Panamanian Clinical Experience-

preparing vaccinations

So I will once more throw up a personal blog  that I wrote on the trip at an earlier date. This was during week 2. So today we were in the clinic and HAD PATIENTS. Woo hoo. Doctor Erick promised us pt’s and they totally came. I don’t know if he actually went into the community and brought them in or what lol…... But when we got there, there were pt’s lined up outside waiting for us. So cool to see considering the past few days the clinic has been almost empty on arrival. So we split up into 2 groups - first myself, Kayla, & Olivia were in the vaccination room where we worked on flu shots, penicillin shots, & oxycillin shots with our Nurse Adelina. We gave a penicillin shot to a little girl in her tush. It was a preventative most likely for STDS. It is sad to see such a young girl (10 years old) get an STD shot….but also smart of them to be giving it. Back home we are often oblivious to the fact that younger generations are involved with sexual activity. For ex: we preach abstinence in the school, well that’s great & all……but we should also equip them with other knowledge if they choose to have sex (birth control, condoms, etc.). That is one thing I have noticed here in Panama, their use of vaccinations is awesome. Better than the US in many ways. Doctor Erick mentioned that he is also big on antibiotics. Every time a person comes in with a cough, they get an antibiotic to prevent pneumonia- which is often the end result of their cough.



One of the shots I gave today was to a young boy who was both very skinny & very timid. He hopped up onto the table and pulled his pants down just a little bit for his wittle cheeks to show. For this, I was nervous. I have never given an IM injection in the gluts before. When I put the needle to the skin, the poor little guy tensed up & the muscles tightened so much the needle wouldn’t budge. I started to panic  sitting there like uhhhm, am I doing something wrong?! Thankfully our nurse came over and helped me relax the boy (by speaking his language lol … now that I think of it I would be nervous too. One large needle, some foreign girl, sticking me in my butt) Eventually it slid in & I released the medicine (oxycillin for an infection of some type). It’s cool to get a lot of interaction with children out here. Back home it is many older individuals in the hospital I have clinical at.

Dr. Eric stitching up a machete injury...



One thing I noticed while working in the clinic, is that how great our nurse with the patients. Not in a sense that she was really compassionate or anything, but she was a great teacher - which is so crucial to nursing. Even though I could only pick up on a few things that were being discussed, what I could hear was good teaching. One big thing she educated every pregnant woman on was the importance of having their baby at the health clinic as opposed to their home (due to the complications that could arise). Even with all her teaching, a lot of the mothers were set on having the baby at the comfort of their own home. Here in panama they often times just have the local medicine lady come to their house to aid in the birthing process. I think it has a lot to do with the culture- a lot of Panamanians are opposed to western medicine (the clinic). Adelina also educated patients on the importance of breast exams and general health checkups. It is crazy to think some of these people walk 8 hours to get to the clinic: barefoot, holding their baby, and any overnight supplies needed….



Another thing I noticed was how many of the people here suffer from respiratory conditions.  It is related to the living conditions, cooking in closed areas with all the smoke. So we saw a lot of nebulizer treatments related to respiratory issues in our clinic. It is also obvious that HIV, blood borne diseases, and communicable diseases are a huge problem in this camarca. It’s interesting to compare that to the United States where a lot of our health concerns are related to obesity, smoking, cardiovascular diseases, etc. Here in Panama they eat relatively healthy and are walking basically everywhere so that doesn’t seem to be a concern here. Their issues arise from their living conditions, lack of water, lack of cleanliness , etc.  



Another exicitng thing I got to do was MY FIRST BLOOD DRAW. My first time ever sticking someone with a needle for blood! Dr. Erick was such a great teacher. He kept telling me to be one with the vein. To close my eyes & feel. He even whipped out a pen and drew on the lady’s arm to show me where to stick the needle lol that may have been a bit extensive-but it helped. There was no way I was going to screw this up. Bevel up, I pushed the needle in at a very low angle and after shifting it to the right a little bit I saw blood! When I began to pull back the plunger Dr. Erick kept saying Mas, Mas, Mas.. I need more blood. I’m pretty sure he even made a twilight reference and told me to pretend I was a vampire….lol Needless to say, He was a great teacher. And the pt was a great pt! It was not as hard as I had expected, as are most things in life. I now feel much more confident going back home ready to do a blood draw of an IV.

We have walked around in the community a few times and it is interesting to see the way these families live out here. The living conditiongs, the cleanliness (lack there of), the small living area, etc. The homes are made out of mud, straw, and sometimes cement. The roofs were zinc. The floors were hardened mud. No electricity. No air conditioning. Running water was a rare find.

We saw a little baby chillin in a hammock. I think

it was her crib

Feeding a deer out in the community

one of the nicer homes we saw

I couldn’t imagine living like that and yet to some of them they consider their home luxury compared to the family sleeping in a shed. It is so funny how you can just walk onto someone’s property out here and they don’t even mind. Back home someone would call the cops if they saw someone strolling around their backyard. I think they are used to people randomly crossing on their property considering how many of the doctor’s, nurses, promotoras knocking on their doors on a regular basis to check their vaccination records…educate them on coming to the clinic…. However, as welcoming as they were, they are very shy. I remember when we asked them a few personal questions relating to their health, they would oftentimes not answer, hide behind their hands, or step away in a guarded manner.

A lot of people out here grow their own vegetables and fruits. I’ve always wanted to grow my own vegetables. It’s kind of cool to go in your back yard grab a few things for a salad and go back in the house to prepare lunch- knowing it is so fresh. However many people in our community aren’t really aware of how to grow their own crops so they are working on educating the community how to do so. At our local highschool you can graduate in a degree with agriculture. (The other degree you can graduate with is housekeeping….. quite the options).

I have learned a lot from just walking around the community and experiencing a little bit of what they experience day after day....

-Brittany Brewer

My clinical group and I on our way home from Beunos Aires...