PASEO Program Adventure—Day 56: Trujillo Alto, Huanchaco, y Lima, Peru

On Friday morning, we hosted another workshop with a different group of Líderes Escolares. Similar to what I mentioned in yesterday’s post, today’s workshop focused on mental health, including psychoeducation regarding the difference between sadness and depression, the difference between stress and anxiety, how to spot signs of suicidality, and resources that the students can use in the case that a peer is experiencing any of the aforementioned topics.

The students who participated in today’s workshop were younger than most of the other students we worked with thus far, but their interest and participation in such serious topics was great to see. Following the workshop, one of the students stood up and thanked us for the work we have been doing in Peru, and for the information and support we have provided the Líderes Escolares with. You can never know if you are making a difference in the surrounding community, and even though we still don’t know whether or not we have been and are making a difference, it was truly rewarding to hear such young students thanking us for working with them. After working with such inspiring, young leaders, one can’t help but feel a great sense of hope for the future.

After our workshop, some of the social workers we have been working with took us out for a delicious lunch, consisting of ceviche mixto and chicharron de pescado. As soon as we finished lunch, I had to get back to Huanchaco for my last Spanish grammar class.

Once our class ended, another student and I ran over to facilitate our last group with adolescent males that I spoke about throughout the past few weeks. Today’s group focused on support systems and evaluating the different types of support we each have in our lives (including practical support, social support, emotional support, and advice-based support). This activity helps you realize the types of support you may or may not have, which is useful in thinking about who one’s main confidants may be. We then focused on TIPP, which I wrote about on Monday.

During times of crises, TIPP is a useful tool that one can utilize to take a step back from the crisis to de-escalate the situation. TIPP can be used when one is about to engage in dangerous behaviors during a crisis, when an individual needs to make an important decision, but is too overwhelmed to think/make a decision, the individual is not processing information effectively, the individual is emotionally overwhelmed, and/or the individual isn’t able to use his/her abilities. TIPP stands for Temperature, Intense Exercise, Paced Breathing, and Paired Muscle Relaxation—all of which are techniques one can utilize during a time of crisis. As we finished the session, we celebrated our time together and the group members’ participation throughout the past few weeks with a chocolate cake.

Following the group, we ran over to the beach to watch the sunset one last time, before having to leave Huanchaco later that evening. After enjoying the sunset, some of the other students and I went for dinner, and returned back to our house to pack, before leaving for the airport. Since I won’t be returning to the States until Tuesday, I took a cab to San Isidro (where I will be staying for the next few days) once I arrived in Lima at around midnight. 

IMG_1414

Advertisements

PASEO Program Adventure—Day 55: El Porvenir y Huanchaco, Peru

On Thursday afternoon, we had our second workshop with Líderes Escolares from three different schools. Today’s workshop focused on mental health, including psychoeducation regarding the difference between sadness and depression, the difference between stress and anxiety, how to spot signs of suicidality, and resources that the students can use in the case that a peer is experiencing any of the aforementioned topics. It was truly incredible to see so many adolescents participate in todays workshop, especially given the intensity of the topics we discussed.

Many of the adolescents mentioned knowing someone with a mental illness and/or knowing someone who has contemplated or attempted suicide. As I mentioned before, seeing so many young individuals take the initiative to learn about mental health in general and ways to help others as leaders in their schools has been, and continues to be refreshing and inspiring.

Following the workshop, we made sure to enjoy the sunset once again, before having a Cena Familiar at a local pizza restaurant with everyone from the program, seeing as it was my last night in the program, as well as the last night of a few other students as well. On our way back to the house, we stopped for picarones (the delicious fried dessert that one could only dream of.) After dinner, we played cards to officially end our last night in Huanchaco.

IMG_1411

PASEO Program Adventure—Day 49: El Porvenir y Huanchaco, Peru

On Friday morning, one of the other students and I hosted an initial workshop with another group of Líderes Escolares. This was the first workshop where we presented by ourselves in Spanish (without one of our professor’s accompanying us). It was definitely nerve-wracking at first, but this was exactly the experience we needed in order to increase our level of confidence in regards to our public speaking abilities—especially in Spanish.

Similar to the other two workshops with Líderes Escolares that we’ve hosted so far, we spoke about changes in adolescence, as well as psychoeducation regarding anger, aggression, sadness, and depression. As I stated before, it’s refreshing and worthwhile to see young adolescents eager to make a difference and help those around them. These leaders will truly be the change in the world that we wish to see.

