Greetings from Costa Rica

Hey, everybody.  Alan, Boramee, Josh, Sara, and Sukhi here.  It's been a while since our last update, so I'll share a few more things than I originally planned.  Here we go...

Saturday we arrived in San Jose, CR.  The area is much more developed than Limon, Nicaragua, where we were previously.  The city is much bigger than say, Lansing, Michigan, and it has all the amenities of a big city, like good public transit, city tours, plenty of restaurants, etc.

We are each staying with host families in nearby Santa Ana.  The hospitality of the people here is incredible and living with a family has been a great way to immerse ourselves in the culture here.

On Sunday, along with my host mom, we toured around the city, using a "train" that goes around the city.

There were lots of beautiful churches...

...and beautiful parks.

But perhaps the most exciting thing was that Sunday was also the day of the Costa Rican general elections.  The air was filled with the sounds of car horns and people everywhere were proud to display their political affiliations.

Even kids were into it.

Many people were crowded around the central part of the city, supporting their favorite candidate.

And if you didn't support their candidate, expect a little talk.

By the way, Laura won.  She is the first female president in Costa Rica's history.

Monday, we arrived at the clinic.

Tuesday, we worked in the clinic and attended Spanish class in San Jose.  Here, we receive 4 hours of Spanish class each week.

Today at clinic we prepared for our first charla, which we will give tomorrow.  It's going to be great.  More in our next update.

Also in the next update, Dr. Schnuth introduces us to the clinic.

Adios!

Clinic in La Promesa

La Promesa is a town close to Alajuelita (where the FIMRC clinic is) that FIMRC goes to every couple of months to offer care. We learned from Dr. Stedhem and Dajan that La Promesa is a little town in which the government had put housing developments in, and relocated people who needed housing from other parts of Costa Rica. It reminded me a bit of Habitat for Humanity from back in the States.

So we arrived at the clinic, only to find that it had been closed up. I really admire the Costa Rican FIMRC staff for being so adaptable, since they were immediately able to find a house in construction on the corner that worked pretty perfectly as a makeshift clinic. So we set up an examining table, pharmacy, psychology area, and waiting room. Now what to do? No patients! So we went door to door, and to the market, asking the residents if they had children who had not seen a doctor recently or needed medical care. Surprisingly, we only went to about a dozen houses, but here word travels fast, and by the afternoon, we already were booked for the next few days! Here are some pics of our clinic in La Promesa and of the children from the area that came for medical care, or simply to play:

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Hola from El Salvador!

We have been in sunny El Salvador for 1 week now and it has been wonderful!

We live in beautiful San Salvador, and our clinic is in Las Delicias a rural community about a 45 minute drive away. Each morning it's similar to waking up in Costa Rica and traveling everyday to Nicaragua because the guest house in San Salvador is in a very well-to-do area while the community the clinic serves is full of homes with dirt floors and an inconsistent supply of water.

Last week we had a very full week, we gave many vaccinations, we did well-baby exams, we did a pap smear campaign for the entire community, we started taking a census going house to house, and we saw patients in the clinic. Each day we walked miles and miles up volcanoes... literally. We are really grateful to be here as the need is great. So far so good! See you next week!

*Brandee, Chanisha, Donna, Emily, Shawna, and Shirley*

Last Days in Nicaragua

I'm typing this up as I eat my last dinner in Nicaragua.  Hard to believe 3 weeks have already passed and tomorrow we're going to pack up our belongings and take a bus down to Costa Rica.

Our stay hasn't been short on interesting people.  We had the pleasure of meeting one of them yesterday, a local natural medicine practitioner.

We even had her take a look at us for the full immersive experience. It was very interesting, to say the least.

Today was bittersweet.We said goodbye to the great people at the Roberto Clemente clinic, where we did most of our work.

We visited the place next door and saw that the water tower frame has been completed.

We also dropped off our donations to various clinics.

Patient charts at Guastcoto

Patient charts organized using a donated cabinet in Las Salinas.

We then took our last Spanish class in Nicaragua.  We must have gone through at least a couple year's worth of high school Spanish right there.  I learned way more than translations to gun show ticket jokes and how to cool slang to make me the hippest guy on the block, really.

To end the day, we spent more time on the beach.  Costa Rica students coming to Nicaragua, make sure to visit the pink beach.  Also make time for the hotsprings.

