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Parent_2018_health_and_safety
- 2. Parent Preparat i on Modul e 2 Heal t h and Saf et y
- 3. • A t horough overvi ew of AMIGOS Heal t h & Saf et y – Prot ocol & Procedures – Part i ci pant Tool s – Heal t h Screeni ng – Heal t h St at i st i cs – Prevent i ng Il l ness – On- Cal l Syst em – Underst andi ng t he CALM Pl an Par ent Pr epar at i on Modul e 2: Topi cs
- 4. • Pr e- depar t ur e – Heal t h & saf et y r ound r obi ns – “ Saf eguar di ng Your Ment al Heal t h” act i vi t y – Onl i ne heal t h and saf et y assessment s – Deci si on maki ng act i vi t y • I n- count r y Tr ai ni ng – Pr oj ect speci f i c heal t h and saf et y r evi ew – Host communi t y speci f i c i nf or mat i on Par t i ci pant Tr ai ni ng on Heal t h & Saf et y
- 5. • Par t i ci pant Heal t h, Saf et y & Tr avel Gui del i nes • Pr ophyl axi s & I mmuni zat i on Requi r ement s • Pr oj ect I nf or mat i on Packet s Par t i ci pant Tool s
- 6. • CALM Pl an • Weekl y Sel f - Assessment For ms – Compl et ed by par t i ci pant & Pr oj ect Super vi sor • Heal t h Logs – Compl et ed by par t i ci pant • Par t i ci pant Per f or mance Eval uat i ons – Compl et ed by par t i ci pant & Pr oj ect Super vi sor Al l o f t he s e d o c ume nt s be c o me a p a r t o f t he p a r t i c i p a nt ’ s o f f i c i a l f i l e wi t h AMIGOS. Par t i ci pant Tool s
- 7. Gui del i nes f or : • Host Communi t y Sel ect i on • Host Fami l y Sel ect i on • Meal Pl an Gui del i nes • Par t ner shi p Sel ect i on & Pl acement s – I ncl udes sl eepi ng ar r angement s Pr oj ect Leader shi p Team’ s Tool s
- 8. The AMI GOS par t i ci pant wi l l not : 1. Engage i n det ri ment al behavi or 2. Use or possess any drugs 3. Leave hi s/her assi gned work area wi t hout permi ssi on 4. Operat e any mot ori zed vehi cl e 5. Handl e f i rearms or any ot her weapon 6. Engage i n act s of di srespect , harassment , or bul l yi ng 7. Engage i n t he consumpt i on of al cohol 8. Engage i n i nt i mat e or amorous rel at i onshi ps 9. Use or possess t obacco product s Par t i ci pant Tool s – St andar ds of Conduct
- 9. St andar ds Vi ol at i on Pr ocess • I n t he event of a st andar ds vi ol at i on a r epor t wi l l be submi t t ed by t he i n- count r y t eam al ong wi t h a st at ement wr i t t en by t he par t i ci pant t o t he Emer gency Management Team. A deci si on wi l l t hen be made on t he out come of t he vi ol at i on: – Warni ng: f or mi nor , f i r st t i me vi ol at i ons whi ch do not pr esent a t hr eat t o t he heal t h and saf et y of any par t i ci pant s – Inci dent : a mor e ser i ous and i nt ent i onal vi ol at i on whi ch coul d be pot ent i al l y damagi ng t o t he i ndi vi dual , or gani zat i on, or host
- 10. Deci si on Maki ng • Tal k about deci si on maki ng, bot h good and bad. • Remember t hat we want t hem t o make t he choi ce t o t r y, t o push t hei r boundar i es, even i f t hey f ai l . I t ’ s par t of t he exper i ence. • Encour age t hem t o t hi nk t hr ough t he ef f ect s of al l t hei r act i ons and how i n a pr ogr am l i ke AMI GOS t hey can af f ect so many di f f er ent peopl e.
