Soccer and mandarins

What a full day! Full of sunshine, a few misunderstandings, and new discoveries. As for discoveries, I finally saw the clinic--the location where we would usually be seeing patients that has been inaccessible for about six weeks. It's in the middle of nowhere, and it's beautiful. About 5 km off the main road there's a bridge over a river, then another 1 km of road to the clinic. We drove to the bridge, then walked across it and the rest of the way to the clinic. The bridge went out after a heavier-than-usual rainy season, and the repairs have been slowed because of the rain as well. We tried to get there a couple of weeks ago, but the road after the bridge was too muddy to even walk on. Today it had dried up enough to walk with no problem, but they'll still need to resurface it before vehicles can get to the clinic. I also discovered Buena Vista, the biggest town after the turn-off for the clinic where we happened upon a high school soccer game this afternoon. We stayed and watched for a bit, enjoying the small town scene. All along the road, there are orange and mandarin trees are sagging with the weight of delicious fruits.

One misunderstanding was regarding an 11 year old who we sent to the closest hospital yesterday because he has a huge distended abdomen, skinny neck, sunken eyes, raspy voice, swollen feet, and just looks terrible. All the tests they could do showed that everything is normal, but he looks anything but normal. I discussed his situation with a doctor from the regional hospital this morning who said that his prognosis isn't good and that "we" need to transfer him to Santa Cruz. In that "we" I heard the we of the hospital, but he meant the we of the clinic (as in I needed to put the kid in the car and take him to Santa Cruz). Now I know to verify this in the future. Sadly, we called a contact at the hospital who told us that there weren't any beds and that he should come first thing in the morning. So, we transported him back to the city and we (the we of David and I) will take he and his mother to the hospital tomorrow and help them navigate the red tape there.

Another misunderstanding resulted in not getting tickets to the professional soccer game tonight between the two Santa Cruz teams. I thought it was clear that I was in for it, but instead I found out an hour before it started that it was sold out and we didn't have tickets. There will be other games, and it was probably wise to stay in since I'm headed to the hospital at 6:45 am.

Quick one

It was just as cold today, but the forecast predicts warmer temperatures tomorrow. These ladies work at our director's private office. They are convinced I need to run out and buy myself a chompa (winter coat).

This is second photo is DJ, konked out on Veronica's bed.

Winter

By now I've whined to just about everyone here: my coworkers, housemates, patients at the clinic, the attendant at the internet place, the security guard at the clinic, etc., etc., so now I will repeat it here--it's unfair how cold it is here! We are dipping into the Bolivian winter, and although it isn't nearly as cold as our Baltimore winter, it seems unfair that I have to live winter again after finally seeing a glimpse of spring in Baltimore. Okay, so I guess I chose to come and live here for the summer, but this should have been included in the job description (and especially the packing list)! Today is a particularly cold day--I don't think it has reached 60 degrees Farenheit. I think I will stop short of buying a down coat (like I have seen some bolivians wearing), but I definitely need to beef up my cold weather wardrobe. I wanted to include some photos of bundled up Bolivians, but my camera battery was too low--will do later.

Equipetrol

Things have been busy down here in the last couple of weeks, so here are some highlights...

Last Friday one of our patients had triple bypass surgery, and I got to watch the whole thing! I actually watched two open heart surgeries that day since I had decided to stay in Santa Cruz and not go out to the rural site. The intricacy and teamwork were fascinating. I got pretty light-headed at one point while they were prepping the first patient, inserting IV's (to be expected), but then made it through the rest of the day with no problems. Phew! The last thing those surgeons needed was an unconscious gringa. One of the surgeons came back late from lunch for the second surgery. The surgery wasn't delayed and his absence wasn't discussed until he walked in late and got the silent treatment.

The other big event on Friday was that we got a puppy for the house, and he has been a constant source of amusement. He's a two-month old golden lab who is super clumsy and affectionate. There will be pictures pronto.

I finally got to go out dancing on Saturday. I've been itching for it since I got here, but the other gringos have been either busy or uninterested. I succeeded in convincing Lisa, my housemate, to come out, and we had a great time despite being the oldest people in the place. Everyone on the dance floor seemed to be paired off for the duration of the night which was kind of discouraging. A medical resident from the public hospital, Rodolfo, joined us at the club. Anyway, the whole scene was entertaining--there's a strip of bars/restaurants/clubs called Equipetrol where some people actually go into the establishments, but many others just park their cars, blast Reggaeton, and buy beers from people who are walking around with coolers. It was good to get out on the town, but I can't say I've found my scene yet.

One week in Bolivia and already out of touch

Well, I had hoped to get this started a little earlier, but lack of internet access at the volunteer house in Santa Cruz has slowed me down a bit. Not to mention the time needed to figure out my responsibilities here and how to carry them out in my broken Spanish.

Anyway, I’m in Santa Cruz, Bolivia until the end of July volunteering for a rural clinic that provides medical care to some communities outside the city with few health resources. It was founded by two American doctors and one Bolivian doctor in 2001. Check out the website for more info on the clinic: http://hamantfoundation.org/centromedico/index.php

Here’s a quick summary of the first week:
Monday – Medical student volunteers picked me up and took me back to the house for breakfast prepared by the housekeeper, Nico. After breakfast, we spent the morning at Galene, the private clinic directed by Douglas Villarroel, the local supervisor of Centro Medico Humberto Parra. Spent the afternoon at a café at the Cine Center (fancy shopping center with restaurants and movie theaters) talking with David, an American who has lived here for five years, getting a sense of the role and current status of community associations in the provision of care from the clinic.
Tuesday – Spent the morning at Hospital Japones with a patient who needed surgery for his goiter. He was seen by the surgeon who requested that he have a pre-operative cardiology screening that afternoon. That afternoon, I accompanied him and another patient (with congestive heart failure) to the cardiologist.
Wednesday – My first day at the rural site. I met Maria and Guinda, the nurses who run the clinic, as well as Dr. Vargas, one of the doctors from the hospital in Portechuelo who helps out one day per week. We were actually located in the church building in Palacios because the bridge to get to the clinic is down. The medical students saw patients, and I managed anything that required more specialized tests or doctors that needed to be done in Santa Cruz. A local family provided our lunch, and we drove back to Santa Cruz after lunch.
Thursday – We saw patients at the health post in Arboleda with Dr. Alejandro. We totally took over the post, so I’m not sure what goes on there when we aren’t there. This facility has a lab technician, allowing basic urinalysis and blood tests to be done.
Friday – At the health post in Arboleda with Dr. Mario. The biggest community group was assigned to be seen, and there were loads of patients. Unfortunately, Dr. Mario walked off at about 3 pm. David and I had planned a meeting with the leaders of the community groups, so we were all quite tired when we pulled out at 5:30. I had planned to drive back (my first time here!), and it was dark by 6:00.
Saturday – Relaxed morning in the city walking around with Andrew, one of the medical students. In the afternoon we had scheduled a visit to the home of a patient in Santa Cruz, but showed up 1.5 hours late because we couldn’t find the house and didn’t have an address! Finally we got there and had a nice visit. At night we had a small gathering for Veronica, one of the students who lives in the volunteer house and had her birthday.
Sunday (today) – Relaxed morning, and spent the afternoon at a café with free wireless. Met some Americans who are Jehovah’s witness volunteers constructing new facilities at the branch here. There was a PCV at the table next to us, but I resisted the temptation to butt in on her lunch. I went home and made peanut butter cookies.

Whew! I hope to post more frequently from now on and plan to include more photos.