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Parent Preparation Module 2Health and Safety

• A thorough overview of AMIGOS Health & Safety – Protocol & Procedures– Participant Tools– Health Screening– Health Statistics– Preventing Illness– On-Call System– Understanding the CALM Plan

Parent Preparation Module 2: Topics

• Pre-departure– Health & safety round robins– “Safeguarding Your Mental Health”

activity– Online health and safety assessments– Decision making activity

• In-country Training– Project specific health and safety review– Host community specific information

Participant Training on Health & Safety

• Participant Health, Safety & Travel Guidelines

• Prophylaxis & Immunization Requirements• Project Information Packets

Participant Tools Acquired Here

• CALM Plan• Weekly Self-Assessment Forms– Completed by participant & PSup

• Health Logs – Completed by participant

• Participant Performance Evaluations– Completed by participant & PsupAll of these documents become a part of the participant’s official file with AMIGOS.

Participant Tools in Country

Guidelines for: • Host Community Selection • Host Family Selection• Meal Plan Guidelines• Partnership Selection & Placements– Includes sleeping arrangements

Summer Leadership Team’s Tools

The AMIGOS participant will not:

1. Engage in detrimental Behavior2. Use or possess any drugs3. Leave his/her assigned work area without

permission4. Operate any motorized vehicle5. Handle firearms or any other weapon6. Engage in acts of disrespect, harassment,

or bullying7. Engage in the consumption of alcohol8. Engage in intimate or amorous

relationships9. Use or possess tobacco products

Participant Tools – Standards of Conduct

Standards Violation Process

• In the event of a standards violation a report will be submitted by the in-country team along with a statement written by the participant to the Emergency Management Team.

A decision will then be made on the outcome of the violation:– Warning: for minor, first time violations which do not

present a threat to the health and safety of any participants

– Incident: a more serious and intentional violation which could be potentially damaging to the individual, organization, or host community/partner agency

– Dismissal: either repeated or severe violation that is dangerous, harmful, or damaging. Individuals who are dismissed from the program will be responsible for the cost of their return ticket as well as a $250 fee to cover all related expenses for their return.

Decision Making• Talk about decision making, both good and

bad. • Remember that we want them to make the

choice to try, to push their boundaries, even if they fail. It’s part of the experience.

• Encourage them to think through the effects of all their actions and how in a program like AMIGOS they can affect so many different people.

• Maintaining participant health & safety– Top priority with primary focus being on

prevention of major issues• All protocols are established by the

Medical Health & Safety Committee– Based on Center for Disease Control

recommendations and when applicable the National Institute of Health

– Tailored to specific project areas

From the AMIGOS Medical Director: David Baron, MD

• All participants are screened in areas of physical and mental health according to explicit criteria.– Report any and all changes in health

status at once to AMIGOS International Office at info@amigosinternational.org

Health Criteria & Screening

• Handled with the utmost confidentiality directly by International Office Screening Team.

• Submit Confidential Health Forms directly to application for review by International Office Screening Team.

• Contact info@amigosinternational.org for any questions about your participant’s Confidential Health Screening process.

Health Screening Process

• Disclosure of health information does not automatically disqualify applicants.

• Intentional non-disclosure or minimization of health history (physical or psychological) will likely result in immediate dismissal from the program at the participant’s expense.

Non-Disclosure Policy

• Following table summarizes the most common ailments reported to the On-Call System. – This data is the number of cases NOT the number

of individuals. – (An individual may have multiple cases)

• Data includes cases for both participants and Summer Leadership Team

 Health Statistics: Defining the Numbers

Summer Health Statistics(an average summer)

Illness / Incident Number of CasesAnimal Bite/scratch/lick 19Post-Exposure Rabies Vaccination 2Upper Respiratory Infection 13GI Infections 166Scabies 5Appendectomy 1Orthopedic Issues 8Malaria 0Dengue (Non-hemorrhagic) 2Yellow Fever 0Typhoid 0Total Clinic Visits 301

• Hand-washing –saves lives and prevents infections!

• Bathing - all participants must maintain good hygiene and bath regularly.

• Clothing - wash clothing as the host family does.

Good Personal Hygiene Prevents Illness

• All participants are required to use a personal water purification method.– RECOMMENDED: chlorine drops or chloride

dioxide. (CDC) – NOT recommended or reliable for the summer:

• UV light decontaminators • Portable water filtration systems

Water Purification

• Host community meal plans are a donation from the community. – Participants need to be gracious guests and eat the

food offered!• Many participants eat on a rotating meal plan

– Reduces the burden on the host family– Popular with participants– Great way to community

Community Meal Plans

• Properly clean, cook, and peel all produce before eating to avoid infection.

• NO homemade juices, ice or water from an unknown source.

• Participants are encouraged to help with mealtime chores.

Food Preparation

1. Participants will NOT become immune to microbes of their host community.

2. Many host communities/project areas may not be able to accommodate all special diets.

3. NO dieting!4. Notify supervisor if there is a concern in-country

regarding meal plan ASAP

Dietary Concerns

1. Vegetarianism - In some project areas2. Veganism - NOT able to support on any project3. Religious Restrictions - May be able to

support minimal food item restrictions.– NOT able to support elaborate dietary

restrictions.4. Other dietary restrictions - Allergies and

other dietary restrictions on some projects.