- 11. • Mai nt ai ni ng par t i ci pant heal t h & saf et y – Top pr i or i t y wi t h pr i mar y f ocus bei ng on pr event i on of maj or i ssues • Al l pr ot ocol s ar e est abl i shed by t he Medi cal Heal t h & Saf et y Commi t t ee – Based on Cent er f or Di sease Cont r ol r ecommendat i ons and when appl i cabl e t he Nat i onal I nst i t ut e Fr om t he AMI GOS Medi cal Di r ect or : Davi d Bar on, MD
- 12. • Al l par t i ci pant s ar e scr eened i n ar eas of physi cal and ment al heal t h accor di ng t o expl i ci t cr i t er i a. – Repor t any and al l changes i n heal t h st at us at once t o AMI GOS Nat i onal Of f i ce at i nf o@ami gosi nt er nat i onal . or g Heal t h Cr i t er i a & Scr eeni ng
- 13. • Handl ed wi t h t he ut most conf i dent i al i t y di r ect l y by Nat i onal Of f i ce Scr eeni ng Team. • Submi t Heal t h For ms di r ect l y t o appl i cat i on f or r evi ew by t he Nat i onal Of f i ce Scr eeni ng Team. • Cont act i nf o@ami gosi nt er nat i onal . or g f or any quest i ons about your par t i ci pant ’ s Conf i dent i al Heal t h Scr eeni ng pr ocess. Heal t h Scr eeni ng Pr ocess
- 14. • December 10, 2017 – E- si gnat ur e ( Let t er of Heal t h Di scl osur e and Consent & Rel ease) • Febr uar y 1, 2018 – Heal t h For m Deadl i ne • Apr i l 15, 2018 – Heal t h Updat e – No ai r l i ne t i cket wi l l be di st r i but ed t o any par t i ci pant who has not compl et ed and submi t t ed al l above paper wor k. Heal t h Scr eeni ng Ti mel i ne
- 15. • Di scl osur e of heal t h i nf or mat i on does not aut omat i cal l y di squal i f y appl i cant s. • I nt ent i onal non- di scl osur e or mi ni mi zat i on of heal t h hi st or y ( physi cal or psychol ogi cal ) wi l l l i kel y r esul t i n i mmedi at e di smi ssal f r om t he pr ogr am at t he par t i ci pant ’ s expense. Non- Di scl osur e Pol i cy
- 16. • Fol l owi ng t abl e summar i zes t he most common ai l ment s r epor t ed t o t he On- Cal l Syst em. – Thi s dat a i s t he number of cases NOT t he number of i ndi vi dual s. – ( An i ndi vi dual may have mul t i pl e cases) • Dat a i ncl udes cases f or bot h par t i ci pant s and Pr oj ect Leader shi p Team  Heal t h St at i st i cs: Def i ni ng t he Number s
- 17. Summer Heal t h St at i st i cs ( an aver age summer ) Il l ness / Inci dent Number of Cases Ani mal Bi t e/ scr at ch/ l i ck 25 Post - Exposur e Rabi es Vacci nat i on 2 Upper Respi r at or y I nf ect i on 11 GI I nf ect i ons 166 Scabi es 5 Appendect omy 1 Or t hopedi c I ssues 8 Mal ar i a 0 Dengue ( Non- hemor r hagi c) 2 Yel l ow Fever 0 Typhoi d 0 Tot al Cl i ni c Vi si t s 301
- 18. • Hand- washi ng –saves l i ves and pr event s i nf ect i ons! Wat ch t hi s VI DEO: – www. cdc. gov/ CDCTV/ HandsToget her / • Bat hi ng - al l par t i ci pant s must mai nt ai n good hygi ene and bat h r egul ar l y. • Cl ot hi ng - wash cl ot hi ng as t he host f ami l y does. Good Per sonal Hygi ene Pr event s I l l ness
- 19. • Al l par t i ci pant s* ar e r equi r ed t o use a per sonal wat er pur i f i cat i on met hod. – RECOMMENDED: chl or i ne dr ops or chl or i de di oxi de. ( CDC) – NOT r ecommended or r el i abl e f or t he summer : • UV l i ght decont ami nat or s • Por t abl e wat er f i l t r at i on syst ems ht t p : / / wwwnc . c d c . g o v / t r a v e l / y e l l o wbo o k/ 2 0 1 2 / c ha p t e r - 2 - t he - p r e - t r a v e l - * Thi s p o l i c y d o e s no t a p p l y t o p a r t i c i p a nt s a s s i g ne d t o p r o j e c t s whe r e p o t a bl e wa t e r Wat er Pur i f i cat i on
- 20. • Host communi t y meal pl ans ar e a donat i on f r om t he communi t y. – Par t i ci pant s need t o be gr aci ous guest s and eat t he f ood of f er ed! • Many par t i ci pant s eat on a r ot at i ng meal pl an – Reduces t he bur den on t he host f ami l y – Popul ar wi t h par t i ci pant s – Gr eat way t o get t o know t he communi t y Communi t y Meal Pl ans
- 21. • Pr oper l y cl ean, cook, and peel al l pr oduce bef or e eat i ng t o avoi d i nf ect i on. • NO homemade j ui ces, i ce or wat er f r om an unknown sour ce. • Par t i ci pant s ar e encour aged t o hel p wi t h meal t i me chor es. Food Pr epar at i on
- 22. 1. Par t i ci pant s wi l l NOT become i mmune t o mi cr obes of t hei r host communi t y. 2. Many host communi t i es/ pr oj ect ar eas may not be abl e t o accommodat e al l speci al di et s. 3. NO di et i ng! 4. Not i f y super vi sor i f t her e i s a concer n i n- count r y r egar di ng meal pl an ASAP Di et ar y Concer ns
- 23. 1. Veget ar i ani sm - I n some pr oj ect ar eas 2. Vegani sm - NOT abl e t o suppor t on any pr oj ect 3. Rel i gi ous Rest r i ct i ons - May be abl e t o suppor t mi ni mal f ood i t em r est r i ct i ons. – NOT abl e t o suppor t el abor at e di et ar y r est r i ct i ons. 1. Ot her di et ar y r est r i ct i ons - Al l er gi es and ot her di et ar y r est r i ct i ons on some pr oj ect s. Can AMI GOS Accommodat e Speci al Di et ar y Request s?