We've all had an incredible time in Nicaragua.  I mean it.  The memories we made here are unforgettable.  We met amazing people.  We visited patients in their homes, saw them in the clinic, and even saw some incredible surgeries.  We were there in the community working with the people and making a real difference.  This is why the LMUV program is so special. 

Costa Rica, here we come.

homestays

A few days ago I was in the van carpooling with the Health Delivery, Inc. staff to the migrant clinic in Imlay City, and I overheard one of the WIC staffmembers talking about a patient who had 11 children and had recently gotten married. "Eleven children is a lot of children to have with no husband" I said. "Don't you know Emily, nobody gets married any more!" the staffmember told me, sounding a little annoyed at my judgmental comment. I felt ashamed of myself. The truth is, I was definitely judging this woman. "Who is paying to raise 11 children?" I had been wondering. Not really wondering--I was feeling put upon as a taxpayer, that almost certainly this single mother living in Saginaw, receiving health care at a free clinic, was not taking financial responsibility for her nearly dozen children. It is tough not to feel less than sympathetic for some of our patients. And that is sad--both for me and for them. I really try not to judge people, but I do it anyway, almost every day.

How can we, the privileged handful of MSU students who choose to come live in this extremely underserved community of Saginaw, MI, learn to relate to our patients? How can we bridge the gap between our wealthy, educated, socially high-status selves and our poor, uneducated, low-status patients?

The photos I posted are samples of what much of Saginaw looks like, especially the areas east of the river and around the hospital, where many of our patients live. We would never live there. We were in particular warned not to look for housing east of the river when we moved out here. So physically as soon as we arrive there is already a divide between "us" and "them."

When we travel abroad, we always stay with host families. The hope is that by living with people from the communities we are joining we will learn about how they live--their struggles, their language, their ideas of how life is and should be. Why don't we do that in the underserved communities back here in the United States? I do not understand how a woman who chooses to have eleven children with no income and no education and no second parent to help her...I do not understand how she thinks, but I should. How can we bridge this divide?

Greetings from Peru!

Greetings from Peru!

From left to right: Stefi (our peruvian medical student volunteer), Sarah (MSU medical student), Rosa (the clinic´s obstetrician), Judy (FIMRC Peru coordinator), Cristian (the clinic´s doctor) and Tyler (MSU medical student. This was taken in Paraiso, a very rural village at about 9,000 feet altitude.

Sarah, Tyler and Rosa in front of the Pregnant Woman Radar. Some women have to walk two hours while in labor to recieve medical care at this clinic. One of the priorities of the Peruvian Ministry of Health is to improve maternal morbidity, so this is how they track who is pregnant in the different villages.

This was a very sweet mother and her five children that we met while doing a survey in La Florida. This town is about a 20 minute walk from where we are stationed in Agallpampa. The survey is being done to assess the different medical and educational needs of the population so that we can create a mobile medical clinic.

Some of our friends in Agallpampa. These children meet us at our door each morning to see if we will be teaching english classes. They are vicious tag players, too.

This is a view outside of the place we are staying in Agallpampa. This building is the Posta de Salud, a clinic that acts as a referral point for many of the surrounding, smaller clinics.

The Past Couple of Days

Yesterday...

We presented another set of first aid talks, this time about dehydration, hyperthermia, and heat stroke, as well cuts, wounds, burns, and blisters.  Annies were out in full force, as the audience reviewed material from the first set of talks.

We donated money towards the building of a water tower for the local clinic.  In the afternoon we even got to help build it.

Today:

We delivered more charlas, this time at a day care center.  Kids learned about making healthy food choices and brushing their teeth.

They also participated in a little exercise.

After all that, it was drawing time, followed by pinata time.  Sometimes I miss being a kid.

Isla Chira (Chira Island)

ISLA CHIRA, COSTA RICA
Our 3 day Excursion to an Indigenous Community [Pop. 3,500]

Our Accommodations on the Island

Setting up clinic for the day

Check-In Station


Bubbles were a big hit in the waiting room



Exam Room

Pharmacy

Setting up Medicines

Dispensing Meds (with a smile, of course)

Patient Education - Wash Your Hands! Brush Your Teeth!

Meals

It's called the Beach of Birds (Playa de Pajaros) -- Our Launch Point from the Mainland to the Island of Chira (Isla Chira) via Boat

~~~Good-bye CHIRA!~~~