Can AMIGOS Accommodate Special Dietary Requests?

• Participants will be living with a host family and should take to reflect on what being a good house guest will look like.– Help with household chores– Be home when expected– Communicate plans– Be tidy– Be friendly and out-going– Abide by household norms/rules

Being a Good House Guest

• Dehydration - one of the top causes of AMIGOS participants seeking medical attention.

• Prevention: drink at least 2 L of purified water daily; avoid contaminated food, and wash hands frequently.

• Rehydration – drink oral rehydration therapy (ORT) or suero.

Dehydration & Rehydration

• About 40% of reported AMIGOS participant medical cases involve stomach ailments.

• Prevention: – Eating food that has been properly prepared.– Drinking water that has been properly purified. – Maintaining good hygiene– Frequently & properly washing hands!– Avoiding dehydration.

Preventing Stomach Related Illness

• Participants may travel with One-Course Antibiotic treatment to be taken for Travelers’ Diarrhea only.– Travelers’ Diarrhea defined in the Parent Preparation

Guide (PPG)• Treatment: single course antibiotics

– TAKE full course as directed by doctor– Note in health log and notify supervisor

• Follow all protocol steps closely

One-Course Antibiotic Treatment for Travelers’ Diarrhea ONLY

• AKA– the common cold• Prevention: – Hand washing, staying hydrated and well rested.

• Treatment:– Rest and drink lots of fluid. – Antibiotics do not treat viral infections (like the

common cold).

Upper Respiratory Infections

• AMIGOS participants spend much of their time outdoors in tropical locations and/or at high elevation.

• Prevention:• Avoid overexposure to the sun.• Wear sunscreen of at least 35 SPF (apply

sunscreen first and then insect repellent).• Wear long-sleeve clothing & hat to protect the

skin.

Preventing Rashes and Sunburns

• AMIGOS works in areas where tropical diseases such as malaria, dengue, yellow fever, chikungunya and Chagas may be present. • Low incidence rates • Collaboration with the CDC to develop

recommendation and track our population’s incidence

• If participants follow our required guidelines the risk will be greatly minimized.

• (For more details on specific diseases see http://wwwnc.cdc.gov/travel/)

Preventing Insect Bite Related Illnesses

• ALWAYS sleep under a mosquito net. • Wear cream-based bug repellent – With 30-50% DEET (CDC)

• NO 51+% DEET!!!– Apply after sunscreen

• Wear pants and long-sleeve shirts during times of high mosquito activity.

Preventing Insect Bites

DEET vs No DEET

• Animal Bites, Scratches or Licks• Type # of Cases– Bite----------------------------12– Scratch/Lick-------------------6

• In 2015, 3 animal exposure cases required post-exposure rabies vaccination.– Post-exposure rabies vaccination process is REQUIRED

in the event of an exposure where the animal cannot be monitored.

2015 Summer Health Statistics

• Rabies – due to lower rates of animal immunization, there is an increased risk of animals carrying rabies. – Rabies is lethal once signs of infection are

present. – Rabies may be transmitted anytime saliva makes

contact with the bloodstream.– Post-exposure shots are REQUIRED, if an

exposure occurs and the animal cannot be monitored for 10 days.

Animal Bites, Scratches and Licks

• AMIGOS prevention policy is rigid – NO TOUCHING animals, especially dogs, cats,

bats and monkeys (mammals). – Latin American dog culture: generally dogs are

not pets. – Exceptions may be made in cases where

transportation is via horseback.• Rabies pre-exposure immunization is not required

by AMIGOS.

Rabies Prevention

• All prescription medication AMIGOS participants are taking during the summer must be disclosed.– Staff must have information available in case of

an emergency to prevent harmful drug interactions.

Prescription Medications

• 24 hour On-Call system • Supports the AMIGOS in-country Summer

Leadership Team• Operated by International Office

professional staff • See Administrative Policy for specific roles

of all parties involved.

Introduction to AMIGOS On-Call Emergency Management System

• Focus is on supporting Latin American project staff members and participants.– Handles medical concerns, mental health issues,

violations of the Standards of Conduct, and other miscellaneous issues that may impact the AMIGOS participants.

• AMIGOS On-Call Staff have direct access to consult with medical and mental health professionals as necessary as a part of the 24 hour On-Call System.– All cases reported are reviewed by health professional

consultants.

On-Call System Focus

• A specific “911” plan developed for each AMIGOS host community to connect them to their Project Staff, emergency care and the AMIGOS On-Call system.

• The CALM Plan requires participants to seek the closest and most accessible source of assistance first.

CALM Plan

• The 1st step in every participant’s CALM Plan is to contact their Project Staff.

• Participants may always contact their parents, BUT if they call you as first step of the CALM Plan – this is considered CALM Plan circumvention and detrimental behavior.

• If you are contacted directly by your participant, make sure they have already activated their CALM Plan before calling you so that local help is on the way!

Avoiding CALM Plan Circumvention

• Support participants in preparing for a healthy and safe summer.

• Empower participants to follow health and safety protocol.

• Understand AMIGOS protocol and know who you should contact with questions.

Role of Parents