- 24. • Par t i ci pant s wi l l be l i vi ng wi t h a host f ami l y and shoul d t ake t o r ef l ect on what bei ng a good house guest wi l l l ook l i ke. – Hel p wi t h househol d chor es – Be home when expect ed – Communi cat e pl ans – Be t i dy – Be f r i endl y and out - goi ng – Abi de by househol d nor ms/ r ul es Bei ng a Good House Guest
- 25. • Dehydr at i on - one of t he t op causes of AMI GOS par t i ci pant s seeki ng medi cal at t ent i on. • Pr event i on: dr i nk at l east 2 L of pur i f i ed wat er dai l y; avoi d cont ami nat ed f ood, and wash hands f r equent l y. • Rehydr at i on – dr i nk or al r ehydr at i on t her apy ( ORT) or s ue r o . Dehydr at i on & Rehydr at i on
- 26. • About 40% of r epor t ed AMI GOS par t i ci pant medi cal cases i nvol ve st omach ai l ment s. • Pr event i on: – Eat i ng f ood t hat has been pr oper l y pr epar ed. – Dr i nki ng wat er t hat has been pr oper l y pur i f i ed. – Mai nt ai ni ng good hygi ene – Fr equent l y & pr oper l y washi ng hands! – Avoi di ng dehydr at i on. Pr event i ng St omach Rel at ed I l l ness
- 27. • Par t i ci pant s may t r avel wi t h One- Cour se Ant i bi ot i c t r eat ment t o be t aken f or Tr avel er s’ Di ar r hea onl y. – Tr avel er s’ Di ar r hea def i ned i n t he Par ent Pr epar at i on Gui de ( PPG) • Tr eat ment : si ngl e cour se ant i bi ot i cs – TAKE f ul l cour se as di r ect ed by doct or – Not e i n heal t h l og and not i f y super vi sor • Fol l ow al l pr ot ocol st eps cl osel y One- Cour se Ant i bi ot i c Tr eat ment f or Tr avel er s’ Di ar r hea ONLY
- 28. • AKA– t he common col d • Pr event i on: – Hand washi ng, st ayi ng hydr at ed and wel l r est ed. • Tr eat ment : – Rest and dr i nk l ot s of f l ui d. – Ant i bi ot i cs do not t r eat vi r al i nf ect i ons ( l i ke t he common col d) . Upper Respi r at or y I nf ect i ons
- 29. • AMI GOS par t i ci pant s spend much of t hei r t i me out door s i n t r opi cal l ocat i ons and/ or at hi gh el evat i on. • Pr event i on: • Avoi d over exposur e t o t he sun. • Wear sunscr een of at l east 35 SPF ( appl y sunscr een f i r st and t hen i nsect r epel l ent ) . • Wear l ong- sl eeve cl ot hi ng & hat t o pr ot ect t he ski n. Pr event i ng Rashes and Sunbur ns
- 30. • AMI GOS wor ks i n ar eas wher e t r opi cal di seases such as mal ar i a, dengue, yel l ow f ever , chi kungunya, zi ka and Chagas may be pr esent . • Low i nci dence r at es • Col l abor at i on wi t h t he CDC t o devel op r ecommendat i on and t r ack our popul at i on’ s i nci dence • I f par t i ci pant s f ol l ow our r equi r ed gui del i nes t he r i sk wi l l be gr eat l y mi ni mi zed. • ( For mor e det ai l s on speci f i c di seases see ht t p: / / wwwnc. cdc. gov/ t r avel / ) Pr event i ng I nsect Bi t e Rel at ed I l l nesses
- 31. • ALWAYS sl eep under a mosqui t o net . • Wear cr eam- based bug r epel l ent – Wi t h 30- 50% DEET ( CDC) • NO 51+% DEET! ! ! – Appl y af t er sunscr een • Wear pant s and l ong- sl eeve shi r t s dur i ng t i mes of hi gh mosqui t o act i vi t y. Pr event i ng I nsect Bi t es
- 32. DEET vs No DEET
- 33. • Rabi es – due t o l ower r at es of ani mal i mmuni zat i on, t her e i s an i ncr eased r i sk of ani mal s car r yi ng r abi es. – Rabi es i s l et hal once si gns of i nf ect i on ar e pr esent . – Rabi es may be t r ansmi t t ed anyt i me sal i va makes cont act wi t h t he bl oodst r eam. – Post - exposur e shot s ar e REQUI RED, i f an exposur e occur s and t he ani mal cannot be moni t or ed f or 10 days. Ani mal Bi t es, Scr at ches and Li cks
