"Our lives are not as limited as we think they are; the world is a wonderfully weird place; consensual reality is significantly flawed; no institution can be trusted, but love does work; all things are possible; and we all could be happy and fulfilled if we only had the guts to be truly free and the wisdom to shrink our egos and quit taking ourselves so damn seriously."
-Tom Robbins

Friday, November 5, 2010

This is a reminder for me to write about the amazing people that are involved with Shoulder to Shoulder. I don't think I realized before I came here the type of organization that S2S is. It blows my mind to hear the stories of those that come through here. Take Ed Zuroweste for one. He has been involved with S2S for several years and he brings med students from Hopkins down frequently. The man isn't real- for lack of a better description, he is inspiring. He is genuine, humble, and exudes positive energy. Not to mention he has done incredible things with his life. Today on the way to Banaderos for a paquete basico, he tells Ashley and me about his times with his good buddy, Paul Farmer- about the dinners and debates he, Paul, and Jeff heck have had. Also about his work with the WHO and his own Migrant Clinicians Network. If you had told me this time last year, as I was sitting in class reading Paul Farmer and further delving into my interest in combining anthropology and medicine, that I was going to be here now meeting such people, I would have laughed and said that would be wonderful, but not exactly realistic.
It's funny- I knew for so long and never doubted that I would leave the US after graduation, and I knew I was going to make it happen somehow, but when I found a way to get to Honduras, I didn't think too deeply about it, I was just ready to go. Lately I've just been focusing on my work and not really thinking too deeply about things- a great way to go about things I've decided. And while I am still in a non-reflective mood lately, I can't help but think about what I'm seeing and doing here. It then follows to question and wonder what I'll be doing after this, what everyone will be doing after our brief lives here.
Just a few things bouncing around in my head now...

Thursday, November 4, 2010

Life's a beach and I'm just playing in the sand

Long time, no post. I attribute that mostly to the fact that I’ve been so absorbed in my work down here. I have been incredibly busy the past few weeks- lots of work with pharmacy, and lots of data entry and clean up with the study. I’m getting less children for the study this month- which I think I’ve mentioned before indicates the seasonality of respiratory infections. I now have days go by when either no kids qualify at all, or the ones that do tell me no, so I go without a patient for the day. This past Saturday Ben took the one hundred samples I’ve collected back to the states to be run through the CDC lab- I’m really excited to see the results.
While on the topic of last Saturday, we closed the clinic for the day- Ashley and Janell arranged to have a huge clinic cleaning day. It was pretty cool to witness- the lab crew came, Kelvin got his scholarship students to come (unasked), and we all got to work. Everyone was in gloves scrubbing walls, floors, sewing screens, fixing toilets, the whole nine yards. So cool to see everyone work so hard to get the clinic in its finest condition- I couldn’t help but smile witnessing it.
So the biggest news, or update really, is my work with pharmacy. It has been a whirlwind of medicines, med orders, and shelf constructing. The new trial is to now have a two month supply of meds in the bodega. Consequently, about two weeks ago roughly 150+ boxes were dropped off in the library. The process of unloading, counting, and shelving the meds was a big one. Worked very long days, but naturally, I was excited to do all of it- I told Alex I am his ayudante now. In order to have the enormous amount of meds fit in the bodega, we (and by we I mean Alex) made new shelves. I’m pretty proud of the acetaminofen shelf I made as well as the board I cut for the sueros. It’s the little things…
I went to Conce that weekend as well to work with Alan on database study queries and do the same med stocking there, but there were far less meds so it went a lot easier.
Sunday after the cleaning Doris, Alex, and I worked on the med orders for the 7 clinics here around Santa Lucía. While I enjoy doing them, it’s a little more difficult when there are several people doing it- making sure everything is checked off, in the box, etc. Monday the final two were finished and another bin was packed up for our newest visitor, Ed- a long time Shoulder to Shoulder pro. Alex left Tuesday morning, so I had to ensure that the orders made it on trucks and other bins went to Conce and San Pedro- after many phone calls and plan changes, everything went smoothly :)

A final note- it’s interesting to think about who keeps things going down here. We are all in our twenties, and we are the ones running the show. I use we loosely- I’m still just training for pharmacy director and I’m not sure where that will go, but for now I’m just enjoying the ride. But Janell, Alan, Alex, and Ben do so much to keep things functioning- not an easy task by any means. Really, it’s incredible.I’ll end the post there. Again, more descriptive than reflective, but that’s how I’ve been feeling lately- I don’t think as much or worry about things and it’s been great.

I’ll be home in a little over a month and I’m getting more and more excited to see everyone!

Wednesday, October 13, 2010

Updates: Pharmacy, Volcanoes, Avocados, and Canadian Thanksgiving

So, I haven’t posted in a while, which makes it difficult to know where to begin…I also am not feeling like my usual sappy self, so I may ramble less…
Just got back from Antigua today- such a great trip. But before I get into that, I want to talk about life in Santa Lucía.
We’ve kind of been saying that the “honeymoon period” is over- which is true to some degree. Things just aren’t new and exciting- life is more routine- or as routine as things can get around here (which isn’t very…).
Although, I do have some exciting news. So I’ve mentioned before how my job is definitely a part of Shoulder to Shoulder, but yet kind of stands alone- I don’t report to anyone here, and I basically work alone. While I absolutely love the study, I’ve been wanting to do something that’s more involved with Shoulder to Shoulder itself. When Art and Dick were here, they mentioned to me becoming involved with pharmacy. Alex leaves in December- for good- and his work here is incredibly important. Doris would ideally take over, but she is unsure about her future here with S2S. So that’s kind of where I come in—I am to observe what she does and work with her to learn how to work in the pharmacy. Which is awesome because she and I get along so well and she’s great about helping me with things. She and I talked today about me leaving for good—a sad conversation, so we cut it short. So while originally I was to train and learn about her job, because she recently told Alex she wasn’t sure if she was going to stay here, I am now training for Alex’s job as well—pharmacy director. I’m not sure exactly where it will go- whether I’ll actually do the work, or just train someone else to do the work. Either way, I’m incredibly excited to work with pharmacy. Art, Dick, and Alex phrased it well with “welcome to team pharmacy”. I tried my best to contain my excitement when talking to them about it- but it’s hard for me to not let on when I’m excited.
So I’ve been really busy with that lately. The beginning of the month is when med orders go through meaning Alex (and now myself as well) first unload and stock the bodegas with meds, then review the orders from the outlying clinics, see if they should receive more or less meds (a puzzle really), then pack up the boxes of meds to be delivered to the clinics. It is quite the process. Alex is also really great about showing me stuff. I’m sure I’m annoying always asking questions and wanting to help- but he handles it well and appreciates my efforts and excitement. We definitely spent a ton of time doing pharmacy stuff last week- I felt like his shadow, but it was fun. I’m posting a pic of the stocked bodega here in SL below:

