistake). I can now imagine how frustrating it is for patients to try to communicate with their nurses to tell them about their symptoms or other information that is vital to their recovery.

So although we have left Talca, which was our “academic week” we continue to learn about factors in the health care system and how we can take that knowledge with us to make us better nurses.A few of us took a final walk around our hotel at 11:30 last night and realized how “familiar” this part of the city has become for us. We know exactly how to get to the metro and are finally figuring out which direction to take the subway. We have seen some familiar faces at the food market, metro and hotel complex. Although it makes our day a bit easier having this familiarity, we long to see our families. Tomorrow we only have a partial day here in Santiago and then off to the airport.

It has been a good trip and we have learned so much.I continue to be impressed by the students’ description of their experiences and I urge you to read their blog entries.I have told them to continue to write a few entries upon their return back to Massachusetts.

Thanks so much to our families and friends and also the people at UMass Lowell who have helped and supported us in our journey to Chile. There are so many people to name, but I need to particularly thank FernMacKinnon and her staff at theStudy Abroad office, Michael Pueschel and the web/communications staff, the faculty, Dean and staff of NURSING and S.H.E., Manuel Cifuentes for being our “point person” during this whole adventure, and who was my first conspirator in developing this trip, and lastly to the Manning family for their support and vision in recognizing that global health experiences can truly enrich a nurse’s education and make him/her a better nurse.

Adios Chile

The Team Approach


It is hard to believe that we have been here for a week now. The experiences have been varied and challenging. I have just read the student blog entries for the last few days and I am impressed with their ability to capture the moments.

Students walking through Talca doing a community assessment: examining roads, buildings, pubic services & people.

The people of Chile have been so welcoming and warm. I know that when we walk down the street we look different and we collect some stares. We are a funny looking group of nine as we walk through the streets of Talca with our backpacks and stop to take pictures or to watch a stray dog. There are lots of stray dogs and it is interesting how this interests the students.

Talca is also a city but of course not as big as Santiago. It is has taken us a few days but we are finally getting a sense of direction. The streets are laid out in a grid so the streets are either parallel or perpendicular with an occasional rotary. Transportation is readily available but we are finding that our clinic locations are walkable so we have been walking and exploring a bit in the last few days.
Hospital de Dia in Talca Chile.JPG
Yesterday we had some great experiences that the students blogged about at Hospital de Dia. We were able to watch multiple patient evaluations by the multidisciplinary team. Half of the student group was in the room with the patient and the team and the other half was behind one way glass wall. Patient permission was obtained to have the students present. It was a bit difficult to follow the exact conversation due to language barriers and translation but what was so apparent to me and the students is that the team of health care professionals care deeply about these patients and each use their own skills in helping to address issues.
Mid way through the day we have “breakfast” with the staff, students and doctor. We are all impressed by these people but today we are especially impressed with the doctor who describes his passion and involvement in the movement in Chile to address the delivery of psychiatric care and make it more community based with varying levels of care that depend on the acuity and disability of the patient illness. He takes that time to draw a schematic so that the students can see the relationship between the various types of care and the multiple “safety nets” that are designed to prevent hospitalization of the psychiatric patient. He is also very appreciative and respectful of the nurse’s role in the care of the patients and truly partners with the nurse to improve the care. He was very generous with his time to explain various points with the students.
After a lunch we went to the outpatient evaluation center which is actually only a few blocks away. The facility was small with a crowded waiting room. There was a nurse who manages a special government sponsored program for anti-psychotics but she was the only nurse. This facility seems to employ more therapists, social workers and psychologists. It is small and crowded and we were surprised to see children in the waiting room. This is the first time we have seen children as patients.
All of these agencies have had to relocate orrenovatedue to earthquake damage. Some are still in temporary quarters and waiting for the new hospital to be built or for resources to build or rent a permanent home.
Earthquake damage to a bridge in Talca, Chile.
One question I have asked at multiple locations is to what extent the earthquake had on the incidence of mental illness or exacerbation of current known patients. Surprisinglymany of the health care workers respond that they do not feel that there was a significant change in the number or severity of mental health patients post earthquake. This seems to be contrary to what one might expect. It is a very interestingcommentaryon the Chilean Health care system.
Overall I am impressed with what I have seen for mental health services in the public health system. We have not seen any private health care but it makes us feel good that the most vulnerable in the system seem to be getting good care.
The students will have more to BLOG about tomorrow so I am going to let them tell you some more….
View aphoto galleryfrom the trip.
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Charlie on the MTA?


Ah …. transportation.

Often we don’t think about it too much until something goes wrong or you are challenged by your mode of transportation. You will have to forgive me as I lapse into a bit of reminicising about transportation issues from previous nursing trips.

Here in Chile I am impressed with the airport and the cleanliness of the streets and metro system. It is such a refreshing change from some of our Metro systems in USA. There are bright murals and lack ofgraffitior the tell tale smell (if you know what I mean). We have had a few adventures today as we navigate the streets of Chile with our wonderful leader, Javier C., who was born in Chile but now goes to school at BU.

Today we had to navigate the metro to the bus station, oops.. not the right station… we have to go a few blocks down to the bus station. We buy our tickets but get on the wrong bus. It worked out fine because we met our correct bus at the next stop.

Once we arrived in Vina del Mar for a visit to the coast (i.e read… “beach, sand, lots of beautiful Chilean young adults having fun). We have to take a crowded city bus but the system here is pretty good so we make it and enjoy a lovely day at the beach. The air is great but the water is pretty cold. At the end of the day, a long wait for empanadas almost caused us to miss the 2 hour bus ride back to Santiago. We arrived back around 9 a.m. (after a few mishaps on the Metro.. “did he ever return, no he never returned and his fate is still unheard”… Boston people will be humming along).

It has been a long day but the students hit the store next door for some food to munch on and I leave them to relax alone. So despite the travel glitches I am recalling transportation in other countries like Ghana where the students traveled in Tro-Tros, which essentially are larger rusted out vans that have seen better days. Today we were a bit crowded on the buses and metro but all in all it was a safe journey. I think about the challenges in poorer countries where the transportation is not that easy or accessible. Two years ago I traveled with 2 live chickens and 25 people in a 9 person van while holding someone’s sleeping baby on my lap.. This year I had some giggles about missing buses and going the wrong way on the MTA. So… this is a learning experience for all of us.

UMass Lowell students pose for a group photo in Santiago, Chile.

Again, we often take for granted our cars and readily available transportation (and the ability to read the schedule and ticket details) at home. Here we are challenged a bit in that regard. So far this experience hasn’t shocked us as much as previous trips, but the learning is still happening.

Today under the sunny skies at the beach I had some great conversations with the students about their life plans and how nursing and this particular trip to Chile fits in with their “bucket list” of dreams. We did discuss the relative comfort we have had the last few days and I hope to see other parts of Chile that may not be as “pretty,” but will show us how the people of Chile live, work and receive nursing care.

I am anxious to see Talca and other areas that are closer to the area that was hard hit by the 2010 earthquake. That was a devastating and deadly (8.8) earthquake but I am told that the area has recovered fairly well. Our work will begin next week so in the meantime we intend to explore Santiago a bit more and learn about the culture and the people.

So… we continue with our transportation challenges throughout this trip. A few more laughs and eventually we make it home.

View a photo gallery from the trip.

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