- 34. • AMI GOS pr event i on pol i cy i s r i gi d – NO TOUCHI NG ani mal s, especi al l y dogs, cat s, bat s and monkeys ( mammal s) . – Lat i n Amer i can dog cul t ur e: gener al l y dogs ar e not pet s. – Except i ons may be made i n cases wher e t r anspor t at i on i s vi a hor seback. • Rabi es pr e- exposur e i mmuni zat i on i s not r equi r ed by AMI GOS. Rabi es Pr event i on
- 35. • Al l pr escr i pt i on medi cat i on AMI GOS par t i ci pant s ar e t aki ng dur i ng t he summer must be di scl osed. – St af f must have i nf or mat i on avai l abl e i n case of an emer gency t o pr event har mf ul dr ug i nt er act i ons. Pr escr i pt i on Medi cat i ons
- 36. • Each pr oj ect ar ea has i t s own set of r equi r ement s. • Requi r ement s ar e based on CDC r ecommendat i ons f or t he speci f i c r egi on of t he host count r y • See speci f i cs i n t he par t i ci pant Heal t h, Saf et y and Tr avel Gui del i nes. I mmuni zat i ons & Pr ophyl act i c Pr event i on
- 37. • 24 hour On- Cal l syst em • Suppor t s t he AMI GOS i n- count r y Pr oj ect Leader shi p Team • Oper at ed by Nat i onal Of f i ce pr of essi onal st af f • See Admi ni st r at i ve Pol i cy f or speci f i c r ol es of al l par t i es i nvol ved. I nt r oduct i on t o AMI GOS On- Cal l Emer gency Management Syst em
- 38. • Focus i s on suppor t i ng Pr oj ect Leader shi p Team member s and par t i ci pant s. – Handl es medi cal concer ns, ment al heal t h i ssues, vi ol at i ons of t he St andar ds of Conduct , and ot her mi scel l aneous i ssues t hat may i mpact t he AMI GOS par t i ci pant s. • AMI GOS On- Cal l St af f have di r ect access t o consul t wi t h medi cal and ment al heal t h pr of essi onal s as necessar y as a par t of t he 24 hour On- Cal l Syst em. – Al l cases r epor t ed ar e r evi ewed by heal t h pr of essi onal consul t ant s. On- Cal l Syst em Focus
- 39. • Al l AMI GOS par t i ci pant s shoul d br i ng a basi c f i r st ai d ki t . – Tr eat mi nor sympt oms – Pr event i nf ect i on, bug bi t es and sunbur ns • Al l heal t h sympt oms shoul d be not ed i n t he par t i ci pant Heal t h Log – CALM Pl an shoul d be act i vat e i n any quest i onabl e case! • See PPG f or l i st of r ecommended i t ems. Fi r st Ai d Ki t
- 40. • A speci f i c “ 911” pl an devel oped f or each AMI GOS host communi t y t o connect t hem t o t hei r Pr oj ect Leader shi p Team, emer gency car e and t he AMI GOS On- Cal l syst em. • The CALM Pl an r equi r es par t i ci pant s t o seek t he cl osest and most accessi bl e sour ce of assi st ance f i r st . CALM Pl an
- 41. • The 1st st ep i n ever y par t i ci pant ’ s CALM Pl an i s t o cont act t hei r Pr oj ect Leader shi p Team. • Par t i ci pant s may al ways cont act t hei r par ent s, BUT i f t hey cal l you as f i r st st ep of t he CALM Pl an – t hi s i s consi der ed CALM Pl an ci r cumvent i on and det r i ment al behavi or . • I f you ar e cont act ed di r ect l y by your par t i ci pant , make sur e t hey have al r eady act i vat ed t hei r CALM Pl an bef or e cal l i ng you so t hat l ocal hel p i s on t he way! Avoi di ng CALM Pl an Ci r cumvent i on
- 42. • Suppor t par t i ci pant s i n pr epar i ng f or a heal t hy and saf e summer . • Empower par t i ci pant s t o f ol l ow heal t h and saf et y pr ot ocol . • Under st and AMI GOS pr ot ocol and know who you shoul d cont act wi t h quest i ons. Rol e of Par ent s
- 43. Quest i ons? Thank You!
Hinweis der Redaktion
- FACILLITATOR –Each slide (except for slides 14, 15, data table, 30, with a picture of DEET vs NO DEET, and the final slide) has audio that will play automatically once you reach that slide. This is to standardize the information being given to parents in each chapter. Please be prepared to expand on and answer questions on any of the topics covered in this presentation. For the three slides with no recorded audio, please explain the slides yourself.
