6.28.2010

Still no internet. There is an internet cafe and international phone down the street from where we're staying, but the internet hasn't worked yet. There also is some sketchy stuff going on with it, like not being able to log out of emails/facebook/etc. So... even if it were working, I'm not sure I would try. Definitely not going to log onto my bank account down there. Haha.
Yesterday was la playa day! We woke up at 6:30 to leave at 7:30 to drive an hour and a half to David, to a resort. We got to the resort at like 9:30 (we left a little later than anticipated) only to find out it didn't open until 10. Thank goodness we didn't try to go earlier. We had to pay $10 to use everything in the resort for the day, but that included the gym, spa, pool, private beach access, international phone lines, and access to all their rentals. Thankfully it isn't their busy time, so even though we didn't make any reservations ahead of time we got to do all kinds of activities. Some people rented surf boards (the waves were absolutely awesome!), some took surfing lessons, I Kyacked, and there were bicyles too. It was my first time swimming in the Pacific. I loved it. I didn't like the black, volcanic colored sand, but the waves were ridiculous. When we got back from our kyacking trip it was storming and we all went out in the water and almost drowned. Thinking back on it, it wasn't a good idea. But it was so fun. These waves were 10+ feet tall and would swallow you if you didn't duck down deep enough. At one point I was tumbling and tumbling underwater and Josh had to pull me up. It was funny because, when the wave was there the water was high so I grabbed onto him like a monkey. Then the water went down and he was literally holding me like a little kid. Haha. I'm sure we looked ridiculous. A few of the others had water proof cameras, so hopefully we got at least a few photos in the water!
After swimming, surfing (no, not me), and some lunch, we all went kyacking. Biggest mistake of my life. It was a three hour trip that we talked into a two hour trip. 19 of us piled into a 12 passenger van, half the people were drunk, so it probably wasn't a good idea for them to go out in kyacks anyway, and our guide didn't speak English. We drive up to this river thing, and the water looks disgusting. The dirt here is dark and there's lots of clay, so the water was totally gross; on top of that, it looked completely still. We went out in the jungle to get malaria! The very thing we're warning our patients in the villages about.
We loaded up into the kyacks in groups of 3 (me, Katie, and Kira were in my boat), and started off down the river. Come to find out, our guide Edwardo did speak some English. I actually thought he spoke very well! I told him I wanted to see monkeys and he said he would try. The first part of the trip was really rough because it was upstream and very narrow. Then the river widened and it wasn't so stagnant. It completely looked like we could've been in Florida though - the sides of the river looked the exact same! We paddled upstream for about an hour and then turned around to come back. We get back almost all the way (or so we thought) and the guide tells us we have to turn around again. Everyone started freaking out, because it's starting to storm, and the tide was coming in so the current was stronger and we had already rowed upstream. Come to find out, per my request, the guide was trying to find monkeys for us. At that point though, we just wanted to go home. A helicopter flew over us and everyone started yelling 'ayuda me' (help me in espanol!). Our guide got a kick out of that. So, we rowed back upstream about 30 minutes to the original stream we came out of and then got to paddle downstream about 45 minutes back to our bus. Luckily it didn't storm too badly, otherwise it would've been awful!
Once we got back to the hotel we immediately went in the salt water. Everyone is still worried about UTIs and stuff from sitting in the stagnant water. We have a few antibiotics among us, but not enough for all the girls. We're worry worts - it's what nursing school does to you.
We ordered dinner to go and then loaded up the bus to head back to San Felix. By the time we made it home - everyone was completely wiped out. We almost needed a day off to recoup from our day off. Haha. I raced into the shower to try and get the sand out of my hair as soon as we got back. There are 6 shower stalls and they were all full. We know we have to take cold showers - and the initial getting in is awful. But after you get used to it, it feels kind of nice. Well, apparently we overloaded the system. We all barely had a trickle of water - and at this point I have lathered my hair... and I mean lathered my hair. We're talking trickle like that of a water fountain... almost nothing. Then, it completely stops. We wait for a few minutes and it came back on... a trickle. That happened 3 times that shower. And I wasn't in very long. 10 minutes total simply because of the difficulty of rinsing my thick hair. I've gotten used to really quick showers. 3 minutes, tops.
That was an adventure. :)
This morning came very early - because we had to leave by 7:30. Of course that didn't happen. And that's really ok to be late in Panama, because when people say be here at a certain time - they mean leave your house at that time. It's kind of annoying and unpredictable, but at least we're never criticized for being late. :) We got up and went to breakfast - that seems to be the worst meal of the day. Today it was two pieces of stale break, with a slice of ham (or so I think) and a slice of american cheese. Yesterday was cereal with warm whole milk. Blech. I've had PB sandwiches both days. The lunches are a little rough, because they sit in the containers all day, but they aren't too bad. Usually chicken and some kind of fried concoction. Dinners are usually very good. Their different rice mixtures are yummy!