Now that med orders are out, we have to prepare for the brigade coming. There is also going to be a 2 month supply store here in Santa Lucía and in Conce starting soon—something that will definitely change how pharmacy runs, in a good way. It’s exciting to think where this will all go…

Side note- last weekend we all hung out drinking and smoking hookah on the porch. Such a blast.

Anyway- on to Antigua:
Ashley and Beth left Wednesday, while Yuan, Alan and I left Thursday. The bus left at noon and we arrived in la Esperanza for dinner. The following morning we left from Esperanza around 4:30, arrived in San Pedro, and from there took the bus to Copan which continued onto Antigua. Finally arrived in Antigua Friday night around 9 or 10—a lot of traveling, but so worth it.
Met up with Ashley, Beth, and Karla and we all went out to eat—finished dinner around midnight, grabbed a beer at a pub, then crashed. For real, it was SO good to see Karla! Really do miss her around here, but she is really enjoying life there and I’m so happy for her.
The following day we strolled around the city and got breakfast at a really cute and chill café- Rainbow Café. From there we walked around some more, shopped at the market for a while, then caught a 2pm bus to Volcan Pacaya. The bus ride was fun- there were all kinds of travelers on the bus- 2 gorgeous women from Norway, an couple from India (and the guy went to NC state for grad school!), two Estonian women, and us gringos. It’s incredible to think how so many people from so many different places travel around and meet each other. I absolutely love witnessing it. Sergio, our tour guide, labeled us the tigres, and after an hour and a half of hiking and sightseeing, we got as close to the volcano as we could. We brought marshmallows with us, so Sergio roasted them over the lava that was under some rocks. The sights were unreal. We were able to see the sunset with only a few clouds obstructing the view. It’s crazy to think- we spent the evening hiking to a volcano, and we toasted marshmallows with people from all over—is this really my life?
That night we went out to eat again and then hit up a dance club. Took a while to settle on a place, but once we were there it was a blast. Some of the group left early, but Yuan, Karla and I stayed and danced until close- fun times.
The following day was the highlight of my trip. After getting brunch at the Bagel Barn (so good!) we got a jalon up to Earth Lodge- an avocado farm outside of Antigua. Legit, this place was incredible. We hiked down for a bit, following signs leading us to the lodge. The place was amazing—wish I could describe the vibe there. The first thing you see when you walk up is just a beautiful patch of land, with a cabin/lodge area, with hammocks and lounge chairs scattered around. The view was amazing—in the distance you could see Volcano Fuego and another city. The people working there were so chill- very down to earth and mellow. Exactly what I needed at that point. We all dropped our stuff off in the cabin dorm (the tree houses were booked—sad) and then got drinks at Happy Hour (3pm). There was a hoop laying on the ground, so naturally I picked it up and began to hoop. Met Ramona, the receptionist/bartender and she and I chatted it up about hooping. She taught me a new trick I want to work on. Wish I could describe how awesome it was to be there- hooping while taking in the view, and then lounging in a hammock with a gin and tonic in my hand. I really want to go back. At 5 pm was the main event- Canadian Thanksgiving. Jazz and some of the others that work there made the most amazing dinner! Stuffing, eggplant, turkey, salad, potatoes, etc. And pumpkin and apple pies for dessert. We also met two other travelers—a woman from England who is beginning a 6 month travel adventure and a guy from Scotland who was so great! It was a blast to just hang out, laughing and enjoying each other’s company. The rest of the night was chill- I hung out outside on the hammock for a while after dinner, bought some new earrings from Jazz (they’re pretty sweet), then joined everyone in front of the fire until we all were too tired to keep talking.
Ashley and I stayed at Earth Lodge the next day until after lunch, while everyone else went back to do various things. The afternoon was spent lounging in the park in Antigua before moving our stuff to the Jungle Party Hostel. I have to say, I wish I could do more traveling and hostel-ing. I love the vibe in hostels (not that I’ve been to many…)—young travelers from all over hanging out and wanting to have a good time. Definitely something I want to do in the future.
The following morning at 3am is when we began the trek back to SL. Short funny story-- I had to run after the bus because it left me as I was using the bathroom in a gas station...of course, that would happen to me. After I got back on the bus- it hit a cow in the road. Yes, that actually happened.
After 2 days of traveling, we are now back home, and we actually just moved upstairs to the apartment. It’s weird to have moved- I was really comfortable downstairs living with Ashley and Yuan. Now I have a room that I’ll be sharing with Jess and Yuan- but they are also living in Conce, so I’m sort of on my own? Another girl, Caitlin, is coming soon, and I’m pretty sure she’ll be staying here as well.

So those are all the updates I have—not very reflective, I know- but I’m sure I’ll be back to that soon :)
Miss everyone at home—only 2 more months and I’ll see everyone again!

Thursday, September 23, 2010

Night Prom

It’s been a long time since I’ve posted. Don’t really know where to start exactly. Things have been great. I’m home, and I have a family here-it’s amazing.
The study is going really well, too. I skyped with Liz the other day to catch up—I’m running low on supplies here, and we are trying to figure out a way to get more down here before the brigade comes in mid-October. Otherwise, I won’t be able to do the study for a bit. Apparently I’ve just about doubled the number of patients that had been recruited before I got here just in the month that I’ve been here. I guess that proves the seasonality of respiratory infections here…or my creepy stalking abilities. Both.

