Thursday, April 19, 2007

a day at the clinic when it was still slow enough to take pictures...and our transporation up the mountain

most of our group and digging something green out of a kid´s ear.

The pharmacy at the beginning of the week...and the pharmacy at the end of the week...sweet.



and some of our patients...



a family near where we stayed, one of the views while we drove to the clinics and the roads that we were driving on.

Tuesday, April 17, 2007

A break from the ordinary to something extraordinary

This past week I was given the opportunity to go to Neyba, a town on the western side of the island to work with a medical group from West Virginia College of Osteopathic Medicine. I always get onto the director here because he says that gringos are so easy to spot in the airport and that they stand out like a sore thumb. I stand corrected now. I went with CSA to pick up the group and then immediately drive to Neyba that day. A group of 7 gringos and an Indian doctor walked through the gate looking absolutely bewildered and completely out of place. They might as well have had a sign above their heads shouting, ¨we don´t belong here...can you tell?¨ although their faces did that quite well for them.

We all thought that we were going to be in Neyba but it turns out that after we got to Neyba we still had a 30 minute (Dominican time) drive ahead of us. That means 1 1/2 hours later we arrived at our destination...a conference center on the top of the mountain with a view of the entire area and the valleys surrounding. It was quite a nice center although it was very hard to communicate because there was no cell phone signal at all there. Come on...I know you´re out in the middle of nowhere...but let´s get some cell phone service going on here! (totally a joke). The only thing that the group didn´t quite like was the fact that the conference center only had cold water for showers. It was pretty much exactly like my shower here in the city so it didn´t phase me at all.

The group was mainly second year students with 2 first year med students so they were all pretty new to practicing...and definitely new to clinics in third world countries in poor rural areas. We started the first day working out of the conference center and setting up a pharmacy (I almost spelled that farmacia...woohoo spanish) and a consulation room in two different locations so we could shuttle patients from one to the other without too much congestion. That was easier said than done considering we saw over 200 patients the first day and most of the families had 5-10 kids who were sick at one time. When they got to the pharmacy, they would hand us all of those records at once and we would have to frantically fill all of them. I ended up being the one translating for everyone in the pharmacy which was slightly interesting because I ended up looking up tons of words the first few hours to even figure out how to say certain things. By the end of the day I was a pro and had figured out dosing and how to explain prescriptions quite well.

The second day the group took off in a flatbed pickup truck to climb the steep mountain roads comprised entirely of rock and mud (mainly just really really rocky - although when it actually rains, it is quite a different story). We arrived at a school established by Vision Mundial (a paragraph of praise follows shortly for this organization!) and set up the clinic much the same as before. This was the case every day from then on as we set up shop in different schools in different communities throughout the entire area. Overall, we went to 7 different communities in 5 days and saw around 938 patients...we were a bit tired at the end of the week after working from 9 am to 4 pm with a 1 hour break for lunch. That averages about 33 patients an hour.

What cracked me up A LOT was the fact that the entire group seemed ok at asking for my 'expert opinion' on spanish terms and for medication dosing. Here´s an idea...let´s ask the college graduate questions about dosing...good call. Two days I worked with doctors helping to diagnose patients and translate all of their symptoms into spanish. What was cool was that there were many times where it was so straight forward that you could just diagnose most of the problems based on their symptoms...the parasitic infection was pretty easy...even if they didn´t have it, you gave one prophylactically. I actually found myself teaching the students a lot about third world medicine and how to listen for different things...woohoo.

The last day we treated a community right on the river and got to take the afternoon to hang out on this beautiful river that flows through the community. It was nice because the day before ended up treating patients until 7pm and were absolutely exhausted at the end of the day.

What was soooo fun was that I still had homework for CSA (which I still haven´t finished) because I was given an entire notebook of homework to do. Go treat patients and be one of the 'experts' on medications and spanish...and then come home to more homework than I had for some classes in college...sweet.

I also basically became part of CSA staff this past week because I helped get the group where they needed to be and checked in for updates with CSA. I also helped take the students around the Colonial Zone on their last day and got them to the airport. Maybe there´s hope for me after all...haha.

Overall, an amazing week in which I learned so much Spanish just by being exposed and having to scream out whatever I could to help the patients understand their medication dosing and to understand their symptoms when I was one of their doctors. I think I´m just going to move to the country side and set up shop from now on just to learn more.

Tuesday, April 3, 2007




Some more pictures from Bahia de las Aguilas. Most gorgeous place I have seen...



A photo to share

Me and Jamie at Bahia de las Aguilas on my one excursion outside of Spanish classes.
The Spanish continues to be hard and has so many rules that I get very confused so many times. I will think I am understanding something and then I try it on my own and have no idea what I am doing. I randomly find myself regressing back into French and giving French names to different items. 6 hours of class a day is quite extreme although it has been good for me - it is definitely what I needed considering my elementary level of Spanish (known as nothing, nada, no Spanish). The only thing I can say is that I wish I had more talking with people so that I can get used to actually speaking. I had Dona Violeta, the Spanish coordinator for CSA, for class the other day and my class was absolutely amazing. I learned more in one class period than I had learned in one week with one of my other teachers. My teacher in the morning is awesome and I usually understand most of what he says to me in class. We get along really well and I enjoy those classes even when I get frustrated. All part of the learning process.

It´s the little things here too that get me through the days. I find myself stopping under a certain tree in the morning just to get a whiff of wet leaves that smell like autumn. There is a corner near my house as I walk to the bus stop in the morning that no one sweeps and the leaves that fall of the tree collect on the sidewalk. When it rains, the leaves fill with water and smell of autumn in the mountains of North Carolina as you hike up the trails that are covered in yellow, red, and orange leaves that have fallen. I´m sure the people around me think I´m crazy because I take a deep breath and smile ever so slightly every time I come to that specific corner. Lovely that it almost got me hit by a car the other day because I wasn´t paying attention at all after that and crossed the road. Oops. Speaking of traffic, that´s definitely another thought that gets me through the day...whether or not I can manipulate public transportation in order to get to work without getting lost. My first day was quite fun in terms of public transportation because I ended up on the other side of the city completely and had to walk 15 blocks. Now I know my way around the city quite well..at least in certain areas. It´s such an accomplishment every morning for me that I made it to work without getting killed as well. Forget the lines on the road for two lanes only - that means 3-4 lanes depending on how tight you are willing to squeeze the cars. The whole system is so hectic but I´ve mastered it! (At least from my house to CSA....yeah that´s about it).

Mornings require coffee and Ana at CSA makes fun of me almost every morning about my coffee taste - completely black. No sugar, no milk. Black. Deybi, my teacher, puts about a pound of sugar in his and swears it´s not that sweet....yeah ok, sure. I like it bitter.

I´m learning faster and am starting to understand more and more spanish although Dominican slang is quite a different story. I need everyone to speak proper spanish to me, por favor. I´m sure it´s like moving to the South and not speaking any English and hearing ¨redneck¨for the first few times. Sometimes I don´t even know what they are saying and I´m from that area. Ah - the wonderful Southern language...