BUEN PROVECHO

San Salvador Stuffed Roast Chicken & Baked Yuca Fries

Stuffing Ingredients:
Oatmeal
Multi-Grain Bread
Falafel Mix
Diced:

   Green Peppers

   Red Peppers
   Yellow Peppers
   Chives
   Zucchini
   Apple
   Mushrooms

Spices:
Salt
Pepper
Chili Pepper

Sauces: 
Worcestershire
Soy Sauce
Teriyaki Sauce

1 Whole Chicken

Directions:
1. Saute diced vegetables with olive oil, spices and sauces.
2. Mix in the rest of stuffing ingredients
3. Let stuffing cool.
4. Stuff Chicken
5. Cover Chicken with spices and olive oil
6. Bake at 200 degrees Celsius (yes- Celsius) for approx. 1 hour and 30 minutes.

Baked Yuca Fries

Ingredients

1 medium yuca
1/2 teaspoon salt
1 tablespoon of olive oil
Garnish

cilantro, chopped or torn
lime wedges


1. Peel and slice it into 4-5 inch lengths.
2. Preheat the oven to 450 degrees F. 
3. Boil for about 30 minutes until tender.
4. Drain the fries and let them dry slightly on a dish towel. 
5. Coat the dried fries with the olive oil and bake them at 450 degrees F for 20-25 minutes.  turning once so they brown evenly. 

BUEN PROVECHO

Vanakkam from Kodai!

We started our journey to Kodaikanal on Friday with a lovely reunion in the Detroit airport.  Our journey then consisted of a 7 hour flight to Amsterdam, unlike US flights we were fed generously with tasty food.  Our 6 hour layover included passing by the casino, visiting the library, seeing the museum and enjoying the full sensory experience of the Bohls exhibit.  We then boarded our 9 hour flight to Mumbai arriving at close to midnight.  After passing through customs, discovering one donation bin had not made the flight, filing a lost baggage report, passing through the baggage scan several times, walking all over the airport to print an itinerary to board the bus to the terminal; we arrived at the ticketing counter only to discover we couldn’t actually get tickets to pass through the plane boarding security until 7:30 am.  So we spent the next 4 hours of our 9 hour layover people watching, playing pictionary, enjoying the airport fare and attempting to sleep (thanks to the car honking and constant flow of visitors, that may have been less then successful).  Our flight finally left the airport an hour late and we arrived in Coimabore, where the remaining bags met us as well as Arun, the FIMRC representative.  The car ride (a supposed 4 hour trek) consisted of a lovely feast of South India food at a local restaurant along the way, fresh coconut from a roadside stand, monkeys, birds, and gorgeous scenery. Unfortunately, the “Elephant Crossing” signs were false advertising. We arrived at our new home Monday evening around 7 pm.  Brian, a fogarty scholar and future Columbian medical student, met us and with Arun gave a great orientation. It was quite the traveling adventure and I’m pretty sure we were all very thankful for a nice warm bed to crawl into.

            Our first day in Kodaikanal we split into two groups.  Brian accompanied Paul and Emily to KMHC (a local hospital) where they witnessed a D&C as well as took history on a patient with ecclempsia for a presentation they will be giving tomorrow. 

Arun, Shawna and I went to Possum (?) Hospital.  Here is a short history lesson on the hospital.  The main physician of the hospital (Dr. Massa) many years ago met two German missionaries who discovered that his goal in life was to provide health care to rural India.  They brought him to Germany where they put him through high school, university and medical school.  His goal of providing health care to rural India landed him a spot in a very competitive ophthalmology residency in Germany.  He then returned to India and began his trek via a “lemonade stand” table on the side of the road providing eye care to local patients.  He grew his practice into one of four hospitals in the state of Timel.  He has already expressed his deepest thanks for whatever supplies we will be able to contribute to his hospital. Throughout the year, he hosts various physicians from all over the world to provide several “camps”.  The next two week camp is in March and will provide plastic surgery to hundreds patients suffering from severe function impairing contractures from burns.  The posters are quite graphic.