So what has happened in the week or so that I haven’t written… Honduras had it’s Independence Day last week- so there wasn’t work on Wednesday. Tuesday night there was a parade and some music in the plaza, so a few of us went there to check it out. Supposedly there’s another parade and dance in December…how excited I am about that is slightly odd.

I’ve had several moments on the upstairs porch just thinking over and over about my life here. There is something about that porch and view that puts me in such a reflective mood. I hope I never forget the view. And the sounds- the generator (a veces), the roosters, the rain, Spanish, and English. I’ve even pulled a total me and thought about where everyone will be after this. It’s interesting to think—we all came from busy lives, and after this we’ll all be starting new stages in our lives, but right now, for this year, we are here together and have a life here. It’s a very unique experience. What's also interesting to observe is how this place is constantly changing- growing, shrinking, cycling people in and out. Some people stay here for years, others for months, brigades come and go, it's rare for us all to be in the same place at the same time, which makes those days and nights so wonderful.

And while I’m on that topic…I’m beginning to realize more and more how unique of an organization Shoulder to Shoulder is. I have heard so many different perspectives and takes on it all- how it started, the current projects, past projects, the future, etc. A few of us got to talking last night about our motives for coming here—often, there are similarities, but everyone has their own story. Art Ranz (chief operating officer) and Dick Buten (director management systems) have been here since Sunday, and having them around has been a very cool experience. For some reason, seeing them walk around the comedor makes me feel so proud to be a part of this organization- makes me realize just how much people care about this place and how much work goes into keeping it afloat. They have such great attitudes also. Beyond friendly and personable. And they have such a passion for S2S- it’s admirable. Hearing them talk to each other and to the gang makes me realize that I don’t want the end of my stay here to be the complete end of my involvement with S2S.

The study was (for the first time) slow the past two days, so I’ve been doing work in the comedor. It’s been nice to kind of take a break. A few of us are going to Antigua, Guatemala in a week or so and I am so so excited for that! Oh, side story- Doris (pharmacist) has been gone for the past two days. When I went down to the clinic this am, we saw each other, I squealed her name and she gave me a huge hug. Such a small thing, but it made my day. I feel so comfortable in the clinic now. I’ve been hanging out in the lab a lot too with Rahul, Norma, Digna, and Veronica. Digna is a wizard with the lab tests and I’m trying to learn things from her. They all also want to learn English, so we help each other out with languages-it’s a great place to be.

One last thing to note—we have all recently gotten into playing basketball. We had an incredibly intense game yesterday- Me, Yuan, Ashley, Karla, Beth, Alex, Chepe, Juan, Cecilio, and Manuel. I can’t even describe how fun it was. We played straight into the dark then made it home just in time for pupusas for dinner. Played again today with some different people, and it was pouring rain the whole time. Life is good here.

Tomorrow, I’m heading to Conce to hang out with everyone there. There is a hike planned for Agua Salada, another waterfall, on Sunday and I’m pumped- supposed to be pretty intense.

I’m sure I’ll have stories to tell after the weekend :)

side note: I'm writing this post from a keyboard attached to my computer through the USB port because I had the brilliant idea to remove my keys from my keyboard last night and clean the base. After jamming the buttons back on...a select few are stuck and do not work...not what you want.

Monday, September 13, 2010

I love the people here

Quite the morning.

I had to write a post to describe just how incredible the people here are. Although, I should note that due to the nature of my work here, I don't really deal with difficult people or other issues that most of the others face. I guess I'm an outsider in that sense-- at times I really wish I wasn't, but I do love the work I'm doing, so it's all fine.

Anyway, this morning I walked into the lab, said hey to Raul and Digna, and both of them just gave me this look of worry and pointed to the fridge. I look over and the small fridge in which I keep all of the samples, frozen, was cracked open. Legit had a huge wave of panic come over me. I rushed over to it, opened it, and everything was iced over and the samples were liquid. Panic. I was terrified that because the samples had thawed that they were ruined. I couldn't open two of the drawers either. Raul saw me struggling and came over to help me. He got a pair of scissors and began chiseling away at the ice. How incredible is that- he was so so helpful. He didn't just say sorry and go back to his work, he took the time to help me- so amazing. So he keeps doing that while I transfer the samples from the little fridge to the big one. I then ran up to the comador in a panic, and teared up when telling Yuan what happened. She was so sweet and came to the lab with me to try and calm me down. Yuan went above and beyond being amazing and she interviewed a patient while I tried to reach Liz. I had texted Alex and Janell- Alex called right away to make sure everything was ok and helped me out with the freezer issues. Yuan even called and left Liz a voicemail explaining to her that I was having issues with the study. I wish I had a better word to describe how incredible it is that they took the time to help me out. Eventually Liz and I spoke and everything is fine. So overall, nothing is damaged and the 150ish sample I have are good. But it was quite the chaotic morning. I still can't get over how great everyone was. Like I said earlier, it is a support system here. I was struggling big time, and I got help and advice from those around me. Absolutely incredible, I can't believe how lucky I am to work and live with these people. Could not be more appreciative right now. And the help was genuine. No one was obligated to help me out- everyone has their own shit to worry about- but they still took time to tell me it would be fine and to help. Unreal.

Never a dull moment here

La vida buena

My posts are becoming less and less frequent. Good or bad thing? Good because it means I’m becoming more and more used to daily life, but bad because I want you all to know the highlights of what I’m doing. First of all, I want to quickly note how the group here has become a sort of family. We legit do everything together, especially the roomies. Work, cook, eat, work out, lounge, joke around, have serious talks, everything. It’s such a great support system here too- if one person is having a bad day, we try to make it better, if one person is happy about something, we celebrate it. It’s amazing.

First brigade came last week, too. Definitely different to have so many more people here. Though I didn’t see them much because the dental students were in the dental clinic all day, and most of the nursing students went out into the field during the days. Oh, and on Wednesday night, the power went out. Usually that's fine because the generator kicks in, but the connection from the clinic to the living area wasn't working, so we were without power. The amazing and admirable part of the story is that Alex and Chepe quietly left that night to make the 8+ hour drive to San Pedro to get the broken part. It really is incredible how much people care about this place-- though frustrations often run extremely high-- only something you truly care about can upset you so much.

