GUATEMALA EXPERIENCE HAS IMPACT
By Mike Field

Nine students from the schools of Medicine, Nursing and
Public Health gained a new perspective on health care in
America recently. They traveled all the way to Guatemala to
get it. 
    As part of an innovative student-run program called
Project Impact, the students spent 15 days visiting
indigenous Mayan populations in remote communities decimated
by decades of civil war. There, they saw medical problems_and
some solutions_they say will affect the course of their
future professional careers.
    "Our purpose was to try to look at health care issues
from an international perspective," said project organizer
Paul Chan, a fourth-year student in the School of Medicine.
"In situations where the community has been at war, access to
clinics and hospitals is very limited. You tend to see the
same ailments--mostly infectious diseases--over and over
again. The trip gave us a sense of how health care is best
promoted under the most difficult circumstances."
    For some of the students, the Mayan community, though
remote and culturally removed from their own background, held
surprising parallels to contemporary American society. "In
Tennessee, where I come from, certain segments of the
African-American community have health indices similar to
third world countries'," said Monica Peek, a fourth-year
student in the MD/MPH program. "I found the Mayan community
similar, in some ways, to what I have experienced there and
here in East Baltimore."
    Peek, who hopes to pursue a career focused on global
African outreach, said her participation in the Guatemala
trip has led her to think seriously about planning a similar
venture to Africa next year. "What I found most interesting
in this trip was that despite the oppression they had
experienced, the Mayan community was very optimistic about
the future. There was a great sense of self-determination,
which is crucial to any community struggling to survive."
    The Guatemala trip was just one of a dozen different
programs that have been organized through Project Impact in
the past year. Some--such as the Sports Clinic and the Turtle
Derby, both sponsored by the first-year medical school class-
-are annual events now placed beneath the Project Impact
umbrella. Most, however, are new programs that have been
created by students eager to participate in community
service, advocacy and public education programs.
    "This is part of being a physician," said Catherine
DeAngelis, senior associate dean for academic and faculty
affairs in the School of Medicine. "Project Impact fits
perfectly with the new School of Medicine curriculum; it's
the kind of responsibility we expect physicians to feel. This
goes beyond taking care of sick people. It means going into
the neighborhood and making people feel better."
    Project Impact was organized three years ago, when
members of the incoming School of Medicine class informally
arranged new opportunities for community outreach. "A number
of us wanted to look for different outlets to integrate
personal caring into our basic training," Chan said.
    With an initial grant of $900 from the Medical School's
alumni association, Chan and a handful of other students were
able to organize a number of different community outreach
programs, including work in homeless shelters and with the
city's mobile health van. Since then, the number of sponsored
projects has grown to a dozen, including the trip to
Guatemala and a similar trip to the Appalachian mountains of
Kentucky. The Medical School's alumni association has
continued to support the program.
    Chan estimates Project Impact has filled 500 volunteer
slots in the past three years. "I think students in all the
health professions are interested in more than just their
studies," he said. "We're seeing more and more students with
humanities backgrounds, creating a diverse and broadly based
group. I think students are very interested in doing more
than just, for instance, becoming a urologist. They may still
become urologists, but they will do other things along the
way."
    Initially, Project Impact was composed entirely of
School of Medicine students. In recent years, however, it has
expanded to include students from other health professional
schools as well.
    Working with students in nursing and public health
introduces medical students to community health and public
health issues they're not exposed to, and vice versa. It
gives people another side of medicine," Peek said.
    "Our goals, ultimately, are the same, but we come from
different perspectives," said Leslie Wirth, a second-year
bachelor's candidate in the School of Nursing. A former Peace
Corps volunteer, Wirth was one of two nursing students on the
Guatemala trip. "Many nursing students at Hopkins already
have degrees and experience and our training occurs in a very
similar fashion to medical students'," she said. "One of the
goals of the trip was to bring medical and nursing students
together to learn about each other's training and
experiences. There needs to be a greater integration of all
students in the health care professions."
    Wirth and fellow nursing student Barbara Blanchard went
to Guatemala with the assistance of a grant made by a School
of Nursing alumna. "Part of our purpose there was to research
a presentation we'll be making as part of the Context of
Nursing course this fall," Blanchard said. "Using slides we
took and our own personal recollections, we'll be examining
how nursing care can be delivered in extreme situations. 
    "The Guatemalan Indians have nothing--no water, no
electricity--and yet they manage to survive," Blanchard said.
"The trip illustrated that you have to consider a person's
cultures and beliefs before you attempt to deliver care.
That's something that will always be a part of my nursing as
a result." 
    In the coming year Project Impact members say they hope
to organize further volunteer opportunities for all students
and faculty members on the East Baltimore campus including,
possibly, a return trip to Guatemala. Their first trip--an
odyssey through some of the worst living conditions in the
Western Hemisphere--increased, rather than diminished, their
resolve. 
    "We all went into the Guatemala trip expecting a lot of
sorrow, a lot of emotional upheaval," Peek said. "But what we
found was a lot of strength, a lot of love and a lot of
happiness. It was inspiring to see how people could struggle
to overcome even the worst situations. If there were tears,
they were of happiness, not sorrow. We weren't sad while we
were there."