Bringing Respiratory Care to Asthma Clinics in Guyana

By: Sharon Armstead, EMBA, RRT

March 1, 2018

How It All Started

The Study Abroad project was truly a goal and vision that came about after returning to Guyana after approximately 46 years. I was born in Guyana but left as a child and returned later and joined a mission group. In 2015, I began a personal journey of missionary service with the team of Bridge Global Medical Missions (BGMM) in Georgetown, Guyana. I was the first respiratory therapist to join the team.

I remember during the first few days in the hospitals I was told that there was “a lot of wheezing” in the emergency rooms. Treating patients consisted of just administrating short-acting nebulizer treatments, but I remember being very impressed with the ICU at the main public hospital, Georgetown Public Hospital Corporation (GPHC), because they had the ventilators I could use. However, physicians only managed the patients while the nurses were left to monitor the ventilators and equipment, which they did not understand.

At the Linden Hospital in Guyana, the emergency room was constantly full of the “wheezers,” and the ICU only had ventilators that were basically nonfunctioning due to language barriers or a lack of biomed professionals. One of my fondest memories was fixing two ventilators from China. I could get the ventilators to work and explain the basic modes because in my mind it was just a ventilator and they could see the modes. The problem was the language was all in Chinese! So, we all got together: a Cuban doctor, a Cuban biomed, and a nurse with Google Translate and finally changed the language to English. It was an interesting day!

When we were on our Study Abroad trip this past January, I was able to place an intubated patient on that same ventilator. After my first visit to Linden Hospital, I addressed a few of my observations with the medical director, and I will never forget his comment. He said, “I thought respiratory would just come do some nebulizer treatments and show us oxygen.”

Study Abroad and Respiratory Care

Then the vision of my project began because I needed to show him the scope of the practice of a respiratory therapist. I asked Dr. Heyliger-Thomas of BGMM if she could assist me in promoting a study abroad program in Guyana with the Ministry of Health. It was very important for me to bring my students to Guyana for many reasons. The most important being the profession was needed there and our students would be excellent representatives.

In 2015, the study “Introduction of spirometry into clinical practice in Georgetown, Guyana: quality and diagnostic outcomes” highlighted increased physician referral to the country’s only COPD/asthma clinic. I wanted to promote the importance of study abroad and international mission work, especially when promoting the care of asthma and the pulmonary patient, which I believe we did. The main project during study abroad was to test the school-aged children in Linden, thereby showing that there was undiagnosed asthma.

The 2 days that we were in Linden brought the largest sign-up for their clinic. When we did our screening at Mackenzie High School, we were able to utilize the portable NDD spirometers and printer purchased by the CHEST Foundation community service grant. We are still collecting data, but the one thing that was revealed was the difficulty in obtaining medication for the treatment of asthma and COPD in some areas.

This project was also a learning experience for our students in many ways: in how they performed their interviews, how the culture affected the way their patients answered their questionnaires, and even how they performed on the tests. The value to the student and the individual of working within a different culture, far away from the norms of North America, allows you to appreciate your patients, the work you do, and your interprofessional team in a whole new light.

I want this experience to have an impact on the students’ lives. You are a teacher, an instructor, a mentor, professor, and much more when traveling with 10 students. The most satisfying moment is the transformation you see in them. They are no longer timid and unsure of themselves; they have greater confidence in their abilities and a deeper understanding of the needs of a patient. They finally understand the importance of culture as it pertains to health care.

The Effect of the CHEST Grant

Applying for the CHEST Foundation community service grant was the largest grant I had ever attempted. Having a support system behind you is the most important piece of advice I can give to future grant applicants. I could not have completed my grant without our grant team at Texas State University. They truly had my back; and close to the deadline when it seemed insurmountable, they helped push me through it. The other piece of advice, is to have a true vision and stick to that vision. The most difficult part of my project was the budget, prioritizing the things or people that I needed. Honestly, I needed help here, because for me, I needed everything. I had to make choices and leave some things out. I focused on what the actual need was for the many.

My ultimate goal for Guyana is to promote and show the need for respiratory care professionals to have that education offered at the University of Guyana as part of its allied health program and assist those in the application to the International Fellowship Program of the American Association of Respiratory Care—there has never been a fellow from Guyana. I believe that Guyana will have the resources, and with assistance, could achieve the goal. My vision and goal started in 2016 and I want to achieve it in the next 10 years.

I would like to thank all the CHEST Foundation donors from the bottom of my heart. This project was real and as a CHEST member myself, it encourages me to be a better donor. Thank you—for it was and is much appreciated. Finally, I would like to express my thanks to my co-Assistant Program Director, Holly Wise (Mass Communications) and Amber Hazelett, RRT, (RC assistant) and the BGMM team for their entire support throughout the study abroad journey.

Interested in applying for a 2018 CHEST Foundation grant? The grant cycle is open through April 9, 2018. Learn more on how to apply.

Sharon Armstead, EMBA, RRT, is a winner of the 2017 CHEST Foundation Community Service Grant Honoring D. Robert McCaffree, MD, Master FCCP. Sharon acts as a Clinical Assistant Professor and is the Director of Clinical Education at Texas State University's Department of Respiratory Care.