On Friday I took the day off from the study to go to San Antonio with a few students from the brigade, Janell, Yuan, Beth, and Karla. I was seriously concerned about leaving the study for a day- I’m getting paid to do this work down here, and leaving the clinic makes me feel like I’m slacking off on the job. But then there’s the part of me that wants to see as much as I can down here. I “trained” Ashley on the study because she was amazing enough to offer to cover for me. Leaving the frontera was great- Yuan and I rode in the back of the truck the way there for about an hour and a half and (of course) the scenery was incredible. She and I kept talking about how this is our life after college and how much we love that we are here. It’s crazy to think back to the beginning of senior year when I was struggling trying to figure out what I was doing after I graduated. How many times did I say to people “Well, ideally I would find someone doing research somewhere, hopefully relating to medicine, and I would help him or her in the field, but that’s unlikely, so who knows what I’ll do.”, and I’m actually doing exactly that now? Crazy how that stuff works out.

At times I feel like the work I do here is minor and insignificant. It's hard not to feel that way when I do the same thing everyday, and witness others going out into the field, or working on other major projects. But I guess you have to put it all in perspective, realize that what I'm doing here is being done for a reason. Respiratory infections are very common here, and no one knows exactly why. I can't remember if I've written about this yet, but Doctor Ruben and I had a long chat the other day about why this study matters so much. It was so great to hear that, especially from him. He is an amazing physician and the fact that he believes in this study makes me feel so good about doing it.

Anyway, back to Friday. San Antonio wasn’t too crowded and there weren’t any home visits that had to be made, so we left after lunch.

I worked some on Saturday morning to ease my guilt about leaving Friday, and while I was working, there was a birth going on. Yuan came and got me- then we got Ashley to join. Ruben was the physician and Deysi was the nurse- so there were 5 of us in there. The whole scene was pretty surreal. It also was different than what I expected- the woman was so calm, practically sleeping between contractions. There were no high tech monitors and drugs; the baby's heartbeat was monitored by a hand-held device to ensure he was doing ok. It wasn't this huge event, Ruben delivered the (huge) baby, and Deysi proceeded to clean it up. It happened so quickly, hard to believe I was there for it all.

Around noon on Saturday Yuan, Ashley and I joined Janell to go to La Esperanza for the night. Took some effort to get us all on the bus, but we did it. After five hours on the bus, we made it. I have to say, I really do enjoy riding on the bus here. It's kind of an adventure. I like just sitting on the bus and staring out the window at things. Though the buses are often crowded and hot, I find it relaxing to sit there and observe. We met up with Janell's friend, Karla, at the hotel and after resting for a bit we headed to the restaurant El Fagon. Nothing super exciting, but it was so fun to be out in a different place drinking and enjoying each other's company.

Made it back to the frontera last night in time to celebrate Yuan's 22nd birthday. We attempted to make peanut noodles, and after some serious issues in the kitchen, it turned out great. Again, the people here are amazing and even the small things we do together are a blast.
I'm heading down to the clinic now....more to come later.

Monday, September 6, 2010

The trip to Conce...


Never a dull moment here. That is a phrase definitely said multiple times this weekend. I’ve been saying that it still hasn’t hit me that I live here, but as the days go by, the feeling that I’m a visitor subsides- though weekends like this past one still make me realize that this is quite the experience.
I want to note how things with the study are going-very well. I've gotten about 35 patients since I've been here. While it is busy for me on most days, but not so much on others, I always find ways to stay occupied. I'm getting to know the people that work in the lab- we chat (read: they laugh at my attempts to pronounce any word with rr) when I'm in there aliquoting the samples and as of this week, we are working on English words and phrases after work. Two things happened last week that got me excited- one being that a mother of one of the children I saw asked me why I was doing the study, what I was studying, if I was in school, etc. Not only was it great for her to be interested, but the fact that I could actually tell her, and speak without much hesitation was awesome. The other thing that happened was after doing a rapid flu test (for Influenza A and B) on a particularly sick boy, I took the mother aside and told her that I had done the test, and her son didn't have influenza. She genuinely thanked me. Really, she was thanking me? I didn't do much, but it was a small thing, and it made me happy. It really is the little things...
Oh, and we made pina coladas on Thursday night using the pinas Maria bought that day- good times for sure.
Now for this weekend-I’ll start from the beginning.
Saturday morning Ashley and I woke up around 5:30 in order to make the 6am bus to Conce. It stops near the center of town, as well as in front of the clinic, so we decided to walk towards it then hopped on midway between the two points. This bus ride was a blast—serious club music for the first hour, then some slow Mexican tunes at the end. According to my new friend on the bus, Roberto, the person singing was the Michael Jackson of Mexico- good to know. The head rest kept falling on me and Ashley, so naturally I removed it and stuck it in the corner—that did not go over well. Eventually a guy came back and shoved it back in- only to have it continually fall on us for the remainder of the drive. We also were given some pamphlets about the origin of life from a Jehovah’s witness on the bus, who then later refused to talk to us. After roughly an hour and a half (and a serious concern that we had missed our stop) we made it to the clinic in Conce in time for breakfast with the crew that was there:Yuan, Karla, Beth, Alan, and Alex. The view from the porch where you eat is absolutely unreal.It’s just untouched, lush, peaceful greenery (for now) as far as you can see and you could gaze off into it for hours just thinking about everything. The more I take those moments, the more I realize how short my stay is here. I would love to find a way to extend my stay- perhaps take on another project? Vamos a ver.
The clinic in Conce is so much nicer than the one in Santa Lucia. Not that SL’s is bad, just that the one in Conce is newer and layed out differently.

