My Experience as a Narcotraficante (and other stuff)
So, things are finally starting to happen around here! I’m very excited with what’s been going on since my last journal...well, I guess I better start at the beginning.
Early last week I went to introduce myself to Valerie, finally. She is quite a character—she took one look at me, and said “you say you want to help? Ok, let’s go!” She immediately sent me with a client of hers to assess the condition of the client’s neighbor, who the client claimed was dying of AIDS. But before I left (not even two minutes after I had met Valerie), she shoved a few day’s worth of Morphine into a plastic baggie, and told me to give it to the women if she was in a lot of pain. So great, all of a sudden not only was I qualified to assess the condition of an advanced-stage AIDS patient, but I was also a drug dealer. So I follow this client to her home in el Ticket (not far from the hospital at all).
The neighbor in question lived in a tiny, dirty, hot, smelly room in the back of a collection of shanty houses. She couldn’t stand up, but was lucid and fairly animated when she spoke. I spoke with her for about 10 min, asking all the questions I thought I should ask and writing everything down. Then her boyfriend came in, and started asking me about this itching
he’d been having all over his body, and that other people got if he shared his clothes. At this point I look around at the buckets of urine etc collected on the floor, remember that I’m sitting on the edge of the woman’s bed (the only place to sit) and realize he must have scabies (or something like it), and realize I’m getting exposed to the buggers at that exact moment. So now I’m an infested, medically-qualified drug dealer. Excellent. I tell him I wish I could help but that he should come into the hospital for some treatment, and I finish up with her. The whole scene is over in about 15 min, and I go join Leonel at Paradise Computers, where he proceeds to laugh hysterically over the randomness/absurdity of it all.
The next day I went to report back to Valerie, and Leonel and I spent a few hours talking with her about the situation of HIV/AIDS patients on the island, etc. I learned a lot from her, including the fact that I’m super naïve—I knew nothing about the sordid activities surrounding cruise ships! I thought they were family-oriented places, and after about 45 min of naïve
questions Valerie asks me, “where did you grow up? The Good Ship Lolliepop?” Well no, Marin county…but close enough. Anyway, Valerie was very informative. I feel know that I have a much better understanding of what’s going on with HIV/AIDS here on the island—although I recognize that everything I’ve heard is from Valerie alone, so it isn’t gospel.
The second time I went back to visit Valerie, I was able to translate for her (she doesn’t speak Spanish!), and we gave two young women HIV tests. We also talked to them about HIV, how it works etc and showed them how to use condoms. I found the whole situation really interesting and gratifying, and I’m very pleased that I’ve had the opportunity to be involved in the program, even if it’s only for a little bit.
Also, I’ve finally connected with Peggy. Peggy is still building her clinic, but now her clinic is associated with a bunch of others on the island, and they are calling themselves the Bay Island Community Clinics (did you know this already?). They are still in the process of filling the paperwork to be an NGO, and the docs have all come together recently to start discussing joint projects. Right now, they are trying to set up some curriculum for health education in schools. They actually may need some help finding some legit, tried-and-true curriculum to use, but I’m not sure where to start with that.
Now associated with the Bay Island Community Clinics is a guy named Dr. Richard _____. He is working with Peggy and the others to set up a residency rotation for Marshall University, in which residents will help train local “health promoters”—key community members who will bring skills and health knowledge into the communities to start to improve health behaviors and practices. I am very interested in their program, and I’m really excited that they’ve included me in what’s going on. Richard in particular has been really helpful, both with my personal project and with career ideas etc (he’s a PhD/MPH). He and I have talked extensively about the best way to make my project applicable. We decided together that we could come up with something more helpful than my original idea of a quantitative survey to identify the most common health issues in different communities. He said that his program could really use a survey that goes one step further. The idea would be to take the patient data from the Global Healing computer (by the way, has this been used for anything else so far?) and data from the diagnosis sheets from Peggy’s clinic to come up with the most common diagnoses for patients from each barrio. We will also analyze the data for most common diagnosis by gender and age group. Then, using these top diagnosis, we will talk with Peggy/docs/etc to talk about the behaviors that are affecting these diagnoses—behaviors that health promoters could potentially focus on educating people about. For example, lots of diagnoses of impetigo, scabies; inadequate bathing of kids; want to improve bathing practices. However, to best do this, we need detailed info about how people are currently washing their kids, in order for our ideas for improvement to have any sort of cultural/environmental relevance here. This is where the rest of my survey would come in: I would do qualitative research on people’s current health practices (using identified key informants).
I am very excited by this idea, and I feel supported by both Peggy and Richard. My only concern is that if I take the project in this direction, we won’t have the info for our clinic about how many people know about the clinic and where do they live and what have they heard about us etc (ie quality feedback stuff). The upside however, is that the research I do would be very helpful for future Global Healing docs: it would give docs a heads-up on the most common diagnoses, and what we know about local behavior associated with leading to these pathologies. This would give docs a better cultural grounding, so that when they give advice (like “wash kid with soap and water”) we will have a better idea of whether or not this advice is getting through, and if what the docs are recommending is even possible (ie in communities where water is only available every 4 days, will they actually be able to bath their kids everyday?).
Ok whew. That was long-winded. What do you guys think? I would love some feedback—I can try to tweak this survey project to be most appealing to everyone (including you guys). I just want to know whether this explanation makes sense to you guys, if you have any ideas/concerns/suggestions etc.
Also, Courtney joined us this Sunday. She’s a resident from Oakland, and is super nice. Reena is another Resident coming this weekend, so it’s gonna be a regular old party here!
Alright, I know there’s probably more I could fill you guys in about but I’m drawing a blank…so whatever I missed now, I let you guys know about it next week!
