Farewell Panama

Well, this is it. We have had our last day at the clinics, and our last day at the maternal-child teaching hospital for UNACHI, the only university in western Panama with a nursing program. I was very intrigued by the similarities and differences between the hospital where I am employed as a Registered Nurse in Tampa and the hospital here in David. One obvious difference is the reduced emphasis on isolation precautions. Panama has not yet fallen victim to the epidemic of antibiotic-resistant bacteria that has swept across the United States, most likely due to less reliance on broad-spectrum antibiotics in both the human population and the livestock industry. So there is much more sharing of space in the hospital - 6 person wards, new mothers holding each others' babies, and infants being collected three at a time in one bassinet for procedures such as tuberculosis vaccinations and hearing tests. The exception to this is the burn room, where a cloth barrier was placed across the door opening to limit the transmission of infection. There also appears to be less fear of child abduction. It is common to walk into a ward and find four of the beds occupied by moms and babies, and the other two beds containing only a tiny, bundled newborn, with no mother in sight. But there were many aspects that made me feel right at home. The nurses were engaged in the performance of the choreographed dance that is hospital nursing around the world - in and out of the med room, responding to situations before they become crises, educating patients and family members, following up on new orders, and trying to find time for the ever-present responsibility of documentation. I found it a comfortable and familiar atmosphere in spite of the language barrier and the unique culture of the Ngobe Bugle patients. Now tomorrow we are going to the International Children's Hospital in Panama City. Another opportunity to compare health systems; this time rural versus urban within the country of Panama itself. And then the next day we are leaving these amazing people behind as we head home, but we are taking with us memories that will last a lifetime, friendships that were forged through sharing basic necessities and accommodations, and a renewed dedication to the calling that is nursing.