TWO student nurses from Edge Hill College of Higher Education have returned from the work experience of a lifetime – in the Philippines.

All final year nursing students have the opportunity to undertake a clinical placement of their own choice. Stephen Flanagan and John Culshaw chose to spend theirs alongside nursing students at the University of the Philippines Manila.

The health service in the Philippines has suffered at the hands of corrupt governments, and through foreign debt and the lack of economic investment. But Stephen and John found that the standard of nursing care was high, despite the minimal resources available to nursing staff.

Stephen said: “Our first stop was the central intensive care unit at the Philippine General Hospital. On first impressions the approach to nursing in the unit was very similar to that in the UK, but the lack of resources and equipment was very evident. This was clearly highlighted by a visit to a general medical ward where four staff struggled to care for 60 patients. Of these, one caught our attention immediately: an infant manually ventilated by his father. No machines, just a belljar filled with a measured amount of water to regulate the pressure and a length of tubing attached to a bag and mask.

“However, outcomes for the patient seemed not to be compromised. The level of skill, initiative and resourcefulness displayed by the nurses was of a high standard, enabling them to overcome problems of minimal resources.”

The Emergency Room at the hospital attends to between 600 and 700 patients a day and, like all the other departments, was short-staffed. John said: “It was common for patients to be lying on corridor floors because there were no trolleys, and staff had to deal with the victims of numerous violent incidents – stabbings and shootings.”

As in the UK, Filipino nursing students have to undertake a community placement. John and Stephen joined third year students in an urban barangay (village) situated in the poorest part of Manila. Based at a local health centre, they participated in health education programmes and visited patients in their own homes.

Stephen said: “The people have traditionally been faced with health problems such as acute and chronic respiratory infections, tuberculosis, sexually transmitted diseases and iodine deficiency, but they are now seeing new problems emerging, such as cardiovascular disease, cancers, mental health problems and Aids. Glue-sniffing in teenagers and adults is also becoming a big problem.”

From there the students travelled to Banilad, a rural barangay south west of Manila. John said: “We visited many families who requested our presence and carried out a brief individual health assessment of each patient. All in all we assessed eight patients, identified problems and implemented holistic care. We also made use of alternative medicine from the Halamang Gamot – the herbal medicine garden – in the treatment of patients.

“We discovered that spiritual healing was a major influence in the lives of the people of the barangay. When people fell ill, rather than consult a doctor, they would seek the opinion of a healer who claimed to be able to carry out operations without surgical intervention.”

The students, who will graduate next year, said that while the experience was fascinating it was sometimes frustrating. Stephen said: “We would assess people’s health and then realise there was no equipment and no medicines to implement the treatment needed. However, despite the difficult circumstances, the local nurses cope well and the standard of care they give is excellent.

“Everyone we met made us very welcome. It was an opportunity of a lifetime and the perfect learning experience.”