PCMO / Peace Corps Nicaragua

Road traffic safety, Sunscreen, and Emotional Support

Road traffic safety:

Road traffic injuries are a leading cause of morbidity and mortality worldwide, and these injuries disproportionately affect low- and middle-income countries.  While low- and middle-income countries account for 54% of the world’s registered vehicles, 90% of the world’s road traffic deaths occur in these countries according to the World Health Organization.  Transportation options can have a direct impact on your service, both in your work and on vacation.  Here are a few tips to stay safe while on the road:

  • Wear an appropriately-fitted bicycle helmet every time you ride a bicycle.  The helmet should fit level on your head and low on your forehead (1-2 finger-widths above your eyebrow).  Adjust the slider on the straps to form a “V” under and in front of the ears.  Center the buckle under the chin and buckle the chin strap.  Tighten the strap until it’s snug so no more than 1-2 fingers fit under the strap.
  • If biking or walking at dawn, dusk, or night, wear light-colored or reflective clothing to improve your visibility.
  • If you can and it’s appropriate, make eye contact with drivers before crossing streets to make sure they see you.  Cross the street with groups when possible.
  • Use a seat belt in every vehicle that has them including taxis and minibuses.


Skin cancer is the most common type of cancer in the U.S.  More than one million people in the U.S. are diagnosed with skin cancer each year.  Two types of rays that affect the skin are UVA and UVB.  UVA rays contribute to premature aging.  UVB rays are the primary cause of sunburns.  A sunscreen with an SPF of 30 is NOT twise as protective as an SPF of 15.  An SPF of 15 protects the skin from 93% of UVB rays and an SPF of 30 protects the skin from 97% of UVB rays (see chart).


Here are some recommendations from protection from UV rays:

  • Limit time in the sun between 10 am – 4 pm
  • Stay in the shade as much as possible
  • Wear clothes that cover your arms and legs
  • WEar a wide-brimmed hat
  • Wear sunglasses
  • Use sunscreen with an SPF of 15 or higher
    • Apply 20 minutes before going out into the sun
    • Apply again if you have been in the sun for more than two hours (or as often as the bottle suggest)
    • Apply before the use of insect repellent (DEET may decrease the SPF of sunscreens by one-third)

Emotional SUpport for Volunteers:

PCMOs are primary care providers who assist Volunteers in maintaining physical and emotional health.  PCMOs receive yearly trainings by the Counseling and Outreach Unit (COU), Office of Health Services, in the latest evidence based techniques to help Volunteers in times of stress and distress.  When a Volunteer identifies as having problems, the first step is for the PCMO to discuss and assess what is going on.  This is the same as what occurs for any physical ailment.  Ideally this talk is in person, however, given the distances most Volunteers are from their Health Units that often is not possible.

One assessment tool used frequently by PCMOs is the PROMIS28, which assesses an individual’s mental wellbeing and related quality of life against US norms.  This questionnaire helps to establish what might be contributing to a Volunteer’s distress.  There could be physical components (such as pain or insomnia) and/or emotional ones (anxiety, depression).

Most often, Volunteers’ emotional distress does not rise to the level of a mental illness diagnosis, but is related to adjustment stressors (loneliness, communication difficulties, work conflicts, loss of support system, unmet expectations, etc.)  In these instances, the PCMO provides short term supportive counseling to assist the Volunteer in techniques of dealing with stress and in becoming more resilient.  Referrals to a mental health professional (local counselor or COU) are reserved for suspected mental illnesses or unsuccessful adjustment support counseling.