The Trip is Done!

All and all the trip was AMAZING! Though there were some frustrating times, in the end I learned so much and could not imagine not doing the trip.

The past 3 weeks are kind of a blur. We did so much in such a short amount of time. I got to see different parts of the country from driving from place to place and experience health care in the jungle and in the city. I also had the pleasure of learning about what nursing school is like in Panama. (Their students have 4 years of actual nursing school, where we only have 2.) I went on a 16 mile hike, four-wheeling, and zip lining. It really was a jam-packed trip. I even got to have the lovely experience of being a patient in a Panamanian hospital when I stepped on a needle that was supposedly used to anesthetize a goat before castrating it. So many things to tell, but that would go on for pages. Panama is a very diverse country and I would love to go back and experience more of it!

¡Adiós Amigos!

Leaving Panama and returning to Tampa has been very bittersweet. While I know we made a positive impact on the people in the Comarcas, it's hard to say goodbye when there is still such a huge need for outside help. The past three weeks have been both very rewarding and eye-opening. I learned about the Panamanian culture and adjusting to "Panama Time" which is very different from the inflexible agendas most Americans follow. This journey also taught me that the amenities I would once label as "essentials" are considered luxury items in other parts of the world. I vow to never again take clean drinking water, hot showers, or toilet paper for granted.

I left for Panama expecting to learn about a new culture, gain more clinical practice, and most importantly avoid taking community during the fall semester. As I return to Tampa I realize I'm bringing back so much more, including once in a lifetime experiences and a handful of unexpected new friendships. I won't soon forget all of our patients in the clinics or Victor, my innocent, sweet, little friend from the orphanage. I had never seen such beautiful scenery until we climbed Volcán Barú and went zip lining in Boquete, both adventures I would go on again in a heartbeat. Everyday was full of learning, not just about the culture but also about tolerance and friendship. I learned a lot about myself too and the way others perceive me. I think everyone who went will agree it was a memorable trip and provided us with experiences that will help shape us into better nurses.

I would like to both thank and congratulate Dr. Cadena and Eloisa for making this trip a success.

"Our fingertips don't fade from the lives we touch..."

i'll never forget you, panama

written on June 10, 2011

Today is our last day in Panama. It is bittersweet; although I miss home, I can't imagine what life is like back in the states. I've made so many great friends here and I know that I will miss them tremendously.

Monday was our last day in the communities in Chiriqui. The clinic in Soloy was amazing, and I learned and witnessed a lot of different things. I gave many injections, immunizations, IVs, and much more. When we were leaving, we said goodbye to everyone and the amazing staff of nurses and doctors who helped us throughout our stay in the Comarca. When we were eating lunch on the bus in front of the clinic, a little 8 year old girl holding her sister came to the window. She looked hungry and desperate, so I gave her the rest of my lunch. She ate it in a blink ofan eye, and the rest of my classmates gave what they could to her. She was very grateful.

Tuesday was our last day in the Comarca in Chiriqui. We ventured out early (of course!) and made it to David to the Jose Domingo children andwomen's hospital. The week prior when we visited the hospital, I had witnessed my first live birth. It was amazing and very humbling. The Panamanian women generally do not use anesthesia during birth, which is very different from the States. On Tuesday, I was in a small group and we were on the post-partum floor. We saw many different things. We also got to hold tiny babies for a few hours. I think some of us fell in love...

My stay here in Panama was amazing. It seems that 3 weeks just wasn't enough time. Although we worked hard in the communities and brought an American touch of health care to Panama, we had a lot of time to connect with each other and bond as classmates. I will never forget the 24 other people who came to Panama with me. Some of them taught me more things about myself than I knew. I learned to push myself in ways I didn't know I could. Thank you to everyone who made my Panama trip so memorable. And thank you to Dr. Cadena and Eloisa for everything.

Its Been Fun!