After our workshop, we returned to Huanchaco for our Spanish grammar class. Right after class, another student and I led a group for adolescent males at one of the other sites we’ve been working at. This week, the group focused on effective communication, as well as different types of communication (i.e. passive communication, aggressive communication, and assertiveness). While many of these adolescents have struggled with anger, teaching effective communication (after last week’s session on anger/aggression) will hopefully be a beneficial tool that these adolescents can utilize on a daily basis.

FullSizeRender-11.jpg

PASEO Program Adventure—Days 47 and 48: Huaraz, Trujillo, Huanchaco, y El Porvenir, Peru

On Wednesday morning, we had breakfast at our hostel (consisting of eggs, toast, butter, jam, freshly squeezed papaya juice, and coffee) for 4 soles (about a dollar and some change). After breakfast, we headed over to the bus station, and returned to Trujillo on an 8-hour bus ride. Once we made it to Huanchaco, we celebrated returning to sea level and being able to breathe again with a trip to the gym, followed by dinner. Because once you return from vacation, what else is there to do aside from eat?

On Thursday, our morning observations at local schools were cancelled since we had a workshop for the Líderes Escolares planned in the afternoon. As mentioned in an earlier post, we have been hosting workshops with groups of student leaders from three different schools in each group, with the focus of changes in adolescence and psychoeducation regarding anger, aggression, sadness, and depression. 

Following this first workshop, we’ll host a final workshop with each group with the focus of empowering the student leaders to share everything they learned with their peers, and also how to spot signs of anger, sadness, depression, and suicide, in addition to how they can refer students to necessary resources, should someone be in need of help.

Today’s workshop was another initial workshop with a new group of Líderes Escolares. There is so much to be learned from the younger generations, and any opportunity to work alongside student leaders and individuals wanting to make a difference in their community is bound to be an enlightening and incredible experience. And today’s workshop was exactly that.

FullSizeRender-10

PASEO Program Adventure—Day 36: El Porvenir, Peru

Today (last Saturday), we hosted our first workshop with three groups of Líderes Escolares from three different schools in El Porvenir. As previously mentioned, los Líderes Escolares are a group of student leaders in each grade (chosen by various teachers and faculty members) from each school that receive workshops and leadership training events, with the goal of motivating and inspiring their peers—all while gaining the knowledge and support to make a difference in their schools and community.

We will be hosting two workshops with each group (with student leaders from three schools in each group), with the focus of changes in adolescence and psychoeducation regarding anger, aggression, sadness, and depression. Following the first workshop, we’ll host a final workshop with each group with the focus of empowering the student leaders to share everything they learned with their peers, and also how to spot signs of anger, sadness, depression, and suicide, in addition to how they can refer students to necessary resources, should someone be in need of help. It was a blast being able to work alongside the Líderes Escolares this morning, especially because when you see such a drive amongst young individuals, it brings about a refreshing sense of hope and change for the future.

PASEO Program Adventure—Day 17: El Porvenir y Trujillo, Peru

This morning (Monday—yes, still behind), I completed my final observation at another school in El Porvenir. It was definitely an interesting experience because the school I observed is a Catholic school (considered more private than the others), as opposed to a national school (or public school, which is what every other school I’ve observed so far is considered). Since students from the secondary school were on a field trip to local historic sites for the day, I was only able to observe students in primary school.

Upon speaking with a local social worker, I was informed that there is a lot of crime among the students, including extortion and theft. When I spoke to the director of the school, she mentioned that a lot of the children have difficulties at home that influence their behaviors, including lack of parental support and/or parents having to work long hours, leaving their children unsupervised upon returning from school. This recurring theme seemingly continues to make its way into every school that I observe. There are so many challenges that these children face both inside and outside of school, but especially once they leave school grounds each day. The risk factors are substantial, and we have to focus on fostering more protective factors in order to provide these children with substantial support so they can have the futures they deserve.

In the afternoon, we had our weekly meeting with a group of local women and family members in El Porvenir that I briefly discussed last week. Each week, two students from the program are responsible for teaching the group members relaxation and emotional regulation techniques for them to utilize at any given moment and teach others in their community. This week, one of the other students and I were in charge of working with the group members’ children—some of whom have physical disabilities and/or difficulties with motor skills and/or verbal communication deficits. We had each child write their names and draw something that corresponds with each letter of their name. The creativity and abilities in these children are truly incredible.

After our group, we went back to Trujillo for our Psicología en Peru course. Tonight, we focused on statistics within the country, all of Latin America, as well as throughout the world. When we look at a global scale, depression happens to be the most common mental illness. However, in Latin America, only five percent of the adult population reportedly suffer from Depression. According to the NIH, “In 2015, an estimated 16.1 million adults aged 18 or older in the United States had at least one major depressive episode in the past year.” If so many people in the United States alone have experienced depression, why is the percentage so low in Latin America? It’s because so many people do not seek or receive mental health services. This number is merely what is reported.