The downside is the living areas- they are much less homey than those in SL and there isn’t really a place where everyone can gather to hang out- but we made it work. After breakfast the girls headed into town to check out the market and buy soda for the night and for the lunch at Delmi’s the following day (more about that later). We stopped at Delmi’s before hitting up the market- she lives in town in a house that is pink giraffe print- it’s awesome. Conce has such a different feel than SL. It has a very friendly vibe and unlike SL, houses are kind of lined up in a row and appear much more welcoming. We told her we would buy drinks and a cake for the lunch party, as well as got ourselves (Ashley and me) an invite. The market was great- tarps set up everywhere with people selling food, CDs, clothes, shoes, and all other sorts of things. Naturally, I had to buy a bracelet and naturally, it took me forever to decide which one.
After the market was lunch (which doesn’t come close to the cooking of the Marias’; I am so spoiled living in SL), and after lunch was the waterfall. We all piled into the S2S truck and made it there in about 20 minutes. After a short hike down to the bottom, we all immediately jumped in to play. It was incredible to just sit in the water and watch the waterfall.
Because it’s rainy season, we weren’t able to swim up to get behind it; the water was too strong. Later, a few of us hiked up farther to see more of the waterfall- so incredibly beautiful.
On another note, it’s amazing to think about the group that’s here- we all decided to take time off from whatever we were doing in the US to come here and work. I’d like to think that we all want more than just a trip to enjoy a foreign country; that we want to experience so much more and learn a ton about life in general. I don’t exactly know how to put into words why I am here. Numerous people have asked me that, and I can never find an answer that really captures my motives for coming here. Yes, I wanted to be exposed to more medicine, yes, I wanted to live abroad, completely away from everything and everyone I know, and yes I wanted to gain experience working for the kind of organization that S2S is, but that still doesn’t explain it. Not sure I ever will be able to, but maybe in time it’ll be easier for me to explain.
We finally decided to head back- this time Beth and I rode in the truck-bed, but I can’t complain, because it’s a great way to take in the sights. The rest of the evening was pretty lazy. We mostly sat on the cottage porch and watched the sunset. Incredible. It was after dinner that we all got together and played corn hole while drinking. Though it may sound tame, we all had a blast. Alan and I were running the game for a while, but then lost the title to Yuan and Alex—not what you want. Stayed up late hanging out and attempting to star-gaze, though they aren’t visible this time of year, so we watched lightening bugs instead…stars soon enough.

Sunday:
After enjoying a lazy Sunday morning, Yuan, Ashley and I headed out to help Delmi prepare lunch for the crew. Seriously, one of the greatest experiences for so many reasons. I’m still not super confident in my Spanish, but it was so much easier to talk with her. We all hung out in her kitchen, helped her cook and clean while just talking about whatever came to mind. Outside her niece was frying the plantains over the fire, while her mother was roasting and drying her coffee beans. She got the beans from a nearby town, dried them, and roasted them with sugar over the fire before she used the machine next to the fire to grind the beans which moments later would become delicious coffee. The outside part of the house where this was going on, of course, had an incredible view and a hammock from which you can enjoy it. The family was so incredibly kind and welcoming and I enjoyed every moment- especially when Delmi kept having us try the food as she was cooking. The rest of the gringo crew came around 12:30 and we all hung around before the lunch feast. It’s incredible that the volunteers/workers here were all so welcomed into her home because we work with S2S. It’s amazing how being here long term really does make you a part of the community here. I really can’t wrap my mind around it all—just the scene of all of us coming together to enjoy each other’s company and share a delicious meal in the house of a friend. Perhaps it’s the complete cheeseball in me, but it was great. After hours of food and fun, we made the trek back to the clinic in the pouring rain. Which didn’t phase any of us; we were excited to enjoy the rainy season. We were also under the impression that the bus was close, so we rushed to pack everything up, only to find out that we actually had about 40 minutes. We were all soaking wet when we finally got on the bus—it was absolutely packed, so we stood in the aisles. Later, people would just hang on to the sides, or climb on the roof- buses here are impressive, especially how they handle the roads here during the rainy season when the roads are mudslides and lakes. Again, it was a blast. I can only imagine the sight- 5 gringas with their packs and soaking wet clothes crammed in the aisle laughing hysterically at each other. We made friends with some of the people around us- Ashley especially because, being that she is nearly 6 ft, she had to hunch over in order to fit. A man was kind enough to give her his seat and the rest of them enjoyed watching us joke around. Definitely had another one of those moments where I thought to myself, “is this my life?” and a huge smile came across my face. I won’t go into the random things that happened, but after 2 or 3 hours we made it back to SL and it was pouring. We jumped off the bus and because it was raining so hard, Karla lost her shoes to the river that had been formed on the side of the road. We made it back into the clinic, and the power went out- like I said, never a dull moment. Generator kicked in, so we all sat down and enjoyed the dinner Janell made; it was great to catch up and share stories.
I could write a ton more about things, but I’ve rambled enough…I’ll post more pictures after the clinic this afternoon. I may be having an English class after clinic hours...should be fun.
Oh and I'm posting a pic of "plato tipico"- which we have for breakfast a lot here, for those of you who ask me about the (delicious) food

Sunday, August 29, 2010

Bats and Hitchhiking

I'm beginning to love the rain here. It's rainy season until November or so and the pattern seems to be a little rain after lunch, a lot of rain around 4, and often rain at night. The rain isn't annoying and violent like it sometimes is back home; it's just background noise here.
(photo: view from balcony upstairs during an afternoon rain)
The weekend has been very relaxing. Slept in Saturday...recovering from the birthday celebrations. Yuan taught Maria how to cook fried rice- and I attempted to help, but mostly got in the way...shocker. The weekend of cooking continued- lasagna made by Alex last night and Janelle made a chicken dish tonight. The day ended with Friday Night Lights, of course. There's talk of a movie marathon sometime this week...it's an exciting life we live down here at night.
Saturday night was hysterical thanks to Ashley. Bats fly around at night, so we keep doors closed to prevent them from coming into our rooms. Ashley and I were on our way upstairs when she commented to me that we need to be sure to close our door- and right as she said that a bat flew out of our room and she let out an ear piercing scream. I shrieked and then burst into laughter. It was the funniest thing I think I've ever witnessed. Ben, Dr. Ruben, and Alex all came down to see if we were ok but I was laughing too hard to respond. The bat is now a running joke around here- good times.

