Assessment of longitudinal data collection through an electronic trauma registry in the Guatemalan Highlands – Koes/French

Hi all!  Brenton French and I, Joseph Koes, are rising 2nd years within the School of Medicine at the University of Virginia.  We, too, are working on a project through the UVA-Guatemala Initiative and are in our third week of Spanish classes here at Celas Maya in Xela (Quetzaltenango), Guatemala.  Through our time working with the UVA-GI, we have spent considerable efforts learning about the culture, customs, and practices of Guatemalans so that we, as outside observers, can best understand how might be able to impact their system of health care in a way that is locally supported and sustained in the long-term.  Our in-country mentor, Jessica Gonzalez, has led us through numerous seminars covering the education system, the health care system, and the fallout from their relatively recent civil war which we feel have prepared us to be able to go out into the field and speak with physicians, administrators, and students about the current status of their health care system.

Our project involves assessing four regional hospitals for their capacity to support a trauma registry designed by the Panamerican Trauma Society [PTS] – a group of trauma surgeons based out of Virginia Commonwealth University.  A trauma registry is a means of collecting epidemiological data on what types of injuries are common in the area.  Ultimately, this data can be used to identify preventable injuries, initiate public heath initiatives to bring about awareness of these issues, and improve care in these facilities through World Health Organization supported “Quality Improvement Programs.”  We will perform site assessments at the proposed pilot project facilities to characterize the patient load, trauma load, infrastructural capabilities, and overall climate of quality improvement.  Specifically, to make the proposed registry function most efficiently we will delve into the possibility of using a simple electronic medical registry that has the capability of exporting data into the PTS trauma registry.  With our research, we will write recommendations based on our experiences to our mentors – Dr. David Burt of the UVA Emergency Department, Dr. Medina of the University of San Carlos, and Jessica Gonzalez – for progressing project proposals between the UVA-GI, PTS, and the University of San Carlos (whose students rotate through the hospitals at which we are performing research).  Ultimately, we hope that implementation of this proposed pilot project can improve the quality of care throughout the local health care system and be used as evidence for implementing similar programs at the larger national level if supported by the Guatemalan Ministry of Health.

As progress on our project is made, we will update the CGH on our work.  Hasta luego.

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Go USA!!!

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Daly Blackburn — Water filtration and health education in rural Guatemala.

1) Who We Are: Our names are Chris Daly and Holly Blackburn, and we are rising second year medical students from the University of Virginia School of Medicine working in collaboration with the UVA-Guatemala Initiative. We are currently in Guatemala taking spanish courses all day err’day to improve our spanish before we embark on our trip to the rural area known as San Lucas Tolimán.

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2) Our Project Description: The focus of this project will be on the evaluation and further spread of water filters and WASH education program within communities surrounding San Lucas Tolimán in the Lake Atitlán area of the Guatemalan highlands. WASH stands for “Water, Sanitation, and Hygiene”, and there have certainly been no shortage of programs like this in Guatemala. Guatemala is home to 14 million people, but unfortunately, (UNICEF) stated that, in 2002, the national sanitation coverage of rural areas in Guatemala was only 16%. Clearly this is an area of health concern in Guatemala that needs continued attention, and we are excited to work on this project as we both have previous work experience in aquatic sciences and are interested in the effects of water on public health.

This project is a direct continuation of a long-standing collaboration that UVA has formed with in-country partners around the Lake Atitlán basin in Guatemala to help alleviate the water crisis. In 2011-2012, UVA-GI students Andi Maddox and Amanda Below started a WASH program in the community of San Martín. In this project, 21 women were educated in various safe water, sanitation, and hygiene practices, after which they received Hydraid Biosand filters. The overall goal was to educate women in the community on filter use and proper health practices before receiving the filters in order to ensure that best practices would occur. In 2012-2013, 28 more women participated in the WASH class and received filters, and another UVA student group conducted a first round of evaluations, which did see improvement in health practices.

At this point, a new community near Lake Atítlan, San Gregorio, UVA-GI has initiated the WASH education and filtration program for all of San Gregorio’s 34 families, and it is anticipated that in approximately four months every family in San Gregorio will have completed the education program and will have a filter installed. We plan to expand on the evaluation of the San Martín project by adding an observational and behavioral changes component to our evaluation of San Gregorio. While communities may retain the information from the education program, this does not mean that behaviors or attitudes about health and sanitation are changed. Ultimately, we will be developing a tool, based on both the evaluation of San Martín and San Gregorio, that can be implemented to track and document the success or failure of the implementation of a WASH education and filtration program in any size community.

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