Soloy Clinic

My first day at Soloy clinic was culture shock. The clinic is small and very unclean, with dogs and cats walking in and out of the clinic. There is no water nor electricity in the clinic. For population of 23,000 of patients registered at the clinic there are 3 doctors, 2 nurses and also there are the promoters that go to the community to speak to people about how to clean water, not to drink dirty water, teach them about healthy living and educate about birth control.

I was placed at the ER with doctor, nurse and nursing student. I gave 3 IM injections all of them antibiotics. Doctor disclosed that he prescribes antibiotics to all patients in IM form due to patients forgetting to take medications or loose medications so they don’t take the prescribed dose of antibiotics that are necessary to be completed in full prescribed dose to kill the infection. According to doctor, patients don’t believe in waking up and taking medications on time. During my day at the clinic I observed that Panamanian people don’t talk much even doctor to patient, their conversations are very short and to the point. I also observed a problem with trust. It seemed to me that Panamanians trust their doctors in that way that they don’t even question doctors what are the side effects of the certain medications or what exactly are they for, they just pick medications and take them. I wished there was more teaching involved. Also there is little trust given to us “gringos” at the clinic. My goal is to work my best in next week or so to get their trust and I think I am slowly getting there now that I was there for 3 days. In addition I think that there is hardly anything that can be done as drastic help until we fix the water problem.

Bienvenidos a Panama!

When we arrived in Panama it was exactly what I thought it’d be like: some large buildings with a lot of family owned shops and rundown apartment buildings. When we first got to the City of Knowledge it really was like its own little town. There was a gym, pool, and fields for almost every sport. It really was a nice area with all the modern appliances I’m used to. Panama City is almost like towns in America with small convenience stores and plenty of beautiful churches. Each of these churches has its own unique history. It makes you wonder how anyone chooses which one to attend. Most of the city is familiar except everything is in Spanish. I know everyone speaks Spanish here but it was strange that almost everything has Spanish on it. I was glad that I’m able to understand most of it. It’s really frustrating though when you don’t know every word and can’t completely communicate. After a day we left for Chiriquí, about an eight hour bus ride away. We stopped by a local outdoor cafeteria and had some really good food, even though I’m not really sure exactly what I ate. While I’m here I’m really trying to eat as much of the local food as I can because you can get McDonald’s anytime. The compound where we’re staying at is run by a Jesuit priest. The scenery is gorgeous and everything is so colorful. I met two little boys last night, Enrique and Daniel, and Kayla showed them a picture of one of the priest’s four dogs. I asked them if they wanted a dog and Enrique, who is four, said “Yes, but we’re not rich so we can’t have one”. It was so great to see their reactions to things they haven’t seen before. The compound is better than I expected because I didn’t think there would be running water. We can at least take showers everyday even if the water is freezing. There’s even a filtration system here. I think the best thing about this country is how peaceful it is and how people go along on their own time.

que diferencia

today is our free day here at la playa de barqueta. we are enjoying the beach with 5 to 6 foot waves, black sand, beautiful pool, with perfect weather whereas we were previously in the comarca of panama serving the community through health education, administration of vaccinations, and information collection on how to better serve the people. it hits me so hard every time to see the drastic difference within the same country. what makes me even more sad is that i know within 2 weeks i will be back home with all of my amenities and comforts of home and they will remain in their poverty stricken communities where the basic necessity of water is hard to come by. it breaks my heart to see people like that. in the midst of such a difficult situation, you see a child smile and it breaks through all the darkness around. how a child can smile and have that happiness is beyond me, but i think it has to do with the innocence of a child where they dont quite understand what is going on. they are just living life with high aspirations.

i am having the time of my life and cant wait to see wait is yet to come.

me llamo...AMERRRICUHH

Yesterday (Thursday), my group and I, accompanied by Dr. Cadena, headed to our clinical site. I was grouped with seven of my classmates (Kelsie, Will, Kristen, Kate, Merdijana, Winnie, and Marcela) to the community clinic of Soloy. On Monday, all 23 students toured the three different clinics in the community which we chose to do our clinicals at--Soloy, Alto Cabellero, and Hato Juli. I picked Soloy because it seemed to have the most going on, and served 23,000 community members. Today we took our bus out to the community and the local elementary school. When we arrived in our big white bus, the children all just stared at us. They all gathered around and were interested in us immediately. We exchanged what words we could and took pictures with the children. They LOVED the cameras and seeing their images on the tiny screen. I am so eager to get back to the elementary school next Tuesday and Wednesday and talk to the children more about community health.

Wednesday was our first day in Soloy. We got seperated and assigned different tasks. Kelsie and I were paired up and worked along side the doctor and student nurse. Dr. Cadena informed us that the doctor knew a little bit of spanish, but she lied. All in good fun, though. The doctor would talk to us in spanish (very fast, it seemed), then Kelsie and I would look at eachother, exchanged what words we understood from the doctor, and decide what he said. Hand signals and sherades helped a lot. We got to measure pregnant women´s abdomens and the doctor would tell us when they started their pregnancy, and he would have us (in spanish) tell him what week they were in, what trimester they were in, and when their expected due date was.