Sunday is the day we all make our own meals- so breakfast is kind of whenever and we all lounge around. This place is definitely feeling like home now. Conversations over breakfast are less formal and more playful. I worked on secondaries after breakfast, but then decided it was time to visit Magdalena, the next town over. So Yuan and I set off walking to take in the sights that we can't see when we run because running requires looking down to avoid twisting an ankle or tripping over the rocks and holes. If I haven't said it enough already, the sights here are so beautiful. The walk probably took about 40 minutes and it brought us right into the center of town. Magdalena is definitely more developed than Santa Lucia- better roads and tiled floors in several of the houses. On Sunday there is a big market in Magdalena, and we arrived as it was ending. We went into the farmacia/tienda to get me a phone and after a nice conversation with the store owner, we found out his sister is the doctor at the health center there, Cesamo Magdalena. After exploring some more we came across a legit soccer game going on in the campo. There were jerseys, food vendors (delicious looking pupusas), and a vuvuzela! It was such a cool thing to witness- and they are really common around here so I'm excited to go to more. We finally decided to head back, took a different way and felt that we were slightly being followed, but ended up being fine. Right as we were discussing how we think we'd be fine to hitchhike, a truck pulls up and we hear "vamos?!" After making sure it was ok- checking for women in the back- we asked where they were going (Santa Lucia! was the response) and hopped in the back. It's funny, before I left charlie was telling me the best way to sit in the back of a truck- advice at which I laughed and said I doubted I would ever use. Chuck- you were right. Hitchhiking is super common around here. We hopped out in front of the health clinic and joined everyone for Sunday leftover lunch inside. I spent the rest of the day working on secondaries on the upstairs porch. The view from there is so incredible and the hammock that is up there completely swallows you. I could sit there for hours just looking at the mountains.

I finally decided to enter my data into the Shoulder to Shoulder database- Alan came down to help me and we found out that those doing the project before me did not enter the data correctly into the system, so now I have to go back and fix them-- difficult, no, but time consuming. No worries though- as I keep saying over every meal "Life is good".
Miss everyone a ton and would love to hear from you all :)

adiosss

Friday, August 27, 2010

Una entrada breve

First week down- several more to go. I'm really starting to get comfortable here and loving it more and more. Today was a fun day- only one patient for my study in the morning, and none in the afternoon. Fridays are generally slow. Mondays are the busiest for sure.
This afternoon was great- mostly Doris and I talking a ton about English and Spanish. We've moved past just working on my Spanish, to now working on her English as well- it's a blast.
I'm pumped for tonight because we are celebrating all of the birthdays that were in August.
I want to tell you guys about Thursday. Well, first, it's interesting to note that Wednesday's here are "pregnant lady day". It's the only day a week we perform ultrasounds, so the pregnant women and girls all come in to have that done. It's amazing that our clinic does so much for pregnant women in the area.
So Thursday a woman was in labor for most of the day. I wanted to observe the birth, but there were already a ton of people in the room and I didn't want to crowd everyone. Ashley and I were hanging outside of the room waiting to see what was going on for most of the time. When Deysi and the other nurses walked out I was able to peek in. I will never forget this image- I saw Rosbinda stitching the mother. It was only for a moment, but kind of surreal. She looked so calm yet so incredibly badass.
Afterwards I wanted to help somehow. I asked Deysi if she needed help and she told me I could help clean the instruments- I was really excited to do that, as odd as that seems. But that was all the direction I got... So I went into a room with a sink and sat there for about 5 minutes trying to figure out what to do. Eventually, I got Ashley to help, but then there were two confused people. Long story short, I ended up almost using gasoline to clean them...yea, don't ask.
Think I'll end the post here- nothing really exciting going on currently, hopefully I'll have stories after the weekend.
I'm posting a picture of where we wash dishes below...

Oh, and I've been dreaming in spanish...good sign, right?

Tuesday, August 24, 2010

Settling in.

So my first real week begins.. So far, so good. There are definitely some downs though. Times when I kind of sit there and ask myself, “what are you doing? Can you even communicate to anyone?”. It’ll get to you for sure if you think about it too much.
Monday in the clinic was great. Liz was with me in the morning, and we got two patients. Alan and Yuan observed me during one of the encounters, so I was nervous, but it went well. The kids I’m working with are absolutely adorable. I’m posting some pictures below.