Today we leave to go home from Panama. I am going to miss it here. I have had such a great experience here! I have had the opportunity to learn so much in such a short period of time. My favorite part of the entire trip was definitely when we went to the orphanage in Boquete. At the orphanage we met with one of the volunteers who moved down to Panama from the U.S. and has been living in Boquete and volunteering at the orphanage for the past year. There were about 60 kids at the orphanage and a lot of them were there for reasons of domestic violence and abuse, so they are considered “unadoptable” because the government is hoping that they will be able to repair the situation at home and return the children to their families. This was the hardest part about seeing all of these children; I wish I could see them and have the hope the one day they will all be adopted by a family who will take care of them. The kids at the orphanage were all so sweet and so excited about the little toys and candies that we brought them. We would open up a package of crayons, and literally hand out single crayons to the children and they would be so excited to get this single crayon. The gratitude of the children that I have seen here in Panama has been so inspiring. I am so glad that I got the opportunity to come here for this 3 week session. I have learned so much from the people that I have come into contact with here and love the cultural experience that I have had.

Hasta Luego Comarca!

This past week was our last week in the Comarca. While at the Clinic in Soloy I have had the opportunity to learn lots of clinical skills (I did 30 vaccinations!) and see a new culture face to face. The experiences that I have had here are so different from those that I have had in the states. People literally walk for days to get to this clinic (one morning we picked a woman up in the bus on the way to the clinic who was being carried in a hammock by two men to get to the clinic. Just by us driving her for the last 20 minutes of our drive to the clinic, we probably shortened their journey by hours.) While it was heartbreaking to see these people suffering from preventable diseases and infections, such as gastroenteritis caused by unclean water and improper food handling, respiratory problems caused by having wood burning stoves in their living spaces, and skin infections and diseases caused by poor personal hygiene, there was also hope in seeing how the medical professionals at the clinics responded to help the people in the Comarca. It must seem like a daunting task for the doctors and nurses who treat the Ngobe-Bugle people, treating only the outcomes, and not being able to properly address the causes because of the vast shortages of water and hygiene supplies. Even with these daunting tasks ahead of them, the doctors and nurses treat the people of the Comarca daily with empathy and compassion, and I feel as if I have definitely learned from them, how to treat and care for patients. Also in response to the needs of the Ngobe people, there were three health promoters who go out into the community (sometimes literally door to door, and sometimes holding little seminars at community meeting places) and teach about clean water collection, moving stoves to outside to prevent respiratory problems, nutrition, and importance of vaccinations and prenatal care. While the experience in the Comarca opened my eyes to the struggles and needs of another culture, It also demonstrated to me how the people of this country are working together to better the lives of the less fortunate and help the Ngobe people to learn how to improve their standard of living, and move forward with a generation of healthier Ngobe people.

Verdad?!?

Wow...I can't believe this 3 week experience is already over. This trip has really allowed me to broaden my horizons and realize just how lucky we are to live the life we live in the US. I really enjoyed seeing how other cultures practice health care, and realize that the American way of doing things is not the only way. I am leaving feeling more competent with my nursing skills I practiced here including IM injections, starting IVs and performing prenatal care. I have made tremendous friendships while here and although I am missing home I wish my time here in Panama could last just a little bit longer.

