So that's how you make cotton balls...

After leaving the City of Knowledge, we traveled to San Felix, Chiriqui to stay at a Priests Compound throughout for the duration of our time in Panama that we would be spending in the community. Three groups were formed and each was assigned to the community & clinic of either Chami, Soloy, or Buenas Aires. My group was chosen to travel to Soloy and work in the health clinic there, as well as visit the school, and Ngobe Bugle Community in the area.

Man in the clinic making cotton balls by hand 

On our first day there, we first stopped at the health clinic to get a tour and introduce ourselves to the Doctors and nurses we would be working for the next few weeks. I can remember watching out the window as the van pulled up to a grungy-looking building with tons of women and children scattered outside. Very few of these people had shoes, and there were random chickens running around everywhere. As we entered the building, there was a long line of people waiting to be seen, and stray dogs weaving in and out through the crowd until they found a chair or desk to sit under (including one in the “Emergency Room”). I was shocked this was a health clinic. As we continued on our tour, I saw cotton balls being made by hand, food being passed out to pregnant women, a little girl popping a squat in the yard out at back as a means of going to the bathroom. Later, I watched as nurses started IV’s and gave injection, after injection without wearing gloves. As we know, this type of practice would be completely unacceptable in the U.S.; however, after spending some time here I have learned there are few other options considering as is they can barely, and often even not afford the proper supplies to treat their patients let alone get gloves, and needles that automatically recap in order to protect themselves.

One of the MANY dogs lying down inside the clinic 

At the school with the kids and their new brushes we gave them!

Next, we went to the school that was just down the street, and up the hill from the clinic. Here, I again saw many children without shoes. In addition, I noticed a fair amount children with decaying teeth, and many looked as if they hadn’t showered in weeks.  As a community nurse, it is necessary to do assessments of your community. Through these assessments problems are often identified and it is the community nurse’s responsibility to find ways to improve and promote health. For this reason, the next day we returned to the school with toothbrushes, toothpaste, and other supplies. We chose to help educate, empower, and provide access to these children by teaching the importance of brushing your teeth, in addition to proper technique. We also did a presentation on health promotion; discussing with older children the aspects of personal hygiene, nutrition, exercise, and the importance of getting adequate amounts of water and rest. Since most of these children are living in poverty, we did our best to tailor the presentation to them by pointing out inexpensive foods that were common to the area but still healthy choices.

One the homes in the Community that I did my 1st assessment on. 

Upon entering the actual community where families lived, I was astonished to see what poor living conditions these people live in. I’ve seen pictures and always known there were places in the world that were like this but to really see it first hand was a truly eye opening experience. The houses were all like little huts made out tree braches and random tarp and aluminum scraps found and tied together. Most houses had over four people living there, but their whole house only consists of one room. For example, for my 1^st community assessment I interviewed a woman who lived in one of these homes with her husband, and her 3 granddaughters that had been abandoned by their mother. The inside of their home was one small room that consisted of a mattress, hammock, and little table they would do the cooking on. In addition to the cleanliness and confined living quarters, a big concern of mine was that all the cooking is done inside. While this would seem like a good practice in the U.S. because most homes there have gas or electric stoves; here they use wood or coal. Using these materials inside a home, especially one with very little air ventilation is very dangerous. After speaking with the doctors at the Soloy clinic, we learned that respiratory issues are one of the biggest problems in the community. Much of this can be contributed to the vast amount of smoke inside the home caused from cooking inside. For this reason, we worked to educate and encourage families to cook outside, since smoke inhalation is so dangerous. 

Inside the home