- All participants complete: A health and safety module which prepares participants to be proactive in the prevention of infectious diseases and other possible illnesses. Mental health module discusses cultural adjustment phases and prepares participants to utilize their existing coping skills in maintaining a positive state of mental health. The health and safety assessment encompasses all AMIGOS health related topics ensuring participants are familiar with the current health and safety message across the AMIGOS network The activity on decision making provides a framework for the independence and responsibility that participants will be faced with while in the field. This activity encourages participants to make decision which will get them outside of their comfort zone in a positive way as well as press them to thinking through the effects of their decisions before they act to prevent negative outcomes. In country training sessions build upon the foundation of knowledge established during pre-summer training. And these sessions provide the project specific details, community safety plans with the local contacts, and specific tips relating to illness prevention (water, food, mosquito, animal risks and safety)
- participant HST Guidelines – include specific instructions for maintaining & monitoring health in the field, as well as travel instructions and emergency procedures. participants are required to carry these guidelines with them at all times. Immunization requirements are specific to the regions AMIGOS work and may differ from your local travel doctor’s broader recommendations. **Please see the enclosed doctor’s note from AMIGOS Medical Director Project Information Packets include the specific details on the local climate, dietary information and MANY other important details.
- CALM Plan – The community specific emergency plans that are key to AMIGOS health & safety protocol. - A very important tool to be covered in detail near the end of this presentation. Self-assessment forms are completed weekly by participants. Then shared & discussed with the Project Supervisor. They cover all main components of the summer projects, host community, partnership dynamics and an individual’s well-being. Health Logs are completed by participants – they are to fill out the a line with specifics for every health related incident – minor or serious – whether or not a clinic visit was necessary Participant Performance Evaluation forms that allow the individuals to conduct a self-evaluation on 14 leadership areas before getting feedback in each of these areas from their Project Supervisor. ALL of these documents become a part of the participant’s official file with AMIGOS and are available post-experience upon request.
- FACILITATOR Note: Have parents turn to these pages and review specifics for 2-3 minutes and ask for any questions. - Be sure to have reviewed the details prior to the presentation so you are prepared to do an overview.
- Standard 1 – “No detrimental behavior” - This is a catch all rule. Be smart. Don’t do anything that puts yourself or others in unnecessary danger. We expect our participants to make wise choices. Includes things like circumventing the CALM Plan, taking un-approved medication, petting ANY mammal and anything just generally not smart or safe.  Standard 2 – “No drugs” – Pretty straight forward. However, you should be aware that this is a super serious standard. Many of AMIGOS host countries have dealt with very harsh US interventions in the drug war. These countries are not inclined to be lenient on US citizens using drugs within their borders. Americans caught using drugs will be put into jail and there is nothing AMIGOS can do to help individuals in these situations. Even the rumor of an AMIGOS participant having drugs is enough to close some countries to all AMIGOS projects. Be very careful to stay away from and report all drug activity with in your community to your Supervisor.  Standard 3 – “No leaving your community” – again, your CALM plan is set up to guarantee we can contact you. We can only contact you if we know where you are. AMIGOS guarantees that we can pull our participants out of the country within 24 hours in case of emergency. Therefore we must be able to reach you at all times. participants can request permission to leave their communities for special occasions and MAY be granted permission if it is deemed safe and appropriate. (This WILL NOT include any political events or large national/international soccer events as these types of events have the potential to become violent quickly.) Make sure you have a clear understanding of what all of the boundaries are of your community AND before you get in any community member vehicle – make sure that they will not be driving out of the boundaries even a little bit. Standard 4* – “No driving motor vehicles or riding (or even sitting on) motos” – the rules of the road are very different in Latin America and both of these activities would be very dangerous for AMIGOS participants. Motorcycle accidents were the number 1 cause of death for Peace Corp participants before the Peace Corp disallowed them for all participants. Additionally, in the past we have had participants with severe motorcycle burns on their legs – just from sitting on them to take a photo. Burns are major health concerns in the developing world as they are very difficult to keep clean and infection free.  Standard 5 – “No guns” – seems common sense. A participant in the 1970s shot himself in the foot while handling firearms and we don’t want you to have a similar accident.  Standard 6* –“No bullying” – this includes name-calling, intimidating, physical harm to individuals or property, cyber-bullying, contributing to an abusive environment, etc. Most of you are aware of the recent events where bullying became a big issue – and one of life and death - in the media. Unfortunately, we have had to deal with cases of bullying in the past and this is simply unacceptable behavior as it runs counter to our organizational vision of “creating positive social change”. See AMIGOS Bullying Policy for more specifics.  Standard 7 – “No drinking” - This is for your protection. Our CALM plan counts on having you and your partner able to handle an emergency situation at any time. You can not afford to have your judgment impaired by alcohol at anytime. AMIGOS is not party time – that can wait 6 or 8 weeks while you lead some of the most exciting projects you’ve likely ever been engaged in!!! Additionally, you will be viewed as health ambassadors and should be setting a positive example for community members and youth groups.  Standard 8 – “No amorous conduct” – the cultural norms of relationships will be different in your host community than they are in the US. You may find yourself in an uncomfortable or dangerous situation if you encourage amorous attention. Proactively avoid this type of interaction with community members. It may jeopardize your personal reputation as well as the reputation of AMIGOS and our partner agency.  Standard 9* – “No smoking” – you will be viewed as health ambassadors and should be setting a positive example.