CRISTINA RONDOLINO- Bitter sweet goodbye

Last day in Panama and I think we are all a little sad. A week ago we would have killed to go home. But, now that we are at the City of Knowledge and easing ourselves back to the luxurious life of semi-hot showers and not sleeping in a room with 17 other girls, I think we will be sad to leave. Last night we went to the discotcca and we all danced our last night in Panama away.
I wont be leaving Panama with just a bag full of coffee and souvenirs. I am leaving having made some really great friends and with an experience that will stay with me forever. This experience was truly invaluable to me because it opened my eyes to the struggles that people around the world go through. The Alto Caballero community had no running water or a safe source of drinking water. It infiltrated every aspect of their lives. I will think of them the next time that I am faced with a dilemma and realize that I am lucky to have the resources I have.
We saw the people wait patiently outside the clinics for hours and sometimes would not get the help they came for and still never once complained, or made a scene. I will think of the Ngobe Bugle people the next time I am impatient (which is often) and realize ,again, that I am lucky.
And next time a storm is rolling in, I will not be sad that it ruined my beach day, but I will be happy that is is bringing lives most precious resource to me and I will think of the Ngobe Bugle people rejoicing when the rain came.
I am also leaving, a lot more confident in my clinical skills. I was able to start an IV for the first time on this trip and I probably did 60 IM injections. I got a head start on pediatrics and OB. I measured the fundus, found the fetal heart beat and, oh yeah, I saw birth! I brushed up on my Spanish speaking skills as well.
All in all it was a wonderful trip. A little rocky at times with what seemed like one catastrophe after another, but it all just adds to the memory. AMERICA HERE WE COME!

oh baby, baby!

Hola!

So, I witnessed the miracle of birth at the hospital. It all happened much faster than I expected. We were ushered into a fairly large room just as the mother was getting ready to push. The thing that I found to be the most bizarre was the fact that the doors stayed wide open throughout the entire birth. Patient privacy definitely does NOT exist in Panama! The mother needed an episiotomy which was performed by a doctor and a med student. As soon as the incision had been made it was smooth sailing from there and a beautiful baby girl was born within a few minutes. The attention was turned to the newborn as they suctioned the nose and mouth, performed the apgar, and all the other necessary immediate tasks. The mother was unbelievably calm and the look on her face as she smiled at her new baby almost made me tear up. This trip has offered me so many new experiences and I wouldn't trade the last 3 weeks for anything.. well except for maybe a lettuce wrap. (JK!) :)

Dr. Best Friend - leading Friendologist of Amrrica

This is Will Boland, I cannot create my own account for some reason.

In Boquete we had a needed break from clinical activities. First we went to some orphanages and a home for boys. At the orphanage most of the kids were under 12 years old. They loved gettin held in the air so they can touch the ceiling or spun around. This is the same kind of playing I used to do with my little brothers. I dont think they get that kind of playing around often since theyre all so young and the people that work there already do so much for them. It was nice to go there and maybe make that day the best day of their week.

Many of us chose to climb the Volcano (what volcano?). This sounded like a great idea with the promise of a panoramic view of the pacific and atlantic oceans at the top. About 45mins into it....I realized this was Not a great idea. It wasnt bad going up, except for the breaks and communication. Going down the mountain I felt like I was gonna throw up and it was raining the entire way, jumping over streams and slipping on rocks. Oh, and at the top all we saw was clouds, yaaaay. My BF got headaches from concentrating on which rocks to step on next. It was fun looking back at it now though, as are all things that suck while youre actually doing them. I can say I climbed a Volcano and the highest mountain in Panama, and so can many of my fellow nursing students.

We are now at COK and the trip is ending. It wasnt exactly what I expected, but it was fun and educational for sure, and that was the goal. Weve been in class with people for about an entire year, but dont realy talk to them. In 3 weeks Ive gotten to know more people outside of my clinical group than I did in an entire year. I still know very little spanish, but I feel like my vocabulary has expanded 10times. Ive learned about a country I knew very little about. Ive learned about a people I never even knew existed (Ngobe). Ive given an IV to a baby for the first time, and seen a baby born. Now its time to go home, and back to normal life and hot showers!

Me llamo Will

This is Will Boland, I cannot create an account for some reason.





Our last clinical days came and went. I have to say it was an interesting experience for the most part. The Doctors at Soloy were very helpful and wanted to exchange knowledge and practices. The last day there was a patient with a venomous snake bite, we were lucky enough to have a Dr that spoke english and he explained to us their treatment protocols and how and where they transport him etc. I gave him some splinting supplies, a tourniquet and a pressure bandage. They may have to use the supplies shortly, whereas for me they were for practice or for "just in case".


