GORMAN JAENSTCHKE: When I was, like, 9-years-old--
I was a kid and it was really hard.
It's in the morning and I was sleeping.
And I felt like I was getting wet.
So when I opened my eyes, the roof of my house
was already gone.
Everything was absolutely destroyed.
The houses were in pieces.
The trees-- our own roof-- it was green--
green.
But after Hurricane Joan, it changed completely--
everything in Bluefields.
MICHAEL HAMMOND: Joan Hurricane affected Bluefields a lot.
Right away-- it was still recovered out there.
They still have old people talking about their losses
and talking about all the disaster that
happened in those times.
I don't know if it shocked us big, because we
wasn't prepared for it.
We should create awareness and be prepared
for this kind of disaster.
Because common-- we are exposed to them.
NOEL CAMPBELL: But they told us, for Pearl Lagoon,
that in 75 more years there wouldn't
be such thing as Pearl Lagoon.
Pearl Lagoon, according to the estimate, in 75 years,
it should be underwater.
That's how fast it is going.
EMMA MITCHELL: I think that nurses
are critical to helping communities
be prepared for disaster subsequent to climate change.
Climate change, being a somewhat slow but hugely impactful
process, allows us, I think, to really maximize
the nursing skill-set.
We work at the individual, the family, the community,
and the systems level.
And as a public health nurse, prevention
is our number one charge.
So I think that we can do everything
along the continuum for disaster preparedness
from, at the one extreme, triage and building
capacity with nurses to be able to respond
to an acute disaster, but on the other end of the continuum,
working with communities to make sure,
for example, their family has a disaster plan,
their community has a disaster plan,
that there's clear communication in the case of a disaster,
that certain preparations have taken
place, critical to a community's resilience subsequent
to a disaster.
I started my nursing research career
looking at women's health and health disparities.
And I didn't necessarily think of myself as a climate change
researcher but have found that, through the approach
of figuring out, with community partners and long-term folks
that I've collaborated with in Nicaragua,
that's such a pressing issue.
And it's so intertwined in women's health and development
in this area that it's become my area of focus.
Here in Nicaragua where Bluefields is,
there's only one school of nursing.
And so that public school of nursing
attracts students from all over the communities in the Southern
Autonomous Region.
As such, when students come and study and then return home
to their communities, they're seen as leaders.
So people go to them for resources.
People go to them for questions and answers.
But we, through this project, have really
worked to try to have them be those pro-active leaders that
assess people's housing, that assess how disaster plans might
work in their individual communities.
In Nicaragua and in many communities in the Caribbean
or communities where economies are
so dependent on environmental conditions and factors,
the margin of impact is really razor thin.
And so we see, more directly, the impact of climate
change in communities like Bluefields,
where the economy is so dependent
on those environmental factors.
GORMAN JAENSTCHKE: Climate changes--
you don't believe that climate changes could carry you
to drug trafficking.
It's something that a line that keeps there.
And when you have a problem, it goes to another and another.
And it increases.
EMMA MITCHELL: So the project started with a request
from the school of nursing leadership.
Because in the event of a disaster,
it's very likely that a foreign aid response would be part
of mitigating that disaster.
And as such, we thought it would be a good beginning
place for the partnership to have our students who
don't necessarily speak Spanish partner with students here
from BICU to learn about what that process would look like.
We subsequently have shifted more
towards making the capacity-building efforts be
more bi-directional, I guess.
So we focus on the potential disasters or potential impacts
of climate change here in Bluefields, have our students
and faculty here inform what the cases are that we develop.
And then our simulation process is
what takes the conversation from that acute response,
that triage--
the conversation and the simulation process
brings us then to--
OK, what can we do to prevent this in the future?
The school of nursing here has really
integrated this into their curriculum
in several different ways.
They've changed their course objectives
to include disaster preparedness, which
is really phenomenal.
They also now require students to create
one of their own scenarios for simulation
and, with their colleagues and fellow students, enact them.
So that now is part of their curriculum,
that they're required to develop a scenario
and show how they would respond to it.
SUBJECT 1: [SPEAKING SPANISH]
EMMA MITCHELL: So simulation really
has been a tool to help shine a lens on some of the ideas
and the strategies that are already being used,
but highlight them in a way that then all
the rest of the students can benefit,
and not just students here at BICU
but our students at UVA too.
DEJA FULLER: As a student, it's just like, oh, this isn't real.
Or it's like, in real life, it would be different.
But I feel like, for the disaster simulation,
it was really more true to form.
Because you are-- like, let's say, there's
an earthquake or hurricane.
You might not get supplies.
Or there are barriers.
And you can get a delivery of something.
So it really started the conversation of, in real life,
things like this do happen.
But here's how you can manage it.
EMMA MITCHELL: With the help of the Jefferson Trust,
we've been able to directly bring
people who have been integral to our development of the project
here in Bluefields to Charlottesville.
And they've interacted with our students, given them
their perspective as well, which has
been a really great benefit.
DIANA HODGSON: [SPEAKING SPANISH]
GORMAN JAENSTCHKE: They learn from us.
But also, we learn from them.
And so it's an exchange.
It's a circle.
And everybody wins.
EMMA MITCHELL: Our students are increasingly
in acute care clinicals that are extremely high-resource, highly
specialized.
And so to put yourself in a position,
through the simulation, where there's
low stakes but high yield, in terms of what you learn,
is a really powerful thing.
DEJA FULLER: I thought it was fun.
In real life, you don't have everything.
You might not have everything, especially in a disaster--
or there are limited resources.
So learning that communication and trying
to be as creative as possible, working with what you got--
EMMA MITCHELL: That awareness-- that cognizance
of the experience of others and the experience of most
of the rest of the world seeing these acute impacts
from climate change is critically
important for our students and as global citizens.
GORMAN JAENSTCHKE: Working with UVA,
it's like finding a light--
a light, so it can guide us into bettering our way of living.