Lima Day 2

Well, where to begin. I'm actually writing this on day 3 because sadly I ended up sick on the night of day 2. It's been a while since I've felt this crappy but I guess there's nothing really that I can do about it. Day 2 actually started off great! It was tour day and time to go visit the outskirts of Lima where we would be setting up clinics-the favelas. The tour was through the giant favelas that engulf the edge of the Andes mountains. It was like nothing id ever seen. I have seen the amount of poverty before especially in some rural areas in India, but the way everything was on steep, large mountains was something I've never seen before. Walking and driving in the area was tiring and definitely scary so just imagining doing it everyday seemed like a huge burden. One of the major favelas that we worked with was Pamplona Alta. The community was one that Medlife considered self efficient because of the way the community worked together. As Medlife see's the situation, the communities where we provide service should have a community that works well together so that the education and the infrastructure we leave will be sustained. Although they are poor, they work together instead of just working for themselves. This is the ideal community that we can serve and the type of communities that we want disorganized communities to strive for.  One of the biggest problems in the favelas is the politics that cause people to become even more poor. People come into the communities and as landlords they build staged communities which are then sold off to poor people who want to live in the urban area to get better jobs. The situation is pretty complicated and the types of problems they have are more than just this but they all involved the landlord and the house buyers who are trying to be closer to the city. One of the other problems is again the aesthetic of the community which makes it harder to go up and down the steep terrain for simple things such as water which isn't portable in all areas. For this reason, the higher you go up on the mountains in the favelas, the more poor you are. There's one story of a woman who everyday had to walk all the way from the top of the favelas to her nursing school and her nursing internship. She would cover herself head to toe everyday in plastic to make sure that her uniform didn't get dirty because although she lived in a less fortunate community, she still was held to the same standards and if she showed up dirty to work she wouldn't be giving a good impression. Similarly in the schools if a child's uniform is dirty they are sent all the way back home and as a child it is very difficult to walk through the favela cleanly. For this reason and more many kids ditch school, don't make it there, or are sent back home to change and come back clean. One of the last things they showed us was the wall of shame. This famous wall splits two different economic classes literally right next to each other. From an aerial view one can see that on one side of the wall there's poverty and on the other is one of the richest communities within Lima. This gap between the economic standing of people in Peru makes it harder for these poor communities to thrive and gain more power in their county. Although there is a law that every person must vote, the mayors take advantage of bribing in order to gain more votes and the favelas accept this form of bribery because they are desperate for supplies and money. The politics within the country are advanced and very controversial. Obviously it's something that can't be solved overnight or even in a couple years. It's interesting to see how different the regulations and living situations are from America, but at the same time the similarities between some parts.

Lima Day 1

Finally after two years the trip is finally here. Traveling is like a drug and after going once I couldn't help myself but to experience it again. The next 9 or so days I'll be spending in Lima, Peru working at a mobile clinic through the organization called Medlife at the University of Michigan. After my first mobile clinic in Costa Rica I came back my sophomore year ready to get more involved in a mobile clinic club because the experience I had on my clinic was one I wanted to share with others. Today we started the day with orientation and learning to get familiar with Peru, specifically miraflores. The town is very safe and the people and the community is great as well! So far we have gone out to the casual hang out spots and also have gone to the night life but I can't wait to really get to work at the clinics learning and experiencing. Two years ago I decided to join the team of people who were planning to start Medlife as a club on campus. Now we are the number one new Medlife chapter. Medlife is a non profit organization at different colleges that is run by a national Medlife organization based in Lima, Peru. At first I was hesitant of the program and what they had to offer that would be different and better than what I was already involved in. I have been looking for the answer to that question since the beginning and my reasoning seems to be getting more and more strong every day. So here's why I joined medlife: medlife is an organization that not only focuses on medicine but also public health. This was one of the first selling points to myself because going to other countries you realize how different the health system is there and it shows how important it is to be helping the community with public health as well as us as students learning about public health and what are the differences in the health systems themselves. Secondly, the organization not only works with general doctors but doctors of multiple different types giving people much better quality of health service. This way the people within the community are offered more specialized care based on what they need as well as doctors (who are found from the area so that they are familiar with the area and diseases) that are more experienced in speculated areas. The last point that really took me a while to find was the fact that Medlife puts its importance in the patient experience. One thing that I have realized that I really appreciate is that Medlife isn't a business that caters to their students (however we are very well taken care of), medlife is focusing on the patients and the communities that we are providing care to. For example although as students we can't diagnose many organizations take advantage of being in a rural areas and let the students attempt at things only a certified doctor can do. If the clinics do follow the rules then the students are only giving away Advil and Tylenol which of coarse is useful but doesn't fix their problems once the medicine is done. Medlife respects the people and doesn't try to create a more memorable experience by being dishonest. The ethical boundaries that can be broken can cost someone an admission to med-school! It's an organization that brings real doctors and dentists and uses as many procedures to give future care and preventative care. Medlife makes it possible for a patient to have follow up procedures after we leave the clinic. For this reason and the fact that there are developmental projects in the community to place infrastructure where needed, Medlife gives students the opportunity to make a difference and provide help even when we leave the 10 day trip. I'm excited to learn about the community, get a feel for the culture, and as I have already been doing, improve on my español!