Im glad we went to the hospital in David, because from a medical experience standpoint much more was gained there. I saw a birth, thorocenticis, gave an IV to a baby, and more. I hope the birth excludes me from seeing one in semester 4! As great of an experience it was, I would prefer not to see that again. It was interesting that they only received some pain meds and family was not allowed in, and they werent even in the hospital as far as I understood.

Adios Panamá

My experience at the hospital Jose Domingo de Obaldia was wonderful. It was my first time working with kids in the hospital, and as much as I loved it it broke my heart to see so many children in pain! One little 2 year old in particular caught my attention. He had no family because he was abandoned so he lived at the hospital, and he was mentally retarded and had a pulmonary infection and only weighed 16 pounds. It took almost an hour to feed him his lunch but I enjoyed taking the time to do it. Unfortunately it is common in Panama for babies to be abandoned at the hospital. I also saw a bone marrow aspiration in the hospital on an 8 year old boy, and that's when I knew for sure I couldn't do pediatrics because I just couldn't handle seeing him in pain! One thing that really amazed me at the hospital was how little they used gloves. The nurses would start IVs without wearing gloves and blood would spill on them. It was also interesting to see all their paperwork and how they pass their meds without the use of a computer system. All of their patients' meds were on little index cards and categorized by what time they were given. The nurse I was with said she had 60-80 patients, I can't even imagine! I get overwhelmed when my preceptor has four! These nurses are sincerely hard workers and I admire them for taking responsibility for so many patients!

I have had such an amazing three weeks and I am so thankful for this unique experience :)

Adios Panama..

Last days in Panama are here. I feel sad for leaving such a beautiful place. I learned so much here, staring with my first IM injection to vaccinating many patients. Giving my first IM injection was the scariest thing for me since I had to give it dorsogluteal injection, but everything went pretty well with great guidance from nurse Rosio. From Panama I am taking a lot especially Panama patience, which is the best lecture that I have learned in Panama just to have patience and everything else will work out itself. This experience in Panama was experience of no toilet paper and cold showers, but overall I loved this trip and I am also excited to go home and take a worm shower.

Gracias Panama por todo. Gracias Dr.Cadena por todo.

Hato Juli Classroom Visit

As part of our clinical experience we were given the amazing opportunity to each visit one of the schools in our communities. For days preceding the visit, our group spent much time planning ways that we could make our time spent there beneficial to the students. We bought supplies and thought of important topics that we could educate a group of students on. After meeting with the director of the school, she selected a kindergarten class for us to visit. That morning, when we walked in to the classroom, I immediately saw the excitement in the children's faces. Even the older students were gathered around the windows and doorways, trying to catch a peak at what was going on inside the classroom. We began our education with a presentation on handwashing. It was surprising to me to learn that most of the children had never even washed their hands before. Our next bit of education was on proper dental hygiene. Following this information, we handed out toothbrushes to each of the students, as well as to many of the students who were peering in to the room. The last, and most exciting event, was teaching the children about the different nutrients found in fruits. Lourdes was great with the children, and she turned the vitamin teaching into a game that the children really seemed to enjoy. She asked the children to throw the fruits to the corresponding nursing student who was holding the sign with the correct vitamin letter on it that the fruit contained. Finally, before leaving the classroom we gave each of the children one of the goodie bags we had prepared for them. The excitement on their faces made the experience so much better. The smallest gifts (such as markers and stickers) made them all so happy. It was a great feeling to know that we had made such an impact in each of these children's lives. I am extremely grateful to have had this experience, it is definitely one that I will never forget!

