We arrived in Chiriqui on Monday evening. We're staying at a religious compound. They feed us and are supposed to do our laundry tonight. There's no a/c, but we have electricity and clean, running water. We're sleeping in bunkbeds. Jenn chose to sleep below me. hehe...
Tuesday was our first day of clinicals. We're traveling more than 90 minutes from San Felix through the mountains to the government-owned clinic in Buenos Aires. Our driver picked up a few people who needed a ride while trying to figure out exactly where the clinic was located. Buenos Aires is in the chamarca of the Ngobe Bugle (indigenous Panamanians). None of the nurses or staff at the clinic speak English. Two of the doctors speak English, which is our saving grace! Their names are Dr. Vladimir and Dr. Eric (first names). They were all so happy to have our help for the next couple weeks. There is also a Peace Corps Volunteer (Kevin) in Buenos Aires who is nearing the end of his two year service, so he speaks Spanish really well.
Our first day was more of an orientation to the clinic and what we'll be doing (vaccinations, pap smears, observation, assessment). We spend a little bit of time with Dr. Eric while he saw a few patients. He translated everything he said and everything the patients said. Dr. Eric informed us that the Ngobe Bugle are paid $100 for each visit to the clinic up to $300 per month. This is typically just enough to feed their family rice and beans and not get a job. There were two children staying at the hospital for treatment of infection via IV. One little boy was so very cute and such a ham. He loved having his picture taken and interacting with us. On Tuesday we gave him some rice and juice. We learned that when patients stay in the hospital they have to bring their own food or their family has to bring them food. Also, there isn't really anywhere for the family members to sleep during the stay at the clinic. In addition, it's a very long distance and most people do not have cars. They have to use public transportation. These are some reasons that most people refuse to go to the hospital in Santiago or San Felix.
On Tuesday we went to the local elementary school to teach the kindergarteners and second graders about proper hand washing and tooth brushing technique. I had a ton of fun! We sang songs and taught them some English. In the afternoon we went to the clinic. There weren't any patients. We had the opportunity to speak with the local shaman. She was a very interesting lady. She showed us a bunch of plants she uses to make teas and baths to help with different types of pain. She also brought us back to her house to see some of the plants growing on her property. I learned that lemongrass is good for anxiety and insomnia and aloe is good for the liver.
Wednesday, we picked up the licensed nurse and one of the doctors on our way to the clinic. It was a good ride because Dr. Eric is funny. I was working on a paper for Nursing Inquiry on the bus, and he asked what I was doing. We talked for a while about research in the US and in Panama. When we arrived at the clinic, there were very few patients. The clinic was originally supposed to be closed for the day because both doctors were going to San Felix. We sat with Dr. Eric as he spoke with a patient who is HIV positive and has Tb. The patient has been receiving his Tb treatment every day (religiously) for the last few weeks/since diagnosis. There are no antivirals in Panama right now. They have been out for 3 months... It makes me sad to think that this young man is trying so hard to treat his Tb but there aren't any antivirals to help control the HIV infection, which means his white blood cell count will drop and he will probably pick up another infection.
Three of us also were able to observe a Pap smear. I volunteered to do the next Pap, but the patient left the clinic before I could call her to the exam room. We walked around the community in the afternoon. It's warm and moderately humid in the community. The clinic does not have a/c. Sometimes they have electric and sometimes they don't. There was also a man who the doctors were told was crazy and had kidnapped his wife and children with a machete. The were waiting for the police to arrive. There was a chance the man would be coming to the clinic for a short assessment. When we returned from lunch, the man was sitting in the doctor's office in the clinic. Dr. Vlad determined that he was alert and oriented. Therefore, the doctors couldn't really do anything. We left the clinic shortly after the man walked out.
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