Today is the first day I have been able to blog so I have alot to say. This trip has been a lot different than I expected but in a good way. I am at a clinic at Soloy which is in the Comarca (indian reservation) of the Ngobe Bugle people. I have had the oppotunity to do lots of shots and vaccinations in the clinic along with learning a lot about this different culture of the Ngobe Bugle people. Today we taught at the local elementary school. I was awesome! The children are so eager to learn and excited that we are there, not to mention that they are absolutely adorable! For the teaching today we taught 3 first grade classes, and 1 second grade class about hand washing, teeth brushing, nutrition, and a few words in english. The kids just couldn´t get enough of it, they were literally lining up to wash their hands in a little bowl that we brough, and so so excited that the tooth brushes that we handed out were for them to take home. Overall today has been one of my favorite days since we have been here, I never though I would see kids so excited to simply have a toothbrush in their hands that is their own. Tomorrow we go back to the school to teach about recycling, I am so excited!

Panama 2011

Today is pretty much half way through the trip! It really has been an amazing experience, I've definitely adjusted to a different lifestyle. Clinicals have been good so far, I've been able to give many IM injections which I hadn't done before coming to Panama. I haven't seen a live birth yet but I'm hoping I will be able to see one before I leave. The community where I am doing clinicals is called Soloy. It is a very poor community that has little health care and no filtered water. The clinic is unsanitary. My group is doing clinicals along with the UNACHI nursing students which is pretty cool because they teach us how they do certain things and we teach them how we do. I was in their Emergency Room yesterday and it is nothing like it is back home. It's an open room with no indicidual private rooms. Everything basically happens in the open, which is completely different thaN the U.S because we are very strict in practicing patient privacy. The school that is up the street from the clinic has over 700 students. The classrooms aren't merely as sophisticated as the classrooms I've seen back home. But students don't know anyhing else so they are content with what they have. Today we taught 4 different classes dental hygine, proper handwashing and about the different vitamins found in fruits and vegetables. It felt good to inform these children on things can do to prevent getting sick and transmitting bacteria. Tomorrow we will be going back to the school and teaching the students about the importance of recycling. Overall, I've noticed the people living in these communities are living the simple life. It doesn't get any more simple then living their life. Goin out into the communities a d seeing all these families that have lived their whole life without clean filtered water is amazing. I've definitely taken drinking water from the faucet as granted. Their lifestyle has given me a new prospective on life. I hope the next few days are filled with good experiences! :)

Panama es mi favorito

Today's clinical experience was definitely the most memorable yet. There was a 21 year old pregnant woman that was in labor, so the ambulance was called but took hours to get to the clinic so the doctor delivered the baby there. It was amazing that he was sitting in his office seeing patients, then had to go deliver a baby while the line of patients got longer and longer, and then after the birth he had to see all of them. He has so much responsibility and always stays so calm. Witnessing the birth of the baby was such a unique experience. The woman only received topical lidocaine for pain, and even though she would moan a little through the pain she was never screaming. I was really scared for a while because one of the techs thought the umbilical cord might be wrapped around the baby's neck because the birth was delayed. Thankfully it wasn't, but when the baby was born she barely cried and was very blue. She finally let out a soft cry which gave my huge relief. I got to hold her and she was so precious! There is usually only a birth there about every 2 months so my group was so lucky to be able to see it.

We also went to the school today to teach the children how to brush their teeth. It was a little difficult since the school didn't have any running water. We were able to have them brush their teeth using basins of water, but it made me realize how hard it is for them to be able to do that at home. 2 people from the peace corps were able to talk to us last night and that was also awesome to hear about. One of them is an engineer who has been building aqueducts and another is an English teacher at a school. When they were describing their hut that didn't have electricity and how many snakes, bats and spiders they have come across, it made me even more thankful for the compound we are staying in!

A new life :)