- The AMIGOs experience is a unique one. We expect a lot from our participants. They’re given a significant amount of indepenece and responsibility at a young age and are very much in control of the quality of their experience. One of the interesting realities of our program is that our participants are the frequently the center of attention in their communities and host families and have the ability to affect others through their decisions and actions. This can be both exciting and scary for our participants who have rarely been given the opportunity to truly lead and be an influencer to this degree. AMIGOS truly believes young people are capable of taking on this challenge with great success. As parents, we ask that you help us prepare them to take on this challenge. Encourage them to get outside of their comfort zone and try new things that might seem daunting at first. Things like speaking more Spanish, being more social, or trying new food, whatever their faced with! Talk to them about making mistakes and failure and remind them that ITS OK!. It’s part of the experience, it’s part of getting older, and it will never stop being a part of life but it’s not a reason to stop trying. They will have the support in their supervisors, partners, and host community to learn from their failures and keep moving forward. Get them to start thinking about the decisions, both small and large, they will have to make which can define their experience. Decisions like whether or not to get up early in the morning and help their host family start the day or bigger decisions like choosing not to engage in something against the standards. Whatever decisions they make they’ll be held accountable for so it’s important to start talking about these things before their experience so that they can have the most positive and rewarding experience possible.
- Member of the AMIGOS International Board and Chair of the Medical Health & Safety Committee Our recommendations may differ from more broadly defined travel medicine recommendations, as they are tailored to the specific regions and participant experiences while on AMIGOS (not standard tourists’ experience). When it comes to health and safety, our main goal is to prevent major issues from arising. All of our health and safety protocols have been established by headquarters staff, the AMIGOS medical director, and the medical health and safety committee. We use the most recent health recommendations from the Centers for Disease Control and National Institute of Health and have key contacts at the CDC who have reviewed them.
- Screened by a set of criteria developed to help ensure the health of all AMIGOS participants in areas of physical and mental health. NOTE: often we need to have a certain level of health stability, so do NOT plan on any changes to medications, treatment, etc that would go against the General Health Criteria points. Any and all changes to a participant’s health status should be reported at once to via the Confidential Health Form III (CHF-III) or send updates directly to IO staff if they occur after the CHF-III has been submitted. This is to ensure proper placement and field support are available for your participant’s most current health status. All applicants are screened in accordance with criteria developed to ensure the health and safety of amigos participants in areas of physical and mental health. We need to ensure we have a certain level of health stability so we recommend that you do not plan on making any changes to medication prior to the program start that would go against the general health criteria. Any changes can be reported via the confidential health form III due in the late spring or by reporting them directly via email to the AMIGOS health screening team at [email_address]
- All participants are responsible for uploading completed confidential health forms directly to their online application. Screening is handled solely by the National Office Screening Team  All participants are responsible for submitting their health forms to their registration dashboard. The AMIGOS staff will then review these forms, keeping confidentiality in mind. Any questions about the health screening process or participant specific inquiries can be directed to the health and safety coordinator at [email_address]
- The disclosure of health information does not automatically disqualify applicants from participation. We have successfully supported a variety of physical and mental health conditions for our participants in the field. However an intentional non disclosure or minimization of a health or mental health condition can be grounds for an immediate dismissal from the program at the participants expense. It’s important to disclosure all conditions so that amigos can ensure adequate support is provided to each participant in the field.
- See next 3 slides for the tables. Table shows the number of people who reported experiencing each type of ailment rather than the number of cases of each ailment reported. Note that the total number of people reporting ailments is not the added sum of the number of people reporting each ailment, but rather how many individuals reported any ailment to the On-Call System.
- The table above summarizes the most common diagnosis and clinic visits reported to the On-Call System. It shows the number of cases where someone was diagnosed with each ailment, not the number of individuals as someone may have been diagnosed with the same issue at two separate times during the summer. This presentation contains preventative steps participants should take to minimize possible exposure to these tropical infectious diseases, even though they are rare occurrences within the AMIGOS contexts. Number of cases does not necessarily mean number of people. A case refers to a single incident that is called in and documented. One person may have more than one case.
- *** Facilitator note: if you have access to WIFI, watch this important video on hand-washing. Hand-washing – clean hands saves lives and prevents infections! Wash with water & soap for 20 seconds. If water is not available, use a alcohol based hand sanitizer discreetly and in a culturally sensitive way. Using proper hand-washing technique can keep you healthy this summer! Bathing Different bathing systems than participants may be accustomed to in community may be present; but all participants must maintain good hygiene and bath regularly. Bathing varies from bucket bath through modern shower.