Yesterday Liz left after lunch and I was on my own. While waiting for patients who met criteria, I talked with Doris. She is seriously awesome. She wants to work on her English more, and I want to work on my Spanish, so we converse back and forth. She is great to practice my Spanish with a) because she is so nice and personable and b) because she speaks clearly and not too quickly. I love that I work down there with her and I’m excited to see where it leads. She is also great about helping me make sure I get the patients I need. I’ll come down in the morning or after lunch and she will have put some charts on my little table/desk area. I also use the charts to complete the chart review and get the other details I need. It’s fun to try and find the docs or nurses to fill in their review. It’s amazing, after just a day of speaking mostly Spanish I already feel so much better about my abilities. Though listening is still incredibly difficult for me. Some of the people in the clinic speak soo quickly, and the more rural they are, the more difficult- often due to lack of teeth.
The clinic “closes” at 4:30 pm. Closes is in quotes because the clinic is open twenty four hours, but after 4:30 only the nurses on call see patients, and they are supposed to be emergencies only.
So in the afternoon the new volunteers had another orientation with the gringos that have been here longer. It was so great to hear about the various projects that Shoulder to Shoulder has done as well as those in which it’s currently involved. For example, often the health promoters go out and perform “paquetes basicos”. With these the promoters provide food and other services to people in the communities. The census is another big project they do. I’m hopefully going to Conce next week with them to see how they interview people in their own homes. I’m going in hopes of improving my own interview style in the study. It really is more than just asking a few questions. You want them to be comfortable and you want to make sure they understand you and what you’re asking. It’ll be incredible to go into the homes and see how people interact with health promoters-- the reception, the dialogue, as well as the scenery. To use an anthropological term, it’ll be real fieldwork. I can’t wait. I also am excited to check out areas outside of Santa Lucia. I still haven’t seen a ton of the area mostly because this first week has been about getting to know the people here and understanding how it all works. If and when I go to Conce I’ll probably stay for a day or so, then there is talk of the Santa Lucia volunteers all going there for the weekend to hit up a waterfall there.
Back to S2S.
I am seeing a lot more behind the scenes type things, more on the administrative side I would say. So what I didn’t realize is that while yes, Shoulder to Shoulder is a health clinic, it is intended to be for emergencies and births. People are supposed to come here after being referred from another clinic in a nearby municipality or aldea, or if they cannot afford care elsewhere. A visit here is 5 lempiras (lemps) if you’ve been referred and 100 lemps if you have not. The exception being if you’re from the aldea of Santa Lucia (and maybe Magdalena as well), then it’s 5 lemps either way. Shoulder to Shoulder is a non profit NGO—which contributes to some difficulties it faces as it continues to grow. People find it hard to believe that S2S can’t provide endless services and treatments, especially when gringos are working in the clinics and have laptops upstairs. But it’s not that simple- money is needed, and getting that money can prove to be difficult at times. It’s also interesting to learn about the difficulties S2S faced when establishing itself. Prior to S2S (and still goes on to a certain degree), most of the Honduran health care providers didn’t really go to work each day- and to their defense, when supplies aren’t there, treatment can’t be provided so it isn’t exactly worth it if you can’t help the patients. Another big issue is that they do not like someone coming in and telling them what to do or how to do their job. Which makes sense…which is again why “helping” involves working with them and ensuring that they are on board and that what’s going on is what they want. Definitely makes decision making more complicated and requires meetings every month. In fact, about 20-30 health care promoters, physicians, nurses, and other people came to the clinic today and are in a big meeting now. If the clinic isn’t busy this afternoon I’ll hopefully go in and observe the meeting.
Another key issue at play is the idea of visions vs. actions. Vision is wonderful and necessary, but vision doesn’t exactly get things done. So many details and issues have to be acknowledged, and as soon as one issue is addressed and dealt with, about 6 more pop up. That definitely explains a lot of the frustrations I’ve heard about and witnessed. One last thing to consider is that S2S is doing what it can with what it has. Someone noted at our orientation yesterday that “sterile” is “clean” and clean is “pretty clean”. Which is not to say that things are dirty by any means, just that it isn’t as easy to keep a sterile field when you’re not in a state of the art hospital with tons of supplies at your disposal. I would say that the clinic runs very well and I love working in it.
After our little orientation we had dinner—pupusas that were so delicious. I still can’t get over how good the food is here. Again, I “helped” the two Marias (the two cooks) by attempting to stuff a ball of dough with cheese and then flatten it out and throw it on the grill. Again, they just laughed at me—but they know I’m trying and we joke back and forth about it. After dinner we all decided to begin Friday Night Lights—there’s not much else to do at night. So we watched two episodes- after that some people went to bed and a few of us stayed up to celebrate Alan’s birthday which is today. To keep it going, we watched Dave Chappelle before calling it a night. I could definitely get used to this.
Today so far has been incredibly busy! I’ve already had four patients, and I think I missed one or two who left before I could get to them. I know I keep saying this, and in these same words, but it is so amazing to interact with the children and (usually) their mothers. The mothers are so kind and nice, which is incredible because my Spanish isn’t the best and I often pause trying to figure out how to rephrase what I need to ask them. While I began just reading the survey verbatim, I’ve gotten more comfortable, and it’s turning into more of a conversation and actual interaction. When I ask them if they want to participate, I feel like they think they have to comply- I need to figure out how to tell them it’s ok if they don’t want to participate. But at the same time, they are just waiting in the clinic, so I guess it gives them something to do until the doctor sees them. Oh, Janelle, the head nurse here gave me the best complement at lunch today- she said she heard me talking in the clinic and she was impressed by my Spanish. For real? I wonder if it was me she heard...She’s from Roatan originally and has been working here for about a year and a half. I told her I would love to visit there, so hopefully that happens before I leave. I should probably stop writing and head back down to the clinic- hopefully there will be patients to see! Though if not, I’ll try and engage Doris in conversation.
More stories to come…

Monday, August 23, 2010

I will definitely post tomorrow about the week so far, but I wanted to at least write something. Had a great night-- celebrated some birthdays, watched friday night lights and laughed at some dave chappelle. Too tired to write about today, but definitely stories for tomorrow.

buenas noches

xx

Friday, August 20, 2010

Arrival and the end of day 1


So I had no internet last night, and I wanted to write what went on during my arrival- so I did it in word and I'm pasting it below. Then I'll get into my first day here! I don't think I'll write every day, but so far, that's what I'm doing...enjoy :)

Thursday:
I arrived in Santa Lucia tonight around 7:30 (9:30 back in NC). I don’t even know where to begin talking about today. I met Liz- my boss who’s the principal investigator on the study, Ben- a guy who has been working with S2S for about a year, did the peace corps in Bolivia and now takes care of a lot of things here, and Kerri- a graduate of UNC undergrad and UNC SPH. They all are so great already and it’s going to be a blast getting to know them. It’s slightly intimidating because they’ve been here for a while, and they mentioned that no one really told them volunteers were coming until recently. Though that wasn’t the case for me, because they’ve all known for a while that I was taking over the study, which is good. Not too sure what the other new people will be doing… They missed their connecting flight today, so they’re getting picked up by someone else tomorrow. As soon as I found the crew of three waiting for me, they ask me how I feel about fish, because we are going to stop at a place on the lake where we can get great fresh fish-naturally, I got extremely excited. So we pack all of our stuff into the back of the truck, and set off. I don’t want to narrate the entire car ride, but I have to talk about the sights. Unreal. I really don’t even know how to describe everything and the pictures I took are almost insulting to what I was trying to capture. The roads were pretty rough and the ride was bumpy a lot of the time, but I loved it all. I was amazed as Ben maneuvered the car over, around, and through mud, water, rocks, and mountains. Extreme four-wheeling for sure.

