From left: Arianna Rossetti, Amanda Lustig and Kelsey Donovan

It was an unforgettable moment when Kelsey Donovan, PA-C, and her colleagues stood by their patient as she saw her unborn baby for the first time via ultrasound during a clinic visit in Nicaragua.

“We were all moved to tears,” said Donovan, a physician assistant in the Brigham’s Emergency Department (ED).

Before meeting Donovan and her colleagues in her hometown of Chacraseca, a small town near the Pacific coast of Nicaragua, the patient didn’t have access to basic prenatal care, including ultrasound scans. As a result, she had been nervous about her baby’s health.

“For this mother to have the reassurance that her baby was OK meant everything to her,” Donovan said.

During a recent five-day service trip, Donovan, along with Brigham colleagues Amanda Lustig, a Development Office associate, and Arianna Rossetti, PA-C, also an ED physician assistant, traveled to Nicaragua with a team from the nonprofit FNE International (FNEI) to care for patients there. The group worked alongside Nicaraguan providers at traveling clinics around Chacraseca to care for about 500 patients with various medical needs.

Establishing Global Partnerships

FNEI — whose first three letters stand for facilitate, network and empower — partners with communities in developing nations to improve housing, health and education. On their recent trip with the group, Donovan and Rossetti volunteered as care providers, and Lustig, a trained medical interpreter, served as an interpreter for Spanish-speaking patients and the FNEI team.

In addition to caring for patients with acute illnesses and chronic conditions, the group performed cervical cancer screenings, treated sexually transmitted diseases and educated patients about reproductive health.

Having been to Nicaragua before with FNEI, Rossetti said it was heartwarming to see familiar faces in the clinic, including a mother and her toddler. During Rossetti’s previous trip there, she had performed an ultrasound on this mother before she gave birth.

“It’s things like this that happen on these trips that I will never forget,” Rossetti said.

An Eye-Opening Experience

Rossetti said the experience of delivering care with limited resources in Chacraseca has taught her how to be a better clinician.

“Sometimes, it can be very easy to jump to perform diagnostic tests on patients back in the U.S., but in Nicaragua you can’t do that,” Rossetti said. “You have to rely on a patient’s verbal history and the physical exam to make a diagnosis.”

Rossetti and Donovan said some patients came to the clinics to talk to someone about their broader physical and emotional well being. Understanding that patients in this rural community have very limited access to psychiatric care, Rossetti and her colleagues advised patients about depression symptoms, stress management and potential coping mechanisms they could practice at home.

“Many patients didn’t want to be alone and wanted a few minutes to talk with us,” Rossetti said. “A lot of times, we can be quick to give patients referrals to specialists, but caring for patients abroad has taught me to sit down and take more time to listen to patients and just be there for them.”

The trio said it was amazing to bond with other volunteers and Nicaraguan medical staff. They encourage anyone who is interested to participate in a service trip at least once.

“This was one of the most rewarding experiences for me,” Lustig said. “I can’t wait to go back.”