- NOTE: participants will be provided with droppers, bottles to hold bleach, and bleach in-country, during briefing. participants will only need to bring their own Nalgene bottles to drink from. Iodine water treatment is NOT recommended. UV light decontaminators and portable water filtration systems are not reliable for the length of time our participants are in the field nor are the appropriate for the water sources often used by participants AND they are not culturally appropriate http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-2-the-pre-travel-consultation/water-disinfection-for-travelers.htm
- Many participants will eat on a rotating meal plan set up by AMIGOS staff and partners with community members. This has been very popular with AMIGOS participants as it allows them to spend quality time with many different community members. It also reduces the burden on the host family of cost for feeding AMIGOS participants. Most common concern – too much food to eat and unsure of how to politely decline. - this issue is addressed in-depth during participant training and in their training materials.
- Host families are made aware of participants need to be careful about water and food cleanliness, but participant need to be proactive about their food and water consumption throughout the host community. Consumption of these items may result in a high risk of infection by worms, parasites, bacteria and viruses! Boil it, peel it, cook it, or forget it.
- A common misconception among participants is that they will become immune to microbes while they are in community. This is untrue, they must continue to follow AMIGOS food, water and hygiene guidelines throughout the summer in order to minimize illness and infection. See project specific information and restrictions, for more information on diet and vegetarian restrictions. Certain project areas can accommodate vegetarians. Veganism is not a burden we are willing to place on our host families & communities. Please help prepare your participant to be a polite house guest and accepting of the food offered. Other special diets & allergies can be evaluated on a case by case basis. Please disclose on application and appropriate health forms. Areas with diets high in beans and rice easily accommodate gluten intolerance. Normally AMIGOS host community members view it as a privilege to feed our participants and offer them the very best they have. Rarely, there are some concerns with how the meal plan is working. Project Leadership Team should be notified as soon as possible about any issues or questions. All participants must maintain an adequate level of calories in order to stay healthy in a new environment and likely increased activity level
- Due to the structure of our programs, we have limitations on the types of diets that we can safely support. Our participants are placed with and fed by host families who generally do not receive any form of compensation. Food provided is therefore the typical regional diet and often the only food the family can afford to provide or has access to. Refusal of any food is generally viewed by host families and community members as disrespect. AMIGOS understands that this issue can often be a sensitive area of cultural differences and it poses a challenge for some of our participants. All participants with food restrictions are required to know how to describe in Spanish their food restriction in a respectful and culturally appropriate way. Vegetarianism AMIGOS is able to accommodate vegetarians in certain project areas only. Please check the project area descriptions carefully for dietary accommodations and restrictions. We do not make exceptions to these accommodations as we are not willing to place this burden on host families. Many AMIGOS participants identify themselves as vegetarians, which can pose particular challenges. In order to avoid offending their hosts, some choose to eat meat over the summer. Others decide to maintain their vegetarian diet (it is easier to do this in some places in Latin America than others). If you are vegetarian and decide to remain so throughout the summer, know in advance how you will explain your reasons (in Spanish) to community members. Avoid making statements that can be construed as judgmental, such as “I believe that killing animals is morally wrong.” This may be a difficult and offensive concept to someone who has worked hard to raise chickens and eggs in order to feed a family. Even if you have taken the time to choose a project where it will be easier to accommodate a vegetarian diet, know how to express yourself diplomatically. Veganism Due to the structure of our programs, strict veganism is difficult for us to guarantee in any of our project areas and this is not a burden we want to place on host families. AMIGOS cannot support a vegan diet. Religious Dietary Restrictions AMIGOS cannot accommodate elaborate dietary restrictions due to our program structure. Certain minimal food item restrictions can be accommodated. Please refer to the project area descriptions for the best project choices based on your individual dietary needs. Other dietary restrictions Allergies and certain other dietary restrictions may be accommodated in certain projects only, depending on individual needs and requirements. Please make sure all allergies and medical health conditions related to diet are disclosed on the Confidential Health Forms.Â
- These are just a few ideas of what being a good guest entails. Think about what hosts’ may view as appropriate guest behavior FACILITATOR SUGGESTION: have short group brainstorm about what the host families may view as appropriate guest behavior. (perhaps vets or vet parents can share experiences)
- Dehydration - loss of water & electrolytes from the body can impair bodily function. Can be the result of exertion, diarrhea, vomiting, sweating, and fever. In extreme cases be lethal. If ORT is not available drink diluted canned juices, Gatorade, mild teas, broth or flat soda.
- Includes - Diarrhea, Gastrointestinal Infections, Nausea, Vomiting, Constipation, Abdominal Pain Some degree of adjustment due to dietary changes is included in this percentage and may be unavoidable. Infections can be prevented by following AMIGOS health and safety protocol.