Back to the sights.
Some of the areas are so incredibly run down; garbage all over the streets, broken windows, missing doors, and sinking roofs. At the same time, though, there’s almost a beauty in the mess. When you look at it, it all seems so calm, so in place. There is no background noise of streets or cars, just a picturesque quiet. But the second I think or say this I quickly question what exactly I’m thinking. By just saying that the scene is beautiful and calm I’m highlighting the fact that I am so unfamiliar with the place, that I have no idea what life here is like. It seems like such a cliché- a Westerner going into the third world wide eyed and excited. Can I really say that things are run down, undeveloped, or lacking? Do I have any idea how Hondurans feel about their daily lives? No. Things seem legit fine. Now where that plays into "helping" another country is another issue. Kind of goes back to the whole philosophy behind working in another country; you can’t do anything without them, they have to be the ones doing it, and they have to be the ones to decide what is best and how to do it. That's what I really like about Shoulder to Shoulder-- it's been here for 20 years- it's the city's clinic, and they are the ones that decide what's best for it. Those of us that come to work here are just that, workers. It's amazing. I love that I have an actual project to work on; a sort of purpose here.
I could go on about the rest of the drive (all 7 hours of it), and how everything, and by everything I mean the handful of sights I took in today, is so untouched, but I want to quickly describe the clinic before I end the post. Granted I only saw it in the dark and pouring rain, but I an at least describe the inside. Walking in the main entrance you enter into the common area, there is a couch, an old tv, and the table where everyone eats. There is a fridge and some other stuff around as well. Off of that room is the kitchen, and further into that is the dishes room. There is an interesting system to washing the dishes- you have to scrub them, then rinse them with water from this huge tub, then put the dishes in bleach water to be later rinsed and used. This room also connects to outside…I can probably give a better description when I see the place in the day time. If you go through the main eating room area, you are faced with a few stairs that lead up to the “apartments”. That place is awesome- there is a common area, kitchen, and office right when you walk in. Beyond that there are about four or five bedrooms- most of them doubles. Come October, one of the rooms will be mine and I cannot wait. Currently, I’m living downstairs in the “dorms”. The room is legit like summer camp. There are five bunkbeds in the two rooms- I am on the bottom bunk in one of the rooms with another girl working here for a year- Ashley. When the other new people come tomorrow I’m sure it’ll be just like summer camp.

Tomorrow Liz is going to show me around the clinic and hopefully we’ll have some patients to recruit together. Saturday everyone is planning on doing some Skyline Chili cook off thing….whatever that is, and they know it’s my birthday then so they have deemed it my birthday celebration as well. We are also talking about going to see the sunrise somewhere on Sunday to continue the celebration.
Ah there is so much I want to do and see here. We drove through Concepcion and Magdelena- both of which have clinics of S2S’s, so hopefully I’ll be able to visit and work there! Apparently the buses are the way to go, so I’m sure I’ll be riding those in no time. I’ll end the post here and will wait to post until the end of the weekend or early next week. Below is a pic of the front of the clinic.

TODAY-- Friday

First real day of "work". Legit amazing. I am so glad to be here. Although, once Liz (my boss) is gone...I may be struggling. I'll be on my own, and while others can help me- it'll be my project. Exciting! This morning I went over all of the forms with Liz and organized my little "station" in the pharmacy. Doris is the pharmacist and she is so great. She only speaks Spanish, so our communication is limited, but that will (hopefully) change soon. After lunch--which, for the record, was chesseburgers--was when I got to work with patients for the study. To briefly sum it up- the clinic opens around 8 or 8:30, and at that time most of the people who will be seen during the day arrive. I go look at the charts and see what triage has seen. If there is someone that meets criteria- a fever with any other respiratory symptom (cough, sore throat, difficulty breathing, etc)- then I go find them to work with while they wait to see the physicians. It's incredible, I have to speak entirely in Spanish. I ask the child's guardian if they would like to participate in the study, they agree, and then I proceed to read them the consent form...which is complicated enough in English, let alone in Spanish. So once that's done, I ask them the questions from the questionnaire, which, again, is easier said than done- though I have to say, I'm making due with the Spanish I know, and I really want to work to improve. So then after that's done, I take the little swabs from the baggies and swab the kid's nose twice, three times if the doc thinks they have the flu--and that swab is used in a rapid influenza test that is kind of an addendum to the study.So I had my first patient! She cried a bit for the swabs, and I was so nervous trying to communicate, but it went well!. After the patient visit, I go to the lab and aliquot the samples into vials-- some are frozen, and some are going to be stored in this new type of buffer system that doesn't need to be frozen for shipment back to the U.S. As soon as I finished working in the lab, another kid qualified, so I went through the whole process again, feeling much more comfortable. I'm sure I'm repeating myself but it's so great that this place is so established. The area is not touristy at all. It's legit another world here, it's unreal..
In the afternoon some of us went on a walk around our town. I tried to take pictures but they don't come close to what I'm seeing. It is so different...every door is open- or maybe they don't even have doors. Some places just seem so dirty and falling apart, but that doesn't seem to phase anyone. Kids are playing in the streets and jump roping just beaming with joy- it's incredible. I want to just sit there and observe for hours. I want to know what is in the houses, what they talk about, what they do throughout the dayand night. There are shops scattered around too, though you would never know they were shops unless you peaked your head in. I don't like to read what I'm writing because I wish I was more eloquent or able to capture the feeling I get when I look around, but I can't.
The new volunteers arrived tonight, so we are all sitting upstairs right now in the more permanent living quarters hanging out. Enough writing for now- I will try and post pictures either tonight in bed or later this weekend at some point.

peacee

Wednesday, August 18, 2010

Departing in the morning

I'm getting up in roughly four hours but am nowhere near tired. Been saying goodbyes for the past week which of course makes me sad because I just may be the biggest sap, a fact to which I'm sure you all can attest. I don't think I'm going straight to Santa Lucia tomorrow, most likely staying in a nearby town, but then off to my new home on Friday! If anyone wants to see where I'll be living, check out the Shoulder to Shoulder website online. I'll be living there, but not working for them exactly. The research I'm doing is run by the Cincinnati Children's Hospital Medical Center and funded by the NIH. I somehow got lucky enough to find a project that would let me work with them and set me up in Latin America, and the woman I'll be working for is amazing. To give a brief description of the project, we're trying to determine the viral etiologies of acute respiratory infections in rural Honduran population of children less than five years of age who present to local clinics with fever and respiratory symptoms. I'll recruit patients throughout the day, obtain consent, help them fill out questionnaires, and take naso-pharyngeal swabs to be frozen in a lab and later shipped to the US for analysis. I'm incredibly excited, but extremely nervous.

So I'll try and keep this blog neat and concise, but I'm sure it will run how I talk and think...all over the place and without much sense. However, I hope you all can enjoy the stories and pictures I share!

muchos besos