TCNJ

7 Thomas hadn't eaten or breastfed for at least a month, and ensuing muscle weakness left him unable to walk. S EVERELY MALNOURISHED, FLACCID, AND CRYING WEAKLY, the 15-month-old was barely responsive when his mother carried him in to the clinic's triage section where Kelly Williamson met them. Williamson '16 immediately sensed the urgency of the child's condition and ushered the boy and his mother to Sharon Byrne for further evaluation. "As soon as they walked in, I knew that this was not a good situation," says Byrne, an assistant professor of nursing and certified nurse practitioner. The boy, Thomas, hadn't eaten or breastfed for at least a month, and ensuing muscle weakness left him unable to walk. He was having trouble breathing; a wound on his leg had gone untreated, allowing an infection to set in. It had taken his mother, Marie, four hours to walk to the free pop-up clinic in Port-au-Prince that day. "I would classify him as 'failure to thrive,'" says Byrne. "We had to transport the baby to the emergency room, or he wasn't going to make it. He's lucky he made it that far." Because Haitian ERs require up-front payment before medical staff will provide treatment, Byrne handed over $95 she had on her, then stayed with Marie and Thomas while another TCNJ volunteer bought IV fluids and medication from a nearby pharmacy. "I'd equate the ER there to a dirty utility room in the United States," says Byrne. "The bed the baby was on was an old OB-GYN table, missing its legs and drawers." Byrne, Williamson, and six others from TCNJ were in Haiti's capital in January to volunteer at a clinic run by the Haitian American Caucus, which opens every few months and relies on staffing from a rotation of aid groups. Over the course of five days, the students treated more than 650 patients—triaging, taking vital signs, performing assessments, and maintaining a pharmacy area to fill prescriptions. "As we were triaging some of the kids, they would say, 'Oh, my stomach hurts, it has been hurting for a couple of weeks now,'" says Kimberly Hackshaw '17. "And I would ask them, 'When was the last time you ate? Are you eating? Are you drinking water?' The kids would tell us that the meal they have at school was their only meal for the day." Though she considers herself a global health "newbie," Byrne has made five trips to the western half of Hispaniola to volunteer as a health-care provider with Explorers Sans Frontières, a Philadelphia-based NGO. On this most recent one, she brought undergraduate students from her Nursing in Global Health class. Byrne designed the course so that students would gain experience in delivering care in a resource- poor community abroad, while also developing cultural competency—crucial skills for anyone working in medicine today, she says. "Providers have to be aware of the beliefs, values, and languages of their host community and show respect for cultural differences," says Byrne. Byrne stayed with Marie and Thomas throughout his time in the ER and checked back with the family later in the week before returning to the United States. "I wanted to provide psychosocial support for Thomas' family— particularly his mother," says Byrne. Ultimately, the triage evaluation and intervention that TCNJ's cohort performed at the mobile clinic was a lifesaving one. Explorers Sans Frontières wired funds to pay the rest of Thomas' bills for his three-day stay in the hospital. He was then transferred to a Catholic children's hospital on a charity basis. Says Byrne,"He continues to receive treatment and grows stronger every day." —Emily W. Dodd '03 Get it done Nursing majors treated more than 650 patients at a Port-au-Prince clinic.

• Cover