Today in the clinic of Soloy, Marcela and I started with immunizations, mostly flu shots. I was happy to be there for Marcela´s first IM injection--she did awesome! And she´s fluent in spanish which helps enormously. After I gave about seven IM injections, I traveled over to the clinic´s Emergency Room, which is very different from the ER back in the states. In the Soloy ER today, I mostly did antibiotic IM injections and other IM injections. I assisted in an IV as well, along with the nurse´s help.

I am very excited for my clinical experiences in Soloy, as well as the other clinical experiences that we have yet to see. The community here in Chiriqui is amazing, and the people are so welcoming (although we are like aliens to them). Tomorrow we are heading to la playa in David, about an hour away from our compound. I am excited to hang out with friends, surf, and enjoy the sun and the Pacific ocean.

panamanian love

(Written on Sunday, May 22, 2011--just got hold of internet for the first time!)

Today, we arrived in Ngobe Bugle, Chiriqui and the comarca. We are staying at the Padre´s IHS compound. Although the accommodations here are not as nice as Panama City, I still have nothing to complain about. It is actually nicer here than I had expected. Living with 18 other girls in one room can get hectic at times, but I think we are all getting along perfectly.

In Panama City, we stayed at an old American military base that is located literally right across from the Panama Canal. The Panama Canal is a remarkable thing--we watched ships go in and out of the canal for probably two hours, at least. Later that night, Matt, Will, Suzi, and I went to a local restaurant on the base that had a great view of the canal; we watched the sunset and saw an enormous cargo ship approach teh canal. Later that night, all 23 of us students and Dr. Cadena and Eloisa went out to dinner and enjoyed the local tastes of Panama. We all bonded and shared stories.

After that second night in Panama City, I realized that I am experiencing an amazing opportunity with amazing friends, and I wouldn´t want to be anywhere else in the world right now.

Blog #2

Today was our third day in the clinic at Hato Juli. It has been an incredible experience so far!

Wednesday I started off by taking a bunch of vital signs prior to the patients receiving vaccinations (vacunes en espanol). Then I got the opportunity to shadow the internist, Dr. Iro Montezuma. He assessed a few patients and prescribed some medications for scabies, cold, GI upset, parasites, headaches, etc. Unfortunately a nurse was not present, so I was limited on the procedures I could take part in. Regardless, it was amazing to be immersed in such a different community as the Ngobe tribe.

Yesterday we got the opportunity to follow the community promotor into the community instead of staying at the clinic. Since he had already been to the area close to the clinic, we got to talk to the people, play with the children, and do some cancer risk surveys for class. It was incredible to interact with people even with such a limited understanding of their language. It has been a challenge practicing my Spanish, but I do think it is coming along!

Today a nurse was finally present and myself and fellow students got the chance to give IM vaccination injections to women, men and children. It was a learning experience! We each did about three or four vaccines.

I find it so interesting how things work in the comarca. Nurse techs are allowed to give vaccines, doctors do not run labs to diagnose and prescribe, the people have no potable water source, all of the women wear (beautiful) long colorful dresses, etc. The houses in the comarca all seem to have clay floors and are very open-- I don´t recall seeing any doors. I am curious to see what the Ngobe people think of us Gringos being here and how they feel about their healthcare system (which is socialized in Panama).

Mas luego!

I'm on a tractor..I cut the grass faster!!

May 25, 2011. Wednesday

Today was our first day in our separate clinical groups. I went to the town of Alto Caballero. There was a long line of women and children waiting to get in to the clinic. Hours are 7a-3p Monday -Friday, so it is usually busy in the morning. It is usually women with their children; very few men were there unless they were the ones sick.

We all split up into pairs and jumped right into helping. The first place I was at was with the doctor , who happened to speak some English. He saw a couple of patients and then explained what was going on with the patient and what he was prescribing. After about 30-45 minutes, we switched stations. I worked with in "triage", so the tech would call in the patient, and my partner & I would weigh, measure height, and take blood pressure (BP for adults, no BP for children). This part was pretty fun because I got to practice saying my numbers in Spanish! The last rotation I was at was giving IM injections to the adults and children.

A couple of things I found to be very interesting about this clinic. First, there is no running water during the "dry season", which is from December-March. They can't even wash their hands! The clinic is all open, and uses minimal electricity. Also, when the nurse showed us how to give the injections, she didn't wear gloves and she recapped the needles, which increases the risk for an accidental needle stick. I was very surprised at how patient the people were as they waited to be seen. They walked hours to get to the clinic, then waited for hours, and no one complained. No one yelled or got angry. So different from America!!

We also visited the elementary school down the street. We spoke to the assistant director and asked him lots of questions regarding the school & community.

Here are some highlights:
-no running water during the dry season, since there is not enough water pressure to push it through the aquaduct.
-enriched rice everyday for lunch. No drinks
-hardly any discipline. Students are well behaved.
-no corporal punishments. They only talk to the parents if there is a problem
- kids walk up to 1.5 hrs to get to school, by themselves. No worries about kidnapping.

I can't wait to get back to school and teach the children about health care. They were friendly and adorable!!