We got to our village of Soloy at like 9:30 or so. It takes my group an hour to get to our destination by bus. And the road is winding and hilly. It's pretty unpleasant. I almost threw up today. One of the other groups apparently ended up on a chicken truck and almost died a few times. They won't be doing that tomorrow. Haha. Anyway, we got there and there were people already lined up outside the door, and then when you walked in there were people sitting, standing, kids running everywhere, coughing. The rooms was completely full. Once you walk into the clinic it's just a huge open room and then all the way around it are rooms designated for different purposes. They have an ER, a dentist office, a record keeping place, an immunization room, and several exam rooms. We were ushered into the back and there were several nurses/techs getting ready for a meeting. Apparently once a month they get together and talk about issues that need to be addressed in the province. The bachelor nurse (that seemed a lot like a charge nurse) was definitely in her early 20s and she was so smart. She knew about every area that was being covered and she was very thorough.
The meeting was all in Spanish - and I got tired of trying to keep up so it became boring really fast. But, one of the students was interpreting some for us. The way they do things here is a lot different simply because of how everything is paid for. The government supplies all the clinics with what they need - and it's really kind of amazing! These techs and nurses and "health promoters" were in charge mostly of vaccinations. They were also in charge of TB treatment. If these patients don't come in for their TB meds (you have to take 4 different drugs to avoid multidrug resistance, and you have to take them for 6 months) these nurses go out into the communities and find them to make sure they get them. Even though the vaccines they are giving are for certain ages, they vaccinate whoever needs it. So some teenagers may be getting vaccines that they should have had as children. We did hear that there were 3 different strains of influenza going around - two of which we had never heard of - so that scared us a little bit. Germs! Ahhhh! I'm pretty sure we all pulled out our handsantizer at that point.
During the meeting I saw what looked like 4 young americans arrive and walk in the back. Then they came out in scrubs and disappeared. When we were being distributed to our different stations, there were two of them in our room. We were in a Dr.'s room. Her (yes, she was a woman) name was Doctora Garcia. The other two people were Canadian medical students volunteering in this clinic for 2 months. Claudia and Anna were so nice and spoke awesome Spanish. When I asked if they knew it before they came they said no. It was funny to hear them speak in Spanish with French accents though. Very cool - and very nice to hear English from someone outside my group.
We spent the rest of the day watching and listening to the doctor diagnos and educate her patients. Different from in the US, the people seeking care are very sick. There's no emergency room visit for a headache. They have TB, pnuemonia, worms, projectile vomiting. It was rough. One woman we saw had a goiter (and enlargement of her thyroid). I palpated it, but you could clearly see it without touching it. There were so many babies and young children with flu-like symptoms and then there was a man with Tuberculosis. I think my jaw hit the floor when I heard that. Here we are standing in a closed room with no ventilation and a TB + patient. Fortunately he was already on the 4 drugs, had no cough, and was simply doing a follow-up appointment. I'll be getting a PPD once I get back. Yikes! There's also way more HIV than we thought. You open up the chart and there's a big sticker inside. Can't miss it. Hopefully, since we have to recap needles because they dispose of the used needles in cardboard boxes, no one will be stuck and we all make it back to the states without the HIV.
Another thing that's different than in the US, is they are very open about any medical information. The doors are all open and when there were patients in our room - other people would be standing in the doorway, listening. The medical files just lay around - and I opened a few to see if I could decifer what was inside. The doctor said I could, of course. There's no HIPPA in Panama. :)
It's really sad just how ignorant these people are about their own health. The doctor kept telling the parents that they needed to not give their sick children river water or even rain water, but to boil the rain water for 15 minutes and then give it. They also said not to let them cough on anyone. To us that's common knowledge, but they don't understand how germs work. Unfortunately, the antibiotics that were prescribed may or may not be followed by the patients because they don't understand the importance of finishing a dosage of antibiotics. Most didn't even really understand what they were being told. They often don't have much response to anything that's told to them.
I got to talk to my mom yesterday - and for about a week (even though it feels like I've been here for a month) I forgot about home. And now, after talking to her, I really miss it. I've never been homesick before or wanted to be home more in my life. I forgot about the few problems and issues and little dramas that I was facing. Life is way too short and being down here has caused me to reevaluate everything and really take inventory or my life. It'll be interesting to see how it affects me long term once I'm home.
Tomorrow is another day at la clinica del salud. Hopefully there's plenty to do. And hopefully the male Canadian medical student needs a shadow. :D