On our drive up the mountain to the clinic in Alto Cabiliero we happened to see Diyana, the nurse at our clinic sitting outside a restaurant in civilian clothes. We thought this was strange, but when we got to the clinic it was immediately put out of our minds as we saw the multitude of people waiting there for treatment. An even more pressing issue was the fact that there was a young woman in labor, who was already dilated 5 cm. An ambulance was supposed to arrive to take her to the hospital but as we sat with her and her contractions came quicker and quicker we realized that the baby was coming much quicker than anticipated. Everyone in our group crowded into the tiny, stifling hot exam room along with the doctor, the mother, the grandmother, and several techs. The doctor was upset because the clinic did not have the capacity to deliver a high risk pregnancy, but he was very calm and patient with all of the students. As the mother moaned with each contraction and the doctor began to cut open her perineum and vagina, I felt like I was going through each cut and pain with her. When the baby's head began to come out I had my hands clasped together and I think that I was more stressed out from just watching than anyone who was actually helping with the procedure. When the mother gave her final push and the baby slid out with a burst of fluids and myconium I breathed a sigh of relief. When I saw the baby however I was shocked. She was a blueish gray color and did not make a sound. The doctor suctioned the fluid out of her mouth, and still she didn't cry. The tech was bringing in the ambu-bag when she finally let out a short wail. I think you could actually feel the tension being lifted when she cried out. As the tech took her to be cleaned off I realized that I had tears in my eyes. I'm not sure if it was just a build up of stress that was suddenly lifted or if it was the immense joy of seeing a new life being brought into the world. When we finally brought the baby into the room where her mother was, she didn't really want to take her it seemed. We told her the baby needed to be fed though and Liz and I helped the baby attach itself to the breast. After she was fed she looked up at her mother as if she was trying to imprint her face in her memory. I told the mother that her baby was looking at her and she looked down at her child, and maybe I was just already Feeling sentimental from the whole experience, but it seemed like you could feel the love between them in their gaze. It was a beautiful experience.
As beautiful as it was though I think I can rule out OB as my future specialty. And what a terrible day not to have a nurse on duty! All of the doctor's time was taken up with these two patients and when we left, he still had a clinic full of people waiting to be seen. I felt bad for them, but they didn't seem to mind. In fact, when we brouht the baby out to be measured and weighed most of them smiled and seemed happy for the child and her mother. All in all it was a fantastic experience and I am very happy that we were blessed with the opportunity to see a new life coming into the world.

Half Way Point

Today is our 11th day out of 22. Its hard to believe that it is half way already. I am missing home, and will be glad to head back, however I will truley miss being here. Panama is quite intriguing. Since I last wrote, we have been to Hato Juli, my clinic, 3 more times and had a fun weekend at the beach.

Clinically I have gotten to do some cool things. Probably my favorite, thus far, was getting to feel a 27 week pregnant woman´s baby. It was amazing to feel such a little head and listen to its heart beat with my stethoscope. Embarrassing but it is the truth, that I finally have done my first manual blood pressure. Infact, I have done many. I know by the end of this trip I will be an expert at manual blood pressures and vaccinations. Panamanians love to get vaccinated! Sadly I have also seen severe cases of scabes. Today, I saw a 2 month old baby and mother with a terrible case. There are so many things, I could go on and on.

Coming up this week we will be going to our different clinics through Wednesday, and then Thursday we will be going to the hospital in David, that will be exciting!

Rhymes with Shmanama

This is WILL BOLAND, Im writing under this blog because for some reason I cannot create my own that will allow me to contribute to the CON blog.

Our time in the clinic has been interesting, educational, and sometimes uneventful. I like to see the differences in how the ¨system¨ works. They run their clinics relatively the same as America. They state why theyre here then are treated according to priority, and transferred if the level of care is beyond the scope of the facility. The Panamanians do have limited resources so they do things like spray cotton swabs with alcohol or use gloves as tourniquets. However with few resources, I would think they would be more careful in how they use them, and take better care of their equipment.

The Nursing students here have much more hands on task-oriented practice than most of us do. They also have different techniques of performing those tasks. They rarely start IVs in the AC, they prefer the hand. This is a basic rule, that nobody really goes by in America, because you can infuse fluid in the distal to an already punctured vein. I explained (or tried to) to one of the nurses that we mostly start in the AC because it hurts less and its easier.

I can only fix one problem at a time. Sorry about that headache.

When we went to our clinical areas for the first time we saw that basically everyone in Soloy sits in one big unairconditioned room waiting to be called. I stayed in the Doctor’s room the first day as she took patients. Each person had to say one thing only that they came there for. This is different than we’re used to because if you have a problem with anything else than say stomach pains you can talk to your doctor about your recurring headaches and have both taken care of at the same time. The doctor was very ademate about only one problem that could be taken care of. She did a lot of teaching with the women she saw and tried to be certain that they understood her directions. One of the biggest cultural differences I have found is the fact that many men have girlfriends as well as a wife. I know you’re thinking that this is the same as America but in Panama they’re very open about it and seem to accept it. Several other differences are that there aren’t many trashcans, soap dispensers look to be about ten years old, and no one seems to know what sterile technique is. We went to the Comarca also, which is the Indian reservation in Chiriquí. Their houses are mostly made out of pieces of wood and straw roofs. As I passed out candy I saw how little these people really have. Some of children have little to no clothing. I told one woman that we were going to be helping teach hand washing at the local school and she asked me how we were supposed to teach that when they couldn’t afford to buy soap, not to mention the fact that the water is unsuitable for use. I really didn’t know how to answer that because what can you really say? You can’t say it’s going to be OK because it’s not alright that they have to live like this. Even though these people don’t have much money they are happy especially when they’re playing in the river or walking their pet monkey, one that was happy jumping on our heads.