We are pretty much at the end of our trip. I must say this has really been a good experience. Aside from being homesick at times and hbing hot showers, we all managed to enjoy our time in Panama to the fullest. Our last day at Soloy was a pretty exciting one. A man came in with a snake bite and had brought in the tail of the snake so the doctor could identify it. Unfourtunately, the clinic did not have the antecdote and the doctor had to call an ambulance which took over an hour. The snake had bitten him on his left lower calf. After an hour of being in the clinic his whole leg and foot were extremely swollen and the venum was spreading. There was also a lady who was close to giving birth so the ambulance took them both to David. I have a lot of injections to children, there was no school that day so the clinic was full. At the end of our clinical day we thanked the nurses and doctors and gave them gifts. The following day we went to the hospital in David and I had the opportunity to go into labor and delivery. Unfortunately, I didn't get to see a live birth. I didn't do much that day. After the hospital we went to UNACHI and did our final presentations, which in my opinion went very well. Today we drove back to Panama City and are spending the rest of the day at the villas. Overall, this has been a very successful trip. I've definitely learned a lot and appreciate everything I had. I know that I am very lucky to have such an amazing family and friends. I'm glad I came on this trip and I wouldn't trade my time here for anything. I want to thank everyone who made this trip possible!

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.

Ya terminamos

Here we are at the end of the 21 day trip to Panama. What an experience it has been. It's hard to go on trips like this because sometimes it is easy to be disappointed, but when you walk into this with an open mind, eager to learn, and try to make the most of every opportunity that presents itself it can become one of the best trips of your life. Looking back over the past three weeks, I have learned so much not only of medical skills, but of a language, a people, a culture, and great food. In Panama, they have what is called "Ojaldra". It is fried bread that only costs $0.15 each. You can make sandwiches by putting some meet and cheese in between two of them or you can just throw some sugar on top and you are set. I am going to try and make these when I get home to share a little of what I have learned with my friends and family.

I loved being in Panama. I was born to travel and can't wait to see what the future holds for my life. I want to thank Dr. Cadena for all the hard work put into this trip and Eloisa as well for coming along, helping lead, and all the translation. Eloisa, you did a fantastic job. I hope to be as fluent as you one day. I want to say thanks to all my classmates for a wonderful trip and that it was great to get to know each of you, away from the norm and even sometimes at your worst.

Post 3

For my last post we found ourselves traveling to the town of Boquete. It is a very nice mountain town that reminds me a lot of small towns present in California and Colorado. It was very "Americanized" compared to the previous parts of Panama we had been in.

While in Boquete I had the chance to partake in the many outdoor activities present. The first day we did a 16 mile round trip hike to the top of Baru volcano standing at 11,000 ft. The second day we did a 14 platform zip-line down another local mountain, which was very exhilarating, followed by a 2 hour four wheeling trip through some local trails.

Also we had the chance to stop at a local school for troubled boys and an orphanage. At the boys school, two other students and I played an intense hour plus game of soccer before heading off to the orphanage. I really enjoyed the orphanage, all the kids were very young and affectionate. We spent the majority of our time there giving out gifts and playing with the kids, it was one of my favorite parts of the trip.

We are now back at the City of Knowledge preparing to leave on Friday and I am looking forward to getting back home to my loved ones and all the amenities I've been without. I will always cherish this trip to the country of Panama and all the great people and experiences I encountered during my stay!!

Post 2

This week we did work in the clinics at the local Comarca. My group was assigned to the Alto Cabellero district, which was an hours drive from where we stayed. I got the opportunity to learn and experience a lot of new skills including suturing, and baby delivery. My only complaint was the lagging drive to and from the district we had to make everyday.

We also spent a large amount of time at the local K-6 school teaching the local children about hand washing, teeth brushing and recycling. It was a very nice experience and this kids were awesome. I really enjoyed participating in the soccer games that occurred on the playground at the end of each school day.

In comparing the education system we witnessed in the Comarca, to the one I experienced growing up in the U.S, there were vast differences. Here in Panama, school is free as long as you have a form of transportation to get there, where as in the U.S that is not the case. Also, the facilities present here are not on level with even the poorest of schools back home. Lastly, the standards of education here are far below that of the U.S.