Costa Rica day 10

So I know it's definitely not day 10, but coming back home I definitely needed sometime to settle down and unpack before I wrote this last post. The last clinic day I really focused on taking notes about all the different patients we saw. It was a great day to do this because we really did see a lot, including a vaginal infection, a hemorrhoid, and even emphysema. The man who had emphysema had started smoking at the age of 9!!! It was crazy hearing the reasoning behind him smoking. He had said that his father used to give him cigarettes because it would cool him down when he was working on the farm. The man had also had time to tell us a lot about his life, like the fact that his first wife died giving birth. And his son was now living in Texas and he misses him a lot, even though his son doesn't really make an effort to come home a lot. It was heart breaking to see the tears in his eyes as he talked about his family and how much he missed his first wife and his son. You could tell through his face that it still broke him a little inside every time he talked about his past. And yet he still lived in the same small country village where his past remains with him. He seemed like a humble, calm man who was still living life and moving forward. His personality, like so many other patients, was inspiring. Although there were many other patients that I met that I loved talking to, he was one who definitely stood out to me. For the rest I have written notes on my medical guidelines packet so that I can remember their stories in the future. An important thing that the doctors also taught me was that as a doctor it isn't about being buddy buddy with your patient. Although we are supposed to help comfort, it is important to be straight up with the patient and the patients have to meet you half way in the situation, you can't force them to tell you things or explain their problems. For example, there was one lady who was really embarrassed about going in the back to show the doctor her vaginal infection or fungus that she had described. The doctor said we couldn't prescribe any medicine until we could see it and we also couldn't force her to show it to us. In this situation that patient wasn't coming half way and that made it difficult for us to help her. Luckily in the end she decided she would let only the doctor check her and it did help her because she did have a fungus. It was definitely a learning experience to see the patient doctor interaction. Lastly, as the day was coming to and end, our translation Matt mentioned how my spanish had improved a lot since the first day we had been in Costa Rica. It definitely put a smile on my face to realize that my Spanish was improving and I already felt a lot more fluent than I was coming the first day of clinic. This trip helped me move forward in learning such a beautiful language and I can't wait to go again to a spanish speaking country to keep improving my spanish! I really felt immersed in the language, the food, the culture, the people, and even the dancing and music! As the summer begins with a busy schedule, I have made goals to keep improving my spanish and staying involved in the spanish culture here in America. I can't wait to see how this trip has helped me grow as a person and as I experience more in my life back home! This trip has been amazing and helped me realize how much I appreciate traveling! I can't wait to go out and explore the world more but until then I'm going to enjoy every moment as the Costa Ricans would do!
Quote of the day: Pura Vida! :)

