Pharmacy Perspectives - Winter/Spring 2017 - 10

International :

Guatemala Rotation
Proves Life Changing
BY DANA A. BRANDORFF

or fourth-year pharmacy student Olga Rundberg, "The Guatemala
rotation was such an enlightening experience both personally and
professionally. There is so much opportunity for pharmacy students
to have a positive impact on these rural communities regarding safe
and appropriate medication use. We also have the opportunity to
advocate for our profession as pharmacists and encourage collaborative practice between health care professionals."
The Center for Human Development (CHD) is a low-cost interprofessional healthcare center located in an extremely poor, rural region of southwest
Guatemala. It was created through a public-private partnership between AgroAmerica, a private family-owned Guatemalan banana and palm oil agro-business,
Children's Hospital Colorado, and the University of Colorado, Denver. Partners
from the University of Colorado, Denver include the Center for Global Health
(CGH), Schools/Colleges of Pharmacy, Medicine, Nursing, Public Health,
Business, Dentistry, Pharmacy, Architecture, and Arts and Sciences.
CU Skaggs School of Pharmacy faculty and administrators visited the clinic
to identify needs and Advanced Pharmacy Practice Experience (APPE) rotation
opportunities. Based on this visit, pharmacy faculty created a six-week APPE at
the CHD for fourth-year pharmacy students. A total of five APPE pharmacy
students have completed the six-week Guatemala rotation and two students are
currently on rotation in Guatemala.
The APPE rotation was developed to include pharmacy distribution activities,
patient/technician/provider/community education, and clinical pharmacy services.
Pharmacy faculty serve as primary preceptors along with a local Guatemalan pharmacist, medical residents, and clinic directors. Pharmacy faculty are available remotely
to answer pharmacy related questions and assist with clinical pharmacy visits.
Expectations of students while on rotation at the CHD include creating
patient medication education sheets, delivering education sessions to clinic staff
and/or patients, working with and educating the pharmacy technician, as well as
serving as a resource for the medical residents and staff for all pharmacy related
questions and needs.
"We track the total number of pharmacy student interventions, number of
interventions accepted, types of interventions performed, and specific student

projects completed in order to
measure the clinical impact of this
rotation," says Jodie Malhotra,
PharmD, director of practitioner and
international development.
"Learning about their culture,
meeting the people and experiencing
the raw beauty of Guatemala was such
an incredible experience but I'd have
to say that the most fulfilling part of
this rotation was the fact that every
day I had the opportunity to make a
difference in someone's life by means
of education," says Rundberg.

Left: P-4 student Melinda Gonzales,
faculty member Hilda Bi Ndikum and
pharmacy technician Carolina at the
clinic. Above: the research lab.

Students reported that they spent
the majority of their time in the pharmacy (70-80%). The remaining time
was split between assisting providers
during clinic visits, conducting home
visits with the community nurses, and
shadowing in the laboratory. Students
provided training and education to the
full-time pharmacy technician and used
a train-the-trainer method to provide
education to the community nurses
who then provided this education to
the community. According to Malhotra,
"In the first year, there were 442 total
interventions recommended during

Irish Eyes Are Smiling
BY DANA A. BRANDORFF

hadowing pharmacists and learning about the healthcare
and insurance systems in Ireland have been the focus of
Lindsay Case and Andrea Bilderback's international rotation
during their final year of pharmacy school. Both are in Ireland under
the tutelage of Dr. Martin Henman at Trinity College in Dublin.
Andrea Bilderback (left) and Lindsay Case (right) are all smiles in Ireland.

CU Skaggs School of Pharmacy and Pharmaceutical Sciences

this time, with 76% (336/442) of the
interventions accepted. The majority
of interventions not accepted were
due to refusal by the patient." Sixteen
student specific projects have been
completed during the five completed
student rotations.
Pharmacy involvement at the clinic
has led to a recent partnership with San
Carlos University Faculty of Pharmacy
with a goal to integrate CU and San
Carlos students at the clinic and in
the local hospital. Our school's APPE
rotation in Guatemala meets the needs

of underserved populations, establishes
effectiveness of distance precepting by
pharmacy faculty, and provides international interprofessional opportunities
for fourth year pharmacy students.
"Going to Guatemala has been
a life changing experience and has
really changed my outlook on life. If
you are looking for an opportunity to
improve your Spanish, be part of an
amazing collaboration, learn about
health care in a third world country
and put your pharmacy skills and
knowledge into practice, Guatemala
is for you!" says Rundberg.

Enthused by the people, countryside and the
overall experience, Case and Bilderback have been
able to merge pharmacy education with exploring the
country. "It's amazing that you can travel across the entire country in a matter of hours," says Bilderback. From
Galway to the Cliffs of Moher and the Ring of Kerry,
the two are leaving no stone unturned, while learning
about pharmacy practice in a foreign country.
"What's really interesting is that pharmacies are not
in grocery stores at all. Irish pharmacies are their own

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