Ooh, we're halfway there - ooh! Putting on our health fairs!

It’s hard to believe that we’ve been in SMA for 2.5 weeks – and that we only have 2.5 weeks left! The time has really been flying by. On Monday we joined the DIF at one of their mobile health clinics… which was very different from what we had expected. The clinic took place in Alonso Yanes, a town we had already visited twice. The mobile clinic itself was actually a doctor’s office on wheels, with one room for check-ins, and one examination room. There weren’t any doctors, but the nurses that accompanied the mobile clinic performed pap smears on the women in the community. We were told that we could shadow the nurses, and that “we” really meant just the girls – so Lauren and I got to see some ob/gyn in action. It turns out that the mobile clinic, while equipped with stirrups and speculums and swabs, was NOT equipped to measure weight, height, and blood pressure… so that’s where we were able to be of use. However, since this was the third time we had visited Alonso Yanes, a lot of our checks were on the same health-conscious folks who had attended our health fairs in the past, so it felt like a lot of déjà vu. Still, we had fun joining in with the ladies of the town as the DIF aerobics/dance instructor led everyone in a zumba/salsa-like session.

That afternoon, we met with Dr. Quiroz, who is responsible for bringing PPS to San Miguel from JR three years ago and getting the program up and running here. He was a fun and amiable guy, insisting that we try his tequila while discussing how our trip was going so far and what we had in mind for the remainder of our time in Mexico. It was great to finally get to know him after weeks (and months, really) of hearing about the great doctor who had been instrumental in providing us with this amazing summer experience. Hopefully we will get to see more of him in the next few weeks!

Today we visited a new town, Guanajuatito. We set up shop in the primary school and did a lot of vision screenings, followed by general health checks once the kindergarteners had vacated the premises for the day. We have come to notice that every time we think the day is winding down and we have checked all those that want to be checked – someone else will show up. This usually happens after we have taken down the eye chart – but sometimes it happens after we have literally packed up every single item into Jason’s gigantic backpack that only he knows how to arrange so that all of the elements of our “mobile lab” will fit. It is very hard to turn people away, and we usually end up unpacking again. The way someone always seems to arrive every time after others are long gone is pretty funny though. It is a little bit of an indicator of what our futures as doctors may hold – that line between when we can stow the stethoscopes and go home to friends, family, and situations that do not involve the “M.D.” after our names, and that desire to do our jobs well and be there for our patients, even if they might need us outside of normal office hours. Right now it is only a slight inconvenience (again, mostly for Jason, as he alone can repack the bag, although he is always a great sport about it) and we are only being detained from our typical afternoon activities of reading, yoga, studying, and siestas for a few minutes – but I hear that something of a difficult balancing act occurs later on (and something about inconveniences to having families?), so I guess I’ll keep you posted on how that pans out.

Dia de los Locos, indeed!

Well, la fiesta de los locos did NOT disappoint. We headed into town early, per the advice of our host family. The parade was supposed to start at 12, so we got there around 11:20… and stood around, watching the streets become lined with other spectators. But 12 came and went, with no indication that the parade would begin in the foreseeable future. Our friend Kip from the Lion’s Club called us while we waited and invited us to stop by his place, grab some ladders, and watch the parade from his street. So we did just that. We placed a small ladder, a larger ladder, and a good-sized step-stool behind the crowd and had an optimal view of the parade – as well as prime positioning for candy to be chucked at us.

It was also as entertaining to watch the people watching the parade – some had umbrellas tipped upside down:  the better to catch candy with, of course.  While we watched the diverse array of costumed people dance their way down the street and collected Mexican dulces, we came to the conclusion that it was sort of a reverse Halloween. We were stationary, while those in costumes came around giving the candy to US. You may know that my hand-eye coordination is limited at best – well, it is MUCH more limited while I am on a ladder, so I myself did not catch too many candies. However, we used my sun hat as a catcher’s mitt and my classmates were much more adept at catching than I was. Lauren even managed to catch a candy that landed up her sleeve.