- Travelers’ Diarrhea is defined as being 4+ unformed stools in a 24 period plus a symptom such as abdominal cramps, nausea, vomiting, fever or chills. Treatment can be Ciprofloxacin, Levofloxacin, or Azithromycin. Follow the doctor’s instructions COMPLETELY! participants should notify their Psup with 24 hours of starting this treatment. And if symptoms persist for more than 48 hours they should activate their CALM Plan. - participants should also activate their CALM Plan immediately if they experience blood in their stool, or have a fever of more than 101 degrees F or higher at any time.
- – as common in Latin America as they are in the USA - Colds are also common during participants time with AMIGOS and it is important that participants take care of themselves to avoid continued infection.
- – Both elevation and tropical areas have increased exposure to the sun and can lead to sunburn and heat rashes Reapply sunscreen as directed by manufacturer.
- See previous slides for AMIGOS Summer 2013 ailment data. Dengue -During the past 4 years, 17 cases of dengue were reported by AMIGOS participants. None of these cases were dengue hemorrhagic fever. Malaria – During the past 4 years, 0 cases of malaria have been reported by AMIGOS participants. Yellow Fever – During the past 4 years, zero cases of yellow fever have been reported by AMIGOS participants. Chagas – zero reported cases of Chagas within the past 4 years. See rabies prevention slide for information regarding animal bite & scratch prevalence. FACILITATORS’ NOTE – There is 4 years of standarized data within AMIGOS current system of health statistics.
- The two biggest ways to prevent mosquito and other insect bites are ALWAYS sleep under a mosquito net and Use a cream based insect repellant with 30-50% deet regularly. Percentages of DEET above 50% have a much higher possibility of causing skin irritations and other health reactions, while they do not increase protection from insect bites. The curve of duration of protection levels out around 50% DEET – in other words, concentrations greater than 50% DEET provide only a small increase in duration of protection while increasing exposure to dangerous levels of DEET chemical. For most people using product with DEET of 30%-40%, this provides ~4-5 hours of protection (depending on the temperature, sweating, etc). We do not recommend using the mosquito repellent/sunscreen combo products as the active ingredients cancel each other out. Day mosquitoes carry dengue; night mosquitoes carry malaria
- Post-exposure shots will be necessary to prevent possible infection, if animal is not able to be contained for 10 days alive and healthy. - Post-exposure shots may not be available in all AMIGOS work areas and so possible exposures may result in early return of participant at their own expense. - Includes bites, scratches and licks to open wounds or mosquito bites. During the past 5 years, 200 cases of animal bite, scratch or lick to open wound/bug bites have been reported. Of these, 10 cases have required post-exposure immunization shot series (due to inability to keep animal contained for a 10 day observation period).
- Pre-exposure immunization is can be about $500.00 out of pocket and doesn’t alleviate the need to for post exposure series of shots it simply requires a less intensive version of the post-exposure series. All mammals can carry the rabies virus. Be aware of all animals, especially dogs, cats, bats, monkeys, and any other prevalent wild life. Pre-exposure immunization is not required by AMIGOS. It is expensive and optional for AMIGOS participants (and often not available). Seek further advice from your local travel doctor. Very low incidence rates in AMIGOS work areas. Easy to prevent infection by simply not petting or touching any mammals. Sleep under mosquito nets to prevent animals (especially bats) from coming near you while you are sleeping.
- Please disclose any and all updates via the proper AMIGOS health disclosure and update forms directly through the online application form. The chapter’s paperwork coordinator can make recommendations if participant and/or their parents are unsure of which form to use.
- Some immunizations are series that can take 6 months to be fully effective. participants should start series right away if they have not already. Information from AMIGOS Medical Health & Safety Committee may appear contradictory to your local travel clinic. However, the AMIGOS Medical Health & Safety Committee has more details on the specifics of AMIGOS host community areas than general travel clinic sites sometimes have access to. FACILITATOR Points: This is also available for handout by the end of the first week of February.
- Connected with medical & mental health professionals in the USA. Active for the duration of the summer projects. FACILITATOR Note: the On-Call system will be delved into in a much deeper way in Parent Preparation Module 3.
- Parents should contact their local chapter with any questions during the summer, NOT this On-Call system. The chapter representatives are kept apprised of pertinent events happening in Latin America and are parents direct link to the system. This keeps our phone lines open and IO staff available to support the projects in Latin America. Much more detail on these specifics will be discussed closer to the summer and in Parent Preparation Module 3.
- Demonstration of the First Aid Kit can be done here or after the presentation concludes. - If a participant needs to use their First Aid Kit, they should at the very least note it in their Health Log. If symptoms are severe and/or do not improve they should be activating their CALM Plan.
- CALM Plan skit can be done here or after this presentation. CALM Plan is a community specific emergency procedure ( a version of 911) – including contacts of community members/local clinics through the embassy and AMIGOS National Office 24 hour On-Call system.
- participants receive training regarding when specifically to activate their CALM Plan. Anytime they are unsure of whether or not to activate the CALM plan, they should follow protocol and make the call!
- <Suggested: have a past parent speak about their experience AMIGOS On-Call experience. >