Urgent care & Puerta del Diablo

Today we had the opportunity to work with Dra. Blanca (the physician we work with in Las Delicias clinic) at an urban hospital that serves as an urgent care on Saturdays. The center averages 230 patients a day, so it was definitely a busy shift!  We rotated between working with the physicians on consults, running triage, and assisting in the procedures room.  This was a great chance to be really hands-on and have lots of one-on-one time with patients who had a diversity of complaints.

Afterwards, we took the afternoon/evening to explore la Puerta del Diablo.  It translates as the Door of the Devil, named for the impressive precipice one can observe looking down from atop the mountain.  We had an incredible view of the entire city and some of the surrounding terrain.  Afterwards, we enjoyed some typical Salvadoran food in a restaurant with an amazing view, munching on the famous pupusa-- a thick tortilla dish stuffed with various toppings such as beans, cheese, and vegetables.

 Atop Puerta del Diablo!

Julie & Angela monkeying around, per usual

If you look closely, you can see Italo (our awesome transport/tour guide) in the distance!

Italo, Julie, and Steve braving the precipice

Steve pretending to fall...haha!!

Sweet girl we met on the trail, enjoying the sunset

Julie & Angela at the restaurant -- you get a glimpse of the amazing twilight view in the background

Italo confirming our massive order of pupusas :)

Tomorrow, we are excited to take on Volcano Santa Ana, complete with nested craters & hot springs!  Stay tuned...

Health Outreach in Las Delicias

We have had a wonderful week with Morena, the community health promoter, helping to accomplish the comprehensive preventive health goals she has for the people of Las Delicias.  Normally she does all this work by herself, so she has been so excited to have us medical students on board to assist with her endeavors and take things to the next level!  Here are some of the awesome projects we've enjoyed being a part of this week:

*Well child checks
We rounded up kids for some quick check-ups in one of the local churches, and also had the chance to visit the school, where we did several exams on the youngest children in pre-K and kindergarten.


*Elder care
We made home visits to some vulnerable elders with terminal illness, discussed palliative measures, and compared some of the community's approaches to what we know as hospice in the U.S.


*Parasite campaign prep
Because we don't get much exposure to parasite prevention/treatment in the developed world, we made sure to get some great tips from Morena, Dra. Blanca, and our Spanish teacher, Guadalupe.  With their help, we developed some helpful talking points for our house-to-house campaign next week.

Angela with one of the children at our impromptu set-up at the church

Dividing up vitamins for the children -- Morena with one of the community leaders she has recruited to assist in outreach in the individual sectors of Las Delicias

Steve makes check-ups fun!

Sometimes it becomes a group effort! (Angela)

Dr. Schnuth is here with us now! --with Julie & Angela in front of Las Delicias clinic

We've decided to make this our classic formation-- Angela, Julie, Steve, Mike 

Julie with one of the pre-K kids at the school

Mike with one of the pre-K kids at the school

Working diligently on our anti-parasites campaign, as Dr. Schnuth supervises

Angela & Julie

Steve & Mike

We also enjoyed a city tour of San Salvador and visited several sites, including the military museum (learned a lot about Salvadorean history), the cathedral (which is currently on lock-down due to protests this election year), and Cuscatlan Park -- where there is an impressive Monumento a la Memoria y la Verdad that recognizes the 30,000 people who were lost to violence during the civil war of the 1980s.

Until next time!

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...

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

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