The types of costumes could best be described as, “Anything goes!” but there were a few groups of people associated with floats that had themes. The Simpsons are wildly popular here in Mexico, so there was a whole slew of Barts, Lisas, Homers, and Marges boogieing by. An Avatar group was pretty impressive with their blue costumes and foliage-covered float. Looney tunes, Disney, Wizard of Oz were all represented. Interestingly, there was a whole group of people dressed like Jim Carey in “The Mask” – yes, while it was a popular film in the states circa 1994, it is apparently still a popular topic of discussion in Mexico.

Our original plan was to have dinner with Kip and his wife, Marge Ann, that evening. But once we had had enough of the locos, we returned our ladders to them and just began our evening with them earlier than anticipated, to everyone’s delight. They have been so warm, welcoming, and helpful during our time here in SMA, and we enjoyed homemade guacamole, Kip’s very strong margaritas, lots of conversation, delicious spaghetti and salad, and the warm SMA evening air. We are not sure how we have been so fortunate to meet so many kind and wonderful people during our time here engaged in various activities in SMA, but they have made our trip that much better.

Today was back to reality, however – we ventured out to Cerranitos, a town much larger than we were accustomed to visiting, and one that was literally right off of the main road. Their need for health services was not as great as it had been in other communities, due to their relatively close proximity to San Miguel, but we did have plenty to do there, all the same. Tonight we enjoyed the sounds, smells, and lights of a thunderstorm outside that brought a significant amount of rain – good news for the region as they are currently two years deep into a severe drought. We also enjoyed the thunderstorm and the rain it brought INSIDE – there just so happens to be a small hole in our roof, so that was pretty fun to discover. Tomorrow we are planning on helping out with the DIF’s big health fair – still pretty unsure about what that will entail, but excited to see the different branches of the DIF in full force in the community.

UNC, Mariachi, and the Giant Tree

The weekend has been a busy one thus far. Friday was filled with another health fair – we returned to Alonso Yanyes again, with Dr. Clark in tow. Together she and I gave a women’s health charla, and with some last minute inspiration Jason’s baseball cap was commandeered to be used as the demonstration tool for the self-breast exam. The ladies of the community were all very amused by that. The Mexican paparazzi were out in full force again, hoping to catch Michael’s dental charla and witness how salt, baking soda, and water can come together to make homemade toothpaste. Apparently this film crew that keeps following us out to the communities is actually working on a documentary. We are hoping they will send us links to the videos once they’ve aired, we are all really curious to see the interviews and footage from our fairs (as well as the other things that might be included in this documentary).

As we had already visited this town before, we finished a bit earlier than usual and so Rafa took us on a side trip to see this gigantic tree a few towns over. It was indeed a very large tree, tucked up in a small rural village in the hills. The network of roots was extensive – and actually several of the smaller trees nearby were really just offshoots from the roots of this one huge tree. The tree also produces water, apparently – there is a spigot coming out from the network of roots, and we even saw some of the local women come by to fill their buckets with the water. Dr. Clark rinsed her hands off in the water, too.  The giant tree was also the perfect time for a PPS SMA photo-shoot that mostly consisted of silly shots – but several serious yoga poses were also captured.



Look! We can spell "PPS!" with our bodies!


Friday evening was our first real night out on the town – our fellow med students in JR had taken the bus into town, and we met up with them. We wandered around el centro, swapped health fair stories, played a pick-up game of soccer in the middle of a crowded market, hired a mariachi band to serenade Nellie for her birthday, then ate dinner at a snazzy restaurant that Rafa had recommended. Rafa and Dr. Clark also joined us, so we were quite the large party. After dinner we hung out in the jardin in front of La Parroquia for a bit, where festivities for the big weekend were beginning (some sort of zumbathon, followed by a salsa concert, lots of people, that sort of thing). Rafa then took us to a bar nearby and we enjoyed drinks out on the rooftop terrace, with La Parroquia all lit up behind us.
 

The birthday girl, surrounded by her mariachi serenaders!