Among so many other challenges, stigma is the biggest problem pertaining to bringing attention to mental illness in Latin America, and especially Peru due to discrimination against mental health. If you seek any type of help or treatment, you’re considered “weak” or “crazy.” You’ll likely be asked, “Are you weak? You’re not strong enough to deal with this?” Alongside stigma, shame and misconceptions about having a mental illness come into play as well.

Even if we were to put stigma aside, psychoeducation is another challenge. If someone does in fact have a mental illness, many times, they’ll go to the local clinic with the belief that it’s a physical illness as opposed to a mental illness. In a perfect world, hypothetically speaking, of course, let’s say that someone does in fact go to the hospital for an issue pertaining to their mental health. As I mentioned the other week, you would have to wait days in the hospital before getting an appointment, and when you finally do get one, your appointment would only last a few minutes, and would consist of being asked a few “yes” or “no” questions to determine if you have depression.

There isn’t enough time to converse with the patient, so the odds of someone actually getting the help he or she needs and deserves are slim to none. But first, you’d have to overcome the stigma and shame in order to even make it to this point. And you’d have to hope that your family wouldn’t abandon you due to shame as well. Now if you want to talk about services, there is about 1 psychiatrist per every 300,000 people in Peru. If we were to look at another country, let’s say Colombia for example, there, you would find 2.1 psychiatrists per ever 10,000 people. Pretty significant difference, right?

The following statistics have been taken from Según el Instituto Nacional de Salud Mental (INSM) (2014): Nearly 5 million people (11.8%) in Peru suffer from some type of mental illness. 700,000 out of 1 million Peruvians suffer from depression, while 200,000 out of 1 million Peruvians suffer from some type of anxiety disorder. Less than 4 percent of these individuals receive services in specialized centers. Why, you may still ask? Fifty percent of such individuals believe they can overcome their mental illness on their own. Thirty percent don’t believe in treatment, and thirty percent don’t know where to go to receive services. (Yes, the percentages overlap.)

This is why education is so important. We must spread the word about mental health because until we can do so, millions of people will not receive the necessary services they require.

Snapshot Challenge Saturday

To conclude my story-telling from my trip to Guatemala for a medical mission this past summer, I’ll leave you with this story. A mother sat down at my triage table with her twelve-year-old daughter and two-year old baby. Upon inquiring into her medical needs and what we could do for the three of them, the mother explained that she had been experiencing depression for quite some time now. Her twelve-year-old daughter had severe asthma, and her mother could not afford to purchase the necessary medication for her. Seeing her daughter so sick and constantly suffering from asthma attacks led the mother into a state of depression. Feeling as though there was nothing she could do for her daughter, the mother had been experiencing feelings of hopelessness and despair on behalf of her daughter. She could not bear seeing her daughter in such a terrible state.

I promised the mother that the doctors would take good care of her daughter, and provide her with the medication needed to help better her asthma. She continuously thanked me, as I walked them over to the room where the pediatricians were working. Later in the day, the mother approached me with a bag of medication and thanked me for my help. She explained that she, as well as her newborn and twelve-year-old daughter had each been seen by a doctor, and that her daughter had received asthma medication to last for four months. She was so appreciative, but she asked if we happened to have any more medicine, seeing as our mission would not be returning for a total of six months.

I walked into the makeshift pharmacy, and the pharmacist said there were only three boxes of asthma medications remaining, but they were not the same kind as the young girl received from the doctor. The mother asked if there was anything I could do, because she didn’t want her daughter to experience such awful asthma attacks again once the medication ran out four months later. I took the new box of asthma medicine and asked the pediatrician if it would be okay to give to the young girl, and he mentioned it was fine; it was just a different brand of medicine. I gave the mother the last three boxes of asthma medication for her daughter, and she actually jumped for joy.

I am not able to understand what it is like to be a parent who has to see his or her child suffer from such severe asthma attacks, but I was able witness firsthand how excited this mother was to receive just enough medicine to last a few extra months for her little girl. Something so simple such as asthma medication is not something I would typically think too much of. But unfortunately, this happens to be a given of life: we often take things for granted without realizing that somewhere in the world, someone would be beyond appreciate of such a possession—especially this particular medication. Seeing the joy in this mother’s eyes was most definitely a beautiful sight to see, and there is no other story I would have wanted to use to conclude the sharing of my experiences on a medical mission to Guatemala this past June.

IMG_4802