Sunday, July 13, 2014

Los Torreros and the end of clinic week!

Our day started a little early yesterday. 4 am early. 

After packing up our supplies, we took the 2-hour chicken truck ride to the Los Torreros community, our new clinic site for the day. We quickly set up our make-shift clinic in three-room community school where a line of women stood waiting. We knew the day would be busy, and as new patients contined to file in throughout the day, we were impressed to hear that we ended Satruday having seen 115 patients. 

Due to the sheer volume of patients this year, out MS2/MS4 medical teams often split up to interview and perform exams separately. It was incredible to see how much all of the second years progressed in their clinical and presentation skills in just six days. 

We also had a unique opportunity to provide family planning to a large percentage of our patients. All fourth year students learned how to place IUDs, and quickly turned around to teach 4 of the second years to place them in our last two clinic days. Our patient breakdown is shown below:

Total pts seen: 496
Pap smears performed: 300
IUDs placed: 12

Our group has experienced the full spectrum of emotions this clinical week. We have felt the sadness of delivering crushing, sometimes hopeless news. We have experienced the frustrations of not being able help every patient we encountered. And we have had flashes of anger over broken health care structures all too common around the world. 

But we have also become hopeful. We have seen the power of modern medicine and experienced the importance of developing and sustaining relationships with the communities and patients we try to serve. Our mission as an organization is two-fold: to provide care and to train our students. The hope of our organization is to reach a point where our screenings and education alleviate the burden of delivering disastrous news. It's a hope we were reminded of every day. 

Our next stop is Amapala, an island off the Pacific Coast where we will have a chance to decompress from a busy week as we await lab results. We will then hike back out to our communities to deliver resukts and counsel our patients on follow-up care. Stay tuned!

Tuesday, July 8, 2014

Two clinic days down!

I apologize for the tardiness of this blog post! Internet (and power) is sometimes hit or miss in our homestay town of El Corpus.

Sunday afternoon, all of the students returned from their 4 day stays in the community where we all delivered our charlas. We had audiences of 30 to 160 women at the charlas, depending on the size of the community. Per HHA rules, a woman must attend at least two charlas in order to guarantee a spot at clinic on their community clinic day (though we have never had to turn away patients in the past). After debriefing Sunday night, we found that our patient population was incredibly receptive to our talks, and had a better understanding of our services and mission as an organization, as well as health resources they have access to in their area. Olivia Myrick and Tara Lane (MS4 trip leaders) also expanded HHA services to a brand new community this year! Continually, our three Family Medicine physicians (Drs. Rupal Yu, Narges Farahi, and Morgan McEachern) joined us Sunday night in El Corpus.

Clinic Monday was a lighter day (60 women!) and gave the MS4s and opportunity to teach the MS2s in the clinic. MS2 and MS4 duos would interview a patient together, etablish a plan, present the patient to an attending physician, and continue the patient encounter from there. The second year medical students are in charge of all physical exams while the attending and fourth year medical student advise and assist. It has been an incredible opportunity for the medical students as the MS2s essentially fill the role of an ´´intern´´ with a supervising MS4 ´´resident´´. The learning curve was huge the first day, but was equally as exciting.

Today, we left El Corpus at 6 am for clinic and saw 92 women from the Guanacaste community in clinic. It is suggested that women receive a Pap year every 2 years after the age of 21 (or every year in the case of abnormal results). We performed 51 Paps today!

Tomorrow and Friday we are expecting close to a 100 women each day, with slightly less busy days Thursday and Saturday before we send all results off to the family planning center (ASHONPLAFA) to be read.

I will try to post about clinic every day this week that we have Internet! For now, I am going to go join everyone for a much anticipated cerveza.

Wednesday, July 2, 2014

Clinic Set-up

We arrived in El Corpus yesterday after a smooth 4 hour ride down south. The quaint, cobblestone town will serve as our home base for the remainder of our trip. After splitting up and meeting our five different host families, we ate dinner and regrouped to plan the following day´s activities. The mountainous views in this part of the country are picturesque and are a sight worth the trip down alone.

This morning, we piled into the back of a ¨chicken truck¨ around 7:30 and made the mountainous climb to our clinic in a tiny pueblo named Madrigales. For the rest of the morning, we set up exam rooms, divided supplies, and prepared the clinic for the patients we will see next week. Katie Paul and Helen Toma (MS1s) have been organizing our supplies all year and ran the show (seamlessly, I might add). We have four exam rooms, a pharmacy, and a sterilization center for speculums. We made note of remaining supplies we need, and closed up the clinic until we return next Monday.

Throughout the Spring, the first year students and public health trip leaders worked together to construct several public health talks (charlas) that will be given in each community. Our four talks include an introduction to the purpose of our organization, family planning, domestic violence, and life stages. Julia and Kendra, our two public health leaders, have done an incredible job pulling together all our presentation materials, and we all feel well-prepared for our community stays.

Tomorrow we head out in pairs to where we will spend three days presenting our public health charlas and recruiting women to come to our clinic. Everyone has a slightly different journey ahead of them - long bus rides, hikes, and even horseback riding.

We return to El Corpus Sunday. Due to the remoteness of some communities, we will not have Internet connection so please check back in four days for an update!