Costa Rica Day 9

Today was our first day at the rural clinic in Cariari! I was definitely expecting a lot worse with the poverty, but it's good to know that the poverty in Costa Rica isn't too bad. I also found out that out of all the Latin American countries, Costa Rica is one of the nicest. Today and tomorrow's clinic is all about the stories for me. I want to leave this trip with some great stories about the people we're hanging out with and the people we meet in the clinics. Some of the greatest stories come from the amazing people we have met on this trip including Santi, Julio, Alejandra, Mateo (matt), Caesar, and Stephan. These people have been so humble and really have taken the time to get to know us. Santi was one of the nicest, sweetest trip coordinators I have ever met. He really gets along well with us college students and knows how to keep us happy. Julio is one amazing bus driver! I really love his quiet personality, but he also is very relaxed and knows how to have a good time. Seeing his face every morning always keeps a smile on my face. Alejandra y Stephan were great doctors who really took the time to teach us in the clinics. I really learned a lot from them and they also took the time to hang out with us after clinics at the bars and clubs to really get to know us. Mateo is definitely an interesting guy! I loved his passion for Costa Rica, even though he is native to California, and I really admire his respect and love for this country. And Caesar was one interesting guy. As we laughed and talked at night, one of the girls looked over at something weird that Caesar was doing and just admired how great and unique each person on this trip was. Caesar is definitely a unique guy with a lot to say. He has a love for other cultures as well and really is a worldly person as he speaks Portuguese, knows a lot about Bollywood, and listens to Arabic music. I'm really going to miss all of these wonderful people on this trip and although I can't wait to do laundry and sleep without the fear of bugs, I really am going to miss Costa Rica and the amazing things that I've gotten to do. Tomorrow is the last clinic and I'm really hoping to cherish each moment. Today I shared the stories of the main people I met in Costa Rica, but for my last Costa Rica trip post (which will be either tomorrow or the day after because I want to enjoy the last few days without a computer) I will talk about the stories of the clinics in Cariari and a reflection of the trip overall. Until then I'm going to enjoy the last days abroad and soak in the clinic, the food, the people, the parties, the language, and la pura vida!
Quote of the day: “To my mind, the greatest reward and luxury of travel is to be able to experience everyday things as if for the first time, to be in a position in which almost nothing is so familiar it is taken for granted.” – Bill Bryson

Costa Rica Day 6,7,8

The last three days we were in Puerto Viejo for the vacation part of the trip. Puerto Viejo was beautiful! Our hotel was really relaxing and I have never felt so great in a hammock. We spent time going to the local clubs, the beaches, and restaurants. Although I absolutely loved Puerto Viejo, it definitely was completely tourists. The town had no native people or culture that defined it. It seemed like a lost island that people from all over the world came to for vacation. It made it kind of eerie, but it was also fun meeting people from all over the world! We also got the chance to go zip lining, which is something I missed out on last time I came to Costa Rica, so I’m really glad I got the chance to check that off of the adventurous things I’ve done! Hopefully next summer will be bungee jumping, which we never ended up doing here in Costa Rica. Relaxing in the ocean and lying on the beach was just the perfect way to relax and start the summer off on the right note. Although some really crazy things happened at the club the second night, the overall nightlife experience was really great. We all had a great time dancing and since the bar/dance club was right on the beach, you could look out and see the waves. One thing I kept noticing when we were at Puerto Viejo was the “pura vida” signs. Pier, the really nice host at the hotel also said goodbye to all of us by sing pura vida. Pura Vida is a saying that they use in Costa Rica to basically celebrate life and show their appreciation for life. I love the saying because it seems so calm and peaceful, just like the people of Costa Rica. I love that the people are so much more relaxed here in Costa Rica because then time goes by slower and you are able to take in each moment. So as we move on to Cariari and work at the rural area clinic, I leave these beach days hoping for a pura vida.

Quote of these last three days: “We live in a wonderful world that is full of beauty, charm and adventure. There is no end to the adventures we can have if only we seek them with our eyes open.” – Jawaharial Nehru