This morning we went out to see Casa Esperanza. During one of our mornings at the DIF before heading out to the communities, we had met this really nice man who runs this organization. We got to talking and he invited us to check out their place. The organization is kind of like a school and afterschool program for kids in San Miguel that have really tough home lives. Casa Esperanza provides food for them, tutoring and homework help, additional lectures and workshops to teach valuable skills, and psychologist support as well as support for their parents. We were all really amazed by the organization and all it has been doing to help these kids. Our new friend Farhad was pretty amazing and so excited to show us everything. We talked a lot about ways to get involved with the group in the future and are hopeful that we can find ways to help!

We met up with our friends from JR for lunch today at our favorite SMA lunch spot – Media Naranja. We hope to visit our fellow classmates on their home turf in Juventino Rosas next weekend. Tonight featured another stellar meal from Kelly – cabbage tacos, or tacos de col (col as an in “cole” – like cole-slaw, get it??) They were really flavorful, especially once the olive oil/garlic/onion/pepper mixture was drizzled on top. Dinner was followed by my favorite dessert – champan de fresa.

Tomorrow will be an interesting day in SMA: it is la fiesta de los locos (literally, the party of the crazies), and the whole town will be swamped by a giant parade (un desfile) where people will be dressed in costume. The few details/advice/warnings we have received about the event are as follows:

1. Wear a lot of sunscreen.
2. Be prepared to be pelted with candy that the “locos” are throwing – they apparently really like to throw the candy at the Americans.
3. Plan ahead for limited bathroom options.

We are also slated to have dinner with our buddy Kip from the Lion’s Club at his incredible home in the heart of SMA, which we have been eagerly anticipating. If going to Mass can be squeezed in there at some point, tomorrow should be an excellent Sunday – and of course a skype date with Dad first thing in the morning to celebrate Father’s Day from afar!



The case of the missing eye charts, and the never ending story (of wire transfers)

Another action-packed day in SMA and the surrounding communities! We returned to San Francisco, the very first town we had visited. We had been warned that there would be a lot of people today, and since we hadn’t done glucose checks and vision screenings there yet, those were our main goals for the day… until we started unpacking and realized that the eye charts (“Snellen charts,” if you will) were missing. No one could remember packing them up from our last community, and for a few minutes we were uncertain if we would be able to perform vision screenings at all. The school in the community had already excused kids from class for the vision screenings, and their parents were there. Luckily, Rafa saved the day – he went down the road (which was quite a ways, down a dirt/gravel road) to a local doctor and fortunately was able to borrow his Snellen chart. From then on out, it was a lot of vision screenings and parental consent forms and child assent forms and dietary nutrition surveys as part of our research project. The day ended up being very successful despite the rocky start, and we now have a repacking procedure to make sure all of our supplies come and go with us!

Jason, providing vision screenings to the kids in San Francisco

We spent another afternoon (this makes the fourth or fifth, at least) trying to coordinate banking and wire transfers over skype and email in order to be able to pay our host family. All parties involved (us, the banks, our contacts and UNC going to the banks for us, and our host family) are getting a bit frustrated with the saga that has involved two separate identities, two corrections to the wire transfer that were actually incorrect, and three separate banks (I think – but I’ve sort of lost track). Alas, we hope to sort it all out soon.

With one more health fair tomorrow, we have a lot to look forward to this weekend: the JR crew called us up and told us of their plans to come visit this weekend, which should be fun; meeting up with Dr. Quiroz at some point, who helped get the SMA branch of PPS up and running; some sort of parade thing in the city on Sunday; dinner at Kip’s house on Sunday. A fathers’ day BBQ in the back yard and teaming up with an organization that helps kids in SMA with difficult home lives for some breakfast/charlas/hang ing out are also possibilities for the weekend.