            The tour of the hospital started with the inpatient wards learning about the various patients in the ward.  One patient was a child who had received a 3^rd degree burn saving his younger sibling from burning hot oil.  We also met the dentist, watched teeth cleaning and learned about dental care in the area.  We then proceeded to the laboratory where we watched blood glucose testing, the process of measuring hemoglobin by hand and provided a sample for a blood smear.  Many patients are attempting to get on the list for the plastic surgery camp so the hospital has a high prevalence of burn patients.  Several patients that are currently healing from burns receive daily dressing changed and wound debridement.  After watching the process for one patient we returned to the lab to examine the blood smear and then were whisked away to a wonderful Tibeten feast in the town for lunch.  Arun and Brian then took us on a walking tour of the town. 

            So far our tentative schedule includes continued clinical work in the two hospitals this week.  Next week we will be administering home surveys culminating in a health presentation addressing some of the local health concerns.  The third week we will be heading to a private hospital on the coast to experience the contrast between the two areas.  Arun and Brian have graciously left the fourth week open to be tailored to the interests of our group. 

Pictures to come...hopefully...

First Day in Las Delicias

Today was an amazing first day in the rural village of Las Delicias, not far outside the city borders of San Salvador.  We had the pleasure of meeting the energetic, knowledgeable, and extremely dedicated health promoter in the community, Morena.  She had us jump right in and help out with her activities in the community.  We made home visits to pregnant women (there are currently 18 in the community), brushed up on our newborn exam skills, assisted with injections, and learned about all of the impressive work that they are doing in the community.

Exploring the community-

From left: Morena, Steve, Angela, Mike

 Morena with one of our pregnant patients, who is due this month!

(Fingers crossed that we can be there for her during labor!!)

Some stats on the age breakdown of Las Delicias.  There are about 35 births per year.

While the average life expectancy is 67 years, some of the residents seem to beat the odds, with 121 elders making it past that-- must have to do with all the great health outreach going on!  :)

Morena's "Risk Map"-- green = low risk, yellow = moderate risk, red = high risk.  

We saw the whole range in our visits today.

There are a number of programs dedicated to improving the health of the community of Las Delicias, including:

• Vaccines for children
• Pediatric weight checks and assessments for malnutrition
• Vaccines and outreach to the local school
• Elder outreach - flu & pneumonia vaccines, as well as a comprehensive meal program 
• Adolescent support group
• Dengue campaigns 
• Animal vaccination against rabies
• Pap smear campaigns

We will have the opportunity to work on a number of these projects during our time here, so keep an eye out for more updates!

¡Bienvenido a El Salvador!

We made it safe and sound to El Salvador! The only hold-up was at customs, where we have to do a little more paperwork to get some of the medical supplies released, but it should be resolved soon. Shout-out to the generous donations from faculty & staff at two of our community campuses, in Midland and Flint!  We couldn't have done this without you.

Upon our arrival, we were greeted by the fabulous FIMRC (Foundation for the International Medical Relief of Children) team, including Marloes, the Field Operations Manager, and Italo, transport and tourism guide extraordinaire.  :)

Since we arrived over the weekend, we were fortunate to have some time to explore some local gems in the region of San Salvador (capital of El Salvador). Italo took us on the grand tour of la Ruta de las Flores, with stops in the villages of Juayúa and Concepción de Ataco, where we explored local cuisine, shimmied to cumbia music, and checked out the artisanal markets. We also had a lovely time at the cascada (waterfall) Los Chorros de la Calera, basking in the sun and cooling off in the crisp water.  And we had the joy of meeting the friendly neighborhood snake of Concepción de Ataco!

Here are a few pictures from our journey:

From left (in both pics!): Angela Kuznia, Julie Celebi, Steven Moyo, Michael Moffat (all 4th year medical students)

Tomorrow, we will meet with Morena, the Community Health Coordinator and local health promoter.  She is a lifelong resident of Las Delicias, the rural village where our clinic is based and where we will be conducting our health campaigns.  We are excited to see what awesome community projects we can be a part of!

Until next time...

We need your help in El Salvador!

