February 6, 2011

Super Hilo getting down and dirty with Mr. Cariaton:

The Clinic at La Promesa while Dr. Stedem explained the government program that brought the families to the area:

Angela giving the demonstration at the conclusion of the STD program and Mike showing enthusiastic support:


Children with their toothbrushes:



At the start of brushing the human mouth:

Doing physical exam for a child with strep throat:







It’s been quite the two weeks since we last checked in. We continued the week at the mobile clinic in La Promesa. The clinic was held in a soon to be soup kitchen for the city. They are still in the process of getting funding for electricity and running water. The clinic is situated at the side of a canyon with a breathtaking view. There are always birds that sore trough the canyon throughout the day. The mother of the house next door was always kind enough to bring us homemade goodies each morning. She made, what I believed was called “pan de pan” which is all the left over bread mixed together with milk, cinnamon and sugar and then baked. One day she brought over the Costa Rican version of Horchata, which is a sweet creamy thick rice drink.
Similar to the week before, we rotated through visiting patients with the doctor, working in the pharmacy and checking patients in. Once patients were checked in we would spend time with the children. We would color with them, read aloud or help them read, or simply spend time talking to them. Dr. Stedem spent time explaining to us that simply talking to the children makes them feel important, as they rarely get attention from anyone besides their friends or siblings. They have few, if any, role models in their lives. I’m hoping they will remember us as fondly as we remember them.
The children showed immense interest in stethoscopes. During one of my days in the front office I spent some time with a group of girls. I would help them listen to their hearts. As soon as their heard the “lub-dub” their eyes would light up like it was Christmas. It was very touching. I also got to have story time with the children, though sadly I think Donde Viven Los Monsturos (Where the Wild Things Are) is a bit out of my Spanish league. I’m at more of a Ve, Perro. Ve! (Go Dog Go) level. Though the kids, after laughing at my attempt at reading in Spanish, were more then happy to jump in and have group read aloud. Joe, our undergrad friend from Princeton, also had a read aloud session with the kids.
Working with the Doctor was always a great experience. He is a wonderful teacher and more then willing to answer any and all questions. He is also very interested in having students as actively involved as possible. He lets us ask questions during the history, do physical exams and help develop the treatment plan. He is great with the patients and they really do seem to respect him. He is also wonderful with the children. He calls them all “campeon” and “princesa”. They light up when he is around. During time with him a few of the things I saw were scabies, allergies, UTIs, URIs, gastroenteritis, colitis, IBS, psoriasis, HTN, Diabetes, strep throat, congenital heart murmur in a young child with chronic fatigue, a variety of neurologic/developmental disabilities, carpal tunnel, malnourishment and a few cases of suspected child abuse.
The doctor also made house calls during the week. One day during the clinic we went to a house of a boy who had gotten an ingrown hair that had become infected and had formed an abscess. The other was a patient who was post-op from a heart catheter.
Tuesday after the clinic we had a little taste of San Jose, the big city. Mike, Angela, Joe and I went into downtown San Jose and visited the Costa Rican Contemporary Art museum. The exhibit had a sacrificial theme featuring alters, lights, bread, blood and oil. The piece that struck me were a collection of oil barrels draped with a sea of dead roses to represent the people that had died for liquid gold. We then visited the National Library and spent some time getting to know our new friend Joe in a quaint coffee shop at the side of a lovely Parque Morazon. Dinner was at Café Mundo, which is a popular restaurant in down town San Jose. We concluded our evening at Café Morezon.
Our health presentation on Wednesday was on STDs and contraception. We began the presentation with a small skit where Angela pretended to have some STD symptoms and she went to the doctor. We hoped the women would grasp that it was ok to ask your doctor about these symptoms as they are not normal and also some exposure to questions the doctor may ask during the visit. We also added information about getting both partners treated and abstaining from sex until after the symptoms were gone. The presentation involved additional information on what STDs are, the most common, how they are transmitted, signs and symptoms and what to do if you think you have one. Then Joe and I got to perform a memorable skit on the importance of using a condom. The opening line was “Mi Amor, Hagamosolo” aka “my love, lets do it”. I’m sure I turned bright red. But the women laughed and hopefully it will give some of them some boost in confidence when it comes to condom usage. Then we concluded with a demonstration of how to use a condom correctly, handing out condoms and a small sheet of patient information on ETS’s (aka STDs) that summarized the information we had delivered. Once the presentation was over, Camilo (the right hand man of the clinic) did a phenomenal job of answering any and all questions the women had. Thank goodness Doctor Schnuth was there to contribute her professional knowledge. It was wonderful to watch the women so engaged in asking questions and I feel that a lot of misconceptions (such as whether or not you can use Vaseline as lubrication) were straightened out and hopefully the women will feel somewhat empowered after the presentation.
The following day we did a dental campaign at the mobile clinic. We went door to door getting the children of the village to come to the clinic. Then we had a presentation on the parts of the tooth, why to brush, why to floss and how to brush. Luckily Camilo’s sister is a dentist and we were able to utilize her as a great resource. She let us borrow a model of a mouth for the presentation and was able to double check our presentation for accuracy and appropriateness. We started the presentation with a skit about Angela the tooth, and Joe as Mr. Cariaton (Mr Cavity). But luckly Super Cepillarse del dientes (toothbrush) and Super Hilo (floss, aka Mike and myself) saved the day by scaring away Joe. We ended by forming a mouth with all the kids as teeth and proceeded to brush and floss them. Then Dr. Stedem showed them a cartoon and we handed out tooth brushes and toothpaste to the kids. We repeated the presentation again at the soup kitchen in Alajuelita that afternoon and ended, as usual, with playing with the kids. I’m pretty sure their favorite phrase is “corre caballo corre” (run horsey run).
On Friday, Angela’s Tica Mom (her house mother), sent enough lunch to feed a small army. We all got to partake in the traditional Costa Rican Taco which consists of corn tortillas, beans, pico de gallo, eggs, and sausage and of course a little topping of Salsa Lizano (the most amazing condiment known to man). After lunch we concluded the week with inventory and organization of the pharmacy. Our Spanish class followed. To end the week we met up with Camilo in San Jose for our last night with Joe.
Saturday we woke up early for our trip to Manuel Antonio. We spent the day relaxing on the beach and playing in the waves. It was filled with people from all walks of life and is known as the Costa Rican Mecca for alternative lifestyles. While we were on the beach we unfortunately saw a near drowning. The lifeguards of the beach ran down to pull him out of the water and laid him on the sand. They proceeded to draw a crowd of people, fan him with a towel and at some point rolled him onto a surf board for a backboard (talk about resourcefulness). The ambulance eventually followed. However, soft sand and mini-vans seem to not mix as the ambulance got stuck in the sand. Sunset soon followed and our evening was concluded with a nice game of foosball with the restaurant at the hostel.
The next day we ventured into the National Park. After walking through the jungle we came upon a nice quite beach. As we were out enjoying the waves a monkey proceeded to open our bags and steal our food. As soon as we realized we ran up to save it only to find the monkey sitting in the tree skillfully opening the package and eating it in front of us. I could have sworn he was laughing at us the whole time.
We walked back into town to enjoy the local fair and then proceeded to a different part of the national park. While there, we got to watch a family of monkeys and a family of iguanas. The waves were big, the sand was white and it was like a little tropical paradise. It was the perfect way to recharge for a busy week at the clinic.

Part 2 to come soon…Cheers, peace and love!

1 comment:

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