Costa Rica Day 5

It was the last day of clinic here in San Juan and tomorrow it'll be time to move onto Puerto Viejo for two full days of touring and the beach! Although I'm excited to explore and hopefully bungee jump, I'm also sad to be done with the first three days of clinic. Today at clinic we took the time to sit in a circle when the crowd died down and talk about the interesting things we learned. We talked about a lady who came in and had her tubes tied but still was able to get pregnant. We also talked about the health system here in Costa Rica and although it looks perfect on paper, here in this urban poor setting you could see the flaws and the suffering the immigrants of Costa Rica have to go through. One interesting thing that one of the translators, Matt, who is originally from California, mentioned was the connections between different parts of the world. I loved that he helped us notice that although we might think Costa Rica and the United States are very different places, we all have similarities as well. For example, we all have immigrants who are suffering from health are, we all have a desire to make use of emergency medical help, along with many other similarities. The beauty in the juxtaposition is also finding the not so noticeable similarities. As Matt phrased it, sometimes living in America, we forget about the rest of the world because we're so focused on ourselves. But there's a whole world out there for us to explore and understand! And it's important to discover the differences, but also the similarities between the cultures to really grasp the meaning of life. As we move onto Puerto Viejo, I'm excited to hold clinics in the country side. The leaders told us to expect a different type of poverty than the urban poor that we have been with for the first three clinics. After our night at the discoteca and the bar I think I've learned one main lesson, respect other cultures, especially when you're in their country. As the days go by, I make it a point to assimilate myself and not take away from the culture, but really put myself into it. I wish I could write more about the day and explain the last thought in more detail, but we have a long day of traveling ahead of us and I think it's just time for me to relax and go to sleep.
Quote of the day: “What you’ve done becomes the judge of what you’re going to do – especially in other people’s minds. When you’re traveling, you are what you are right there and then. People don’t have your past to hold against you. No yesterdays on the road.” – William Least Heat Moon

Costa Rica Day 4

Today was the second day of clinic and along with feeling more comfortable with the routine came a better understanding of spanish and of the diseases. For example, I learned how to check ears for infection, and I also became pretty familiar with what medicines are used for what sort of diseases. I loved practicing my spanish, even though it did make the day more tiring. At this point I feel that my small group doesn't even need a translator because we all have a good understanding of what they are saying and are able to communicate with the patients and doctors without our translator. I loved the atmosphere in the clinic today because everyone was a lot closer and since there weren't as many patients, we could spend time talking to everyone and getting to know them better, including the doctors, the translators, and even many of the patients. Again, every day it astounds me how the people coming to the clinic can be so patient and kind. It amazes me that they don't get annoyed with the line and the wait. But as one of the translators, Mike, told us, the clinic is better than the public health care. Surprisingly, even though the health care is free here, that's only if you work legally for Costa Rica and you pay taxes. However, the majority of people living in these small, poor towns are immigrants who don't have official jobs and don't pay taxes. They are mainly from Nicaragua because over there there is a high poverty rate. They could all pay about $12 a month for private insurance, but even that isn't affordable for some families. And there is always a long wait for going to the hospital and getting an appointment. And most of the time they just end up diagnosing you acetaminophen (a simple Tylenol). Even though the health care here seems great when you think about it, it's actually not as perfect as some people perceive it to be. After the clinic we ended up going to dinner at a chinese place. At dinner we talked about all the amazing natural medicine that the doctors told the patients at the clinic to use. Like one of the doctors today told a patient to cut a water bottle in half and heat it and close one side to use as an inhaler for babies who can't use real inhalers. The doctors also suggested two drops of breast milk in the babies nose to get rid of a cold because the baby was too young to get any medicine. I appreciate this other form of medicine and really do believe it makes a difference. I think it's important as a doctor to know both methods because sometimes it is better to go about dealing with the disease with natural medicine. Another crazy fact I learned about Santi today was that his older brother died when he was 20. I feel like there is so much I don't know about Santi, but I want to keep learning more because his life is just so interesting and intense. We ended the night by playing some games and laughing late into the night...in our bus...in the hotel parking lot because we couldn't disturb the other guests. We all bonded and got closer as we laughed about silly jokes and shared our crazy childhood stories. I am really thankful to be on this trip because each and every person is unique and interesting, and I love learning something new every day. One patient that I loved seeing was Gloria, the grandma. She was just a great person and reminded me of my own grandma! She was social and really spent time getting to know us and talk to us. She was also hilarious and came back to the clinic both days to see us. I hope to have more stories of patients that I can remember as memorable because that connection with patients is what will help me grow as a person who wants to work with people for the rest of their life. What a day. :)
Quote of the day: “Travel is more than the seeing of sights; it is a change that goes on, deep and permanent, in the ideas of living.” – Miriam Beard