Hitting our stride, with help from Dr. Clark

Our trip out to La Cuadrilla was more successful than yesterday – the town knew we were coming this time, and many people showed up to have their blood pressure, glucose, and vision checked! We only got a little lost on our way out there this morning – it is amazing how many little towns are out there once you turn off the main road – but after that everything went well. Dr. Clark was a huge help talking with everyone, giving medical advice, filling out surveys, and even meeting one of the women that she recognized in a documentary about immigration – “Letters from the Other Side.” The TV crew again showed up – luckily Michael brought his Mexican TV personality and wowed the media again. We saw over 40 people, which was a lot of finger-prickin’, glucose-checkin’, blood-pressurin’, waist-measurin’, eye-screenin’, survey-takin’ action for one day. Apparently the town we’re going to tomorrow will have an even bigger turnout, so hopefully we’re prepared for that!

This evening we got our hopes up for rain – which, according to some people, hasn’t happened in SMA in like 2 years – however, dusty conditions prevailed. Descriptions of nasal mucus ensued (hey, we’re all med students here) and from the combination of the dusty conditions out in the communities and the pollution in the city, we’re talking about some pretty interesting nasal mucus. And you know it’s pretty late for me to keep blogging and I just wrote a whole blurb about nasal mucus, so that’s probably a sign that this entry should come to an end.

The Unexpected Health Fair

Well, even though today went differently than planned (you may be beginning to sense a pattern…), it was still a good day, nonetheless. We were very excited that Dr. Clark would be joining us out in the community, and equally excited when we found that we would be traveling by suburban again. However, when we got to the community we discovered that no one had informed them that we would be coming. We waited around for a while and joked with Dr. Clark that she had cursed us by coming to visit the SMA group after we had heard about some of the difficulties that she and the group in JR had encountered with the new padre (apparently the new priest would not let the charlas commence without attendance to Mass in the communities, first). Eventually we were able to talk with some of the community leaders and discuss the situation. The directora of the school was very friendly and asked us to let us know when we would be returning because she thought that the people in the town would really be able to benefit from the health fair. So our new plan is to return to this community tomorrow, although we’re still not exactly sure where the communication broke down between the DIF and the community.



Following Dr. Clark through SMA, her little "doc"-lings!



So instead of putting on our health fair, we instead hung out with Dr. Clark in SMA – we saw the lovely house she is renting in el centro and were a bit envious of the convenience of the location, we took her to our favorite SMA lunch spot (yep, that’s right: Media Naranja), and we walked through the artesian market to peruse the souvenirs, postcards, paintings, and jewelry. In our typical fashion, we stuck out just a little bit – not only did we look like a group of Americans, but we were all still wearing scrubs from the aborted health fair attempt.  We did, however, change before we made our trip to Office Depot this time (it had been a few days since we had been there, after all – I think we’ve only had to go there 5 times so far, but it’s a good thing –we’re using up all of our screening sheets and recommendation forms because we have been able to see so many people out in the communities). Hopefully we’ll be able to have our health fair tomorrow and get Dr. Clark in on the action – we know she will be a great resource and help to us, and it has been nice to be around someone who knows the ropes in SMA!

A little bit off of the beaten track, and a little beaten up by the bumpy track

A few changes in plan today – we were all set to go to the big health fair being put on by the DIF, but instead the DIF decided it would be better to spread out resources and so we instead went out into another community. Today’s community was called “Artesano de la Luz” and it definitely seemed like the most economically strained of the towns we have visited so far. Lots of people showed up for health checks though, which was great. We were screening machines, and were able to get a lot done. We did not do our charlas today, as Rafa had explained that this town in particular had very little access to any sort of health care, and so the checks would be more valuable. The people in this community were, as ever, extremely kind and very gracious.

Another change in our plan today – the chevy suburban we have been ferried about in by the DIF was being used for the health fair, so… we got to ride in one of the trucks. It was a much bumpier ride than we had grown accustomed to, especially once the bumps were no longer caused by speed bumps in the city but instead by unpaved roads as we moved farther out into the countryside. But all things considered, it was a good day with a lot of screenings and surveys collected.

Another knock-out dessert tonight – fresa champan. Like the mango champan, but strawberry flavored.