Dear friends and supporters of the LMU program:

It's that time of year again-- when the Leadership in Medicine for the Underserved students travel abroad to engage in service with needy communities abroad.

The departure date for the senior class of LMU is fast approaching - we fly out on January 28th! We are gathering together needed supplies and donations for our respective sites in El Salvador and India. Wondering how you can help us within the next month?

For CASH DONATIONS, please visit:

https://www.givingto.msu.edu/gift/

1. Under “OR”, type in Leadership in Medicine for the Underserved

2. Select "Leadership in Medicine for the Underserved-Saginaw" when it comes up.

3. In the upper right hand corner, designate your desired donation amount, and click "save & continue".

4. Enter the necessary information, and click "submit donation".

If you are interested in SUPPLY DONATIONS, please see the list below for needed items in El Salvador. Contact macombe2@msu.edu or julie.celebi@gmail.com to arrange pick-up in the Flint/Saginaw area or mail items to:

Michigan State University

Flint Area Medical Educaiton

ATTN: Catherine Macomber

One Hurley Plaza

Flint, MI 48503

Thanks in advance for your support of the medically underserved!!

Project Las Delicias, Donation Request List

MEDICAL SUPPLIES DONATIONS

Childrens Gummy Vitamins

Childrens Chewable Vitamins

Prenatal Vitamins

Acetaminofen (Children and Adults)

Acetaminofen Infant Drops (Babies)

Ibuprofen Suspension (Children and Adults)

ProAir HFA Inhalation Aerosol & Canister

Asthma Inhaler: Qvar 80mcg/100mcg Inhalation Aerosol w/Canister

Asthma Inhaler: Ventolin 100mcg

Iron Supplements (Adults)

Pregnancy Tests

Glucose Strips for One Touch Ultra Mini

Glucose Strips for Prodigy Autocode

Glucose Strips for Contour

Toothpaste (clinic supply)

Antibiotics for Children Claritromicyn

Hydro Cortisone

Alchohol Wipes Childrens

Allergy meds (liquid and tablets)

Antibacterial Cream

Alcohol Wipes

Cleansing Wipes

Calcium Supplements adults

Antibiotics (please specify which ones!!),Claritromicyn

Anti-Bacterial Cream

Baby scale

Pedia- lite

Scale (digital and extra batteries)

Pediatric Nebulizer Mask/Tubes

Exam bed paper

Newborn Clothing

Tongue Depressors

Pedialyte Oral Electrolyte Maintenance Solution

Baby clothes (Newborn males)

Baby wipes

Stethoscope

Packets for Nebulizer

Mosquito Nets (Infused with DEET)

Nasil spray

Cloth Diapers (New born/infant)

Ear thermoter

Body Wash

CLINIC SUPPLIES DONATIONS

Towels

Sharpies

Whiteboard Markers

Soccer Balls (Size 5)

Needle for inflating balls

Duct Tape

Pens

Jump Ropes

Colored Pencils

Coloring books

Money for paint to repaint the clinic

Crayons

Frisbees

Baby clothes (Newborn males)

Puzzles

Books in Spanish

Dictionary En-SP/Sp-En

Combs

Projector

CAMPAIGNS DONATIONS

Dental Campaign

100 Little Toothpaste for Children

100 Children’s Toothbrushes

Or Money for Dental Campaign to buy supplies locally

Dengue Campaign

50 small Sponges

50 small bags of bleach

Or Money for the Dengue Campaign to buy supplies locally

Fluoride Campaign

Fluoride for 100 children

Q-tips for Fluoride application

Plastic cups

Gloves

Hand Washing Campaign

Big bottle of fluid soap (for instruction)

100 small bar soaps

Money for Hand Washing Campaign (supplies bought locally)

Good Foods Campaign

Money for fruit for class(es) of children.

Went to the Anthropology Museum on Wednesday

We took a trip to the anthropology museum last Wednesday, as a field trip for Spanish class.  It was an excellent way to learn about the culture, history, and language all at once!

Figurines

Ruins

My personal favorite

Costa Rica part II...

