Alex Giuliano Experience

Last summer, I had the good fortune to hear the testimonials of two of my upperclassmen about their experience in León, Nicaragua with FNE International. The summer off between the first and second years of medical school provided me with the ideal opportunity and ample time to immerse myself in another culture, all while advancing my medical education. I decided that I wanted to pursue a similar experience, so I contacted Michael Cipoletti to help me start coordinating my project.
With the help of FNE International, my plan was to conduct a community-health research project in León and the surrounding area. The goal of the project was to survey known diabetic patients about their diabetes knowledge, disease self-management, and their social beliefs, with questions geared towards measuring their beliefs of cultural “machismo”. I also brought portable HbA1c tests with me to be used in the study. HbA1c levels tell a patient what their average blood glucose levels have been over the past three months. These A1c scores were to be compared to the patient’s survey scores, looking for correlations between them. In addition, the study would be able to detect specific gaps in patient knowledge and self-management. By gaining quantifiable data on these gaps, future volunteers and local clinical workers would be able to better focus their energies on these aspects of patient education. At the same time, by providing the patients with an A1c score and explaining exactly what it meant, I aimed to educate them about their current management of their disease.
With my classmate Brooke, we were able to conduct our research projects under the guidance of a phenomenal teacher, Dr. Reyna Somarriba. Dr. Somarriba, who is the primary physician for the majority of the community of Chacraseca, has been working with FNE International for years. Our day would being with intake of patients. After this, Dr. Somarriba would task me with giving a “charla” to the waiting patients. The educational chats that I would give were always about preventing diabetes and maintaining a proper diet. At first, I dreaded giving these talks; I have never been a good public speaker and my Spanish was very rusty. However, over time, I grew more comfortable in my role as not just the medical student in the clinic, but also as an educator to the patients.
Pushing me out of my comfort zone was only one way that Dr. Somarriba helped me to grow as a medical professional. During our hours in clinic, she fully expected us to be a part of the diagnostic and treatment process. We learned countless clinical pearls from her and in the process saw firsthand how challenging, yet rewarding, primary care in a resource-limited setting could be.
Throughout our stay in Nicaragua, FNEI provided an immense amount of support to us students. Rebecca Hervieux was constantly looking out for our wellbeing and assisting with logistics onsite. José Narváez and Michael Cipoletti were both invaluable in helping me contact diabetic patients in clinic and in the community. However, the single greatest thing about my work with FNEI was the friendships that I made with other students involved in the program. We were a tightknit group and it was very difficult to say goodbye to everyone when the time came!
Overall, my two months in León was so much more than a medical learning opportunity. It was a once-in-a-lifetime experience. It showed me how raw determination, when combined with the dedication and ingenuity of a group of people, can help provide long-lasting, positive effects on the health of a population. It provided me with an opportunity to meet some incredible people. I look forward to the day that I can return to Nicaragua to see them again and continue with FNEI’s goal of advancing health and education in the region.

Alex Giuliano M.D. Candidate Class of 2020 UConn School of Medicine