Weekend in Boquete

My favorite highlight in Boquete was experienced at an orphanage that we had the opportunity to go to. This particular orphanage had babies ranging from a few months old up to seventeen year old teenage girls, some of whom were parents of these babies. We ended up bringing toys, candy, bookbags, and fruit for the kids. When we were giving these away, the look on these kids faces was priceless. They were all filled with glee and excitement. After handing everything out, the excitement did not end there. We had the chance to play with the kids for a good hour. I found this one little boy who appeared to be five years old, away from all the other kids. When I approached him, he was timid and did not open up when I asked his name. However, that changed after I reached in my pocket and handed him a piece of candy. The little boy ended up giving me a hug afterwards. I then took him on the swings followed by me picking him up and throwing him up in the air. He seemed to enjoy that, so we did it several times, until he became exhausted. Play time was unfortunately over and we ended up saying our goodbyes to the kids. I felt great knowing that I made the boy's day.

The following morning, several classmates and I decided to do something daring and bold. We were going to hike up a volcano. I talked to several people that had done it before and they said it was very strenous both mentally and physically. However, I brushed it off because I thought they were exagerrating as to how difficult it was. Boy was I wrong! It was by far the hardest thing that I have ever done. The first twenty minutes of the hike was the most difficult for all of us. Mainly, because of how steep the incline was. I wanted to go back to the car and drive back home. We had to take numerous breaks just to recuperate from the countless inclines we had to hike up. But after about six hours or so of hiking, we eventually made it to the top! We all felt accomplished. Unfortunately since it was cloudy, the view wasn't so great from the top of the volcano. However, it still felt good knowing that I was up there. After about thirty mintues or so of enjoying the view and recuperating, we ended up walking back down the volcano. Unfortunately, it began to downpour on us, which made it even more difficult for us because the rocks were slippery. Luckily after three hours of hiking back down, we reached the bottom of the volcano safely.

"Winners take time to relish their work, knowing that scaling the mountain is what makes the view from the top so exhilarating." -Denis Waitley

Cleanup Slash Orphanage Visit - Kristen´s post

Education groups were interesting, to be sure. It wasn´t just a learning experience for the kids, but for me as well. I´m not a very good teacher, but since Kate and I and Suzi were responsible for putting together the activities, I had to step up and get especially creative. It wasn´t like our audience was going to be particularly difficult. First and second graders, but it was still a little bit of a challenge.

Being in charge of those kids and trying to teach them essential hygeinic tasks started out as a mild test of trial and error. At first they weren´t very cooperative, but when we finally looked like we were having fun, then they started to have fun. The sad part was that while we had the opportunity to pass out toothbrushes and let these children wash their hands, we knew that most of them didn´t have access to those resources for the long term. Many of the kids had hands so dirty that the water we used was cloudy after just a few hand washes, and several had damage to their teeth.

The next day we attempted a different, more hands on kind of teaching. We took three hundred elementary schoolers out on a march to save the planet, passing out garbage bags and gloves and taking the kids on a hike to clean up the community. We and this herd of children carried banners and picked up garbage, separating the recyclable materials from the ´basura´or regular trash and continuing on our way. It was really neat to see all of these kids working together, and after the face the road sides really looked much much better.

A few days later we got to see children in a different kind of environment. The orphanage we visited near boquette was a small establishment tucked away in the mountains, housing over thirty children ranging from ages zero to 12 for boys, and zero to 18 for girls. I could feel my heart break as we passed out crayons and toys and handed out fruit, each of us taking turns carrying babies and playing hide and go seek as we milled around the compound and just absorbed what we were seeing. We didn´t stay for very long, but the little faces were permanently imprinted in my memory, especially the face of one particular little girl, who was no bigger than a four year old, and was seven in reality. She didn´t know how to talk, but she was a commanding little presence, dragging us around and smiling and insisting to be held.

Making them smile was probably the best thing I could have done for them, and it warmed my heart. I was sad to leave those children who needed nothing more than someone to love on them. It was an amazing experience.