Traditional Costa Rican dancing:
Alvaro and his family:

Waiting for the dentist at el Comeador:

Dental visits:
Group picture with Mama Rae, Camilo, the neighbor family, Matt, Claire, and the rest of the Costa Rica/Nicaragua group:

One-on-one patient education:Listening to a heart murmur:

Dr. Schnuth trying her hand at raking coffee:

Answering questions after a presentation:

Checking BP's:

After our weekend at Manuel Antonio, we started the week by meeting two new FIMRC volunteers for the week, Matt and Claire. They are 3rd year Physician’s Assistant (PA) students at NMDNJ. It made for an interesting week having someone else there with the same name. It was definitely nice to have the additional energy, knowledge and experience.
Once we were back at the clinic at Alajuelita it felt like home. It was another wonderful week of working with the doctor, the psychologist, in the pharmacy, and performing front office/check in duties. After the clinic hours were completed, Dr. Stedem gave us an enthralling presentation on snake bites. He talked about the different species of snakes in Costa Rica, the color patterns signifying dangerous species (Remember: RANA Rojo, Amarillo, Negro, Amarillo aka Red, Yellow, Black, Yellow are the POISONOUS species!), the physiology of venom and how anti-venom is made. Costa Rica is one of the worlds leading exporters of anti-venom.
Once David arrived we had our 7th Spanish lesson. It’s been very helpful to have a Costa Rican medical student as a tutor as he is able to answer questions about not only the grammar but the subject matter as well.
That evening we spent some time getting to know the new PA students. It was fascinating to learn about the program they are in, some differences between PA school and medical school, and about the different career options available to them.
Tuesday we spent the afternoon at a local coffee plantation. They welcomed us with a cup of iced coffee and a small taste of what was to come. Our tour guide was very knowledgeable and engaging. The Doka Estates was founded by the Vargas family at the foot of the Psoas Volcano and still utilizes the same building it started with over 100 years ago. They grow the highest quality Arabica beans. While coffee plants can be used for 100 years but each year the quality decreases slightly thus the Doka Estate only uses their plants for 25 years. The workers hand-pick the red coffee “cherries” and fill giant baskets. After savoring the natural sweetness of the coffee bean fresh from the plant we saw the gathering gate, the peeling machine, the drying fields, the sorting bins, the storage room and ended in the roasting room. Dr. Schnuth got to try her hand at raking the drying coffee beans; she was so great at it that our guide offered her a job. In the roasting room we got to smell some freshly roasted and ground coffee. The best part of the tour may have been the gift shop where we got all the free coffee and chocolate covered espresso beans we could handle, needless to say we all left just a little happier then when we arrived. After the coffee plantation Dr. Schnuth invited us up to her dwelling to enjoy the view and get a taste of some of the goodies Costa Rica has to offer. We got to meet the family that lives in the house next to her. During our time there, we had an impromptu lesson on Costa Rican slang as Camilo translated the ever popular You Tube video: “Gringo Pinto”.
The topic of our health presentation on Wednesday was pregnancy. Our opening skit involved our newly married couple, Angela and Mike, and a slight slip in judgment that resulted in Angela becoming pregnant. He friends told her to go to visit the doctor but she was afraid because she was a Nicaraguan immigrant. In Costa Rica the National Government (the Caja) guarantees all women, regardless of status, 7 free prenatal visits. Additionally, all deliveries are free of cost to any women. We gave additional information regarding the importance of healthy eating, not smoking, not drinking, not using illegal drugs, checking medications with your health care provider, circumcision, and the importance of breast feeding. The concluding skit involved pregnant Angela and me, as her sassy friend. As the bad influence, I tried to get her to smoke and drink to celebrate her pregnancy. But Angela knew better and since her doctor told her not to, and since she knew she needed to be responsible for the well being of herself and her baby. After the presentation we handed out patient education and then allowed ample time for questions. The women, once again, had tons of questions and Camilo fielded them like a champ. Again, many misconceptions were debunked. Hopefully the women will walk away feeling empowered knowing a little more about the wonders of pregnancy and their future babies will be healthier for it.
That evening we had a wonderful treat as we went to a traditional Costa Rican restaurant complete with traditional dancing. The restaurant was on a hill over looking San Jose. Our driver, Alvaro, who became one of our favorite people we’ve met while down here, brought his beautiful family. We got to spend some time getting to know the man behind the blue bus. Videos of the dancing soon to come.
Thursday, as a follow up from the previous week, we were lucky enough to have a real dentist accompany us to the Comeador (soup kitchen), while he checked the teeth of the children we were set on entertainment duty. There was some piggy backed line dancing, a nice series of piggy back running races, Anda! (tag), general dancing while the children on our shoulders entertained us with their wonderful singing, vuelto (spinning in circles), patty cake, and group jump rope. It was a lot of fun but we were all exhausted by the time we were done. That evening our Tica Momas had a potluck style goodbye dinner for us. They shared their food and also some of the less-then-flattering stories of our times with them, including the night I ate the plantain leaves and Angela almost got attacked by her host mom’s big black scary dog. We gave our presents to our moms and exchanged thanks and appreciation for all they had done for us. They shared some stories of previous students.
Our last day at the clinic was bitter sweet. We were joined by Dr. Linda, a retired internist from the Seattle area who had been involved in National Health Service Corps and also done some work through temp agencies. We got to pick her brain on what it was like to work for both. She spoke about being a female doctor, raising a family, what it was like to get into and work for the National Health Service corps, what working on an Indian reservation was like, and the differences between rural and urban medicine. We also got her take on the political changes in medicine and the possible direction that it’s heading. She spoke about what it was like to be in medicine during her generation vs. what it may be like for us during ours. She way very honest and very open to answering any and all questions we had. It was very informative and gave me quite a lot to think about. We shared our last lunch (which happened to be left over Arroz con Pollo with enough to feed a small army) with Dr. Stedem and Camilo. We concluded with our last Spanish lesson with David.
That evening was filled with packing and preparing for our last night in Costa Rica. We met up with the PA students, had a few tearful goodbyes with the host families and went off to enjoy our last night in San Jose with Dr. Stedem and Camilo. Good times were had by all, an excellent way to end our Costa Rican adventure.

Sunday: Food Tour

Cuisine is a big part of any culture, and so this past Sunday we went on a food tour.

This was a starter we shared on our first stop.  We didn't want to spoil our appetites, but sometimes food is too good to pass up.

Our second stop.  Coffee is grown on the mountainside.  Why does it look like a waffle iron?  To collect water.

This dog was sitting close to me while I was enjoying my chocolate covered fresa, manzana, pina, y sandilla.

Our last stop was holding a large event, with both great cuisine as well as entertainment.

She sings to me as I take the photo

Uncut churro

Multiple ways of peeling mangoes

The window of what was the most fun shop in the pueblo

One of the rarer sights to see

Greased Lightbox

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Saturday: Hiking the Izalco Volcano

Weekends provide an opportunity to explore the local area and familiarize ourselves with the country.  This past Saturday, our destination was the Izalco Volcano at Cerro Verde.

A lake we passed on the way to the volcano

Izalco Volcano

Sukhi, Boramee, and Madonna

After about 1300 steps down into a valley, we began our trek up the volcano.

We made it to the top!

360 degree view from the top

Boramee and Madonna take in the view

Other hikers enjoying their time atop the volcano

A little bit of catch up

Quick recap of the past few days...

We organized and stored the supplies we brought to El Salvador.  Some of the bins needed a little cleaning.

Boramee works on creating some posters to advertise the upcoming Campana Citilogia, where we will be performing exams for breast as well as cervical cancer.

Angie discusses what she would like the posters to say.

Emily working on a poster

Madonna and Karyn working on their posters

Angela working on a poster. 

Sukhi creating the large poster.

Thursday for Spanish lessons we went on a field trip to Joya de Ceren, an agricultural village that was buried underneath layers of ash due to a local volcanic eruption.

well-preserved pottery

One of our Spanish teachers explains the picture

Chocolate

We have all been having a great time thus far.  It has truly been an experience that has us immersed deep in the local culture, the health problems of today, and the history of yesteryear.