We started work on Monday with both of us in the clinic with Edwin. He showed us basically what he does each day, and we took turns interviewing patients. On Tuesday all three of us went to the clinic again and did essentially the same thing.
On Wednesday Edwin left for El Salvador so Christine and I both went to Global Healing to make sure we remembered how to do everything before we left each other alone in the clinic. Dr. Breslin gave me a very short tour of the hospital and I was very grateful to get a little more of the "big picture" of how the different departments there interact. I would still love a more complete tour by Dr. Charles or anyone else, but that will probably come when I need to get something done and I'll just figure it out for myself.
On Thursday I went to work in Clinica Esperanza because the pre-med volunteer there was taking a day off and I wanted to see the place. I spent the day in the pharmacy with Betty mostly doing data entry and learning how the clinic works. I assume that once I work there a few days I will be able to help measure out prescriptions and possibly translate for the nurses and doctors, which will be interesting. It was also enlightening to see how the clinic takes in large quantities of donated medications and incorporates them into their pharmacy. I noticed that the clinic there will take peoples' personally prescribed medication, which is different from Global Healing but seems to make sense. For both the Global Healing clinic and Clinica Esperanza I am slightly amazed by how they keep consistently providing quality services with what seem like inconsistent supplies of medications, equipment, and volunteers. For most of the non-profits that I've worked with in the states, "turn-over" a very sore point and constant reason for concern, but here these clinics seem to be built around an acceptance of extremely high turnover with volunteers coming and going every month, and they seem to function alright. Also, with the medical supplies that seem to come in randomly (except for the few things that the clinic buys outright), somehow prescriptions manage to get filled one way or another. It's like stability out of chaos. Very cool, and not at all easy to pull off, but I look forward to learning more how it all works.
On Friday I went to the Global Healing Clinic and Christine went to work in Clinica Esperanza. We had almost 20 patients so we stayed quite busy. I am enjoying practicing and improving my Spanish and haven't run into any insurmountable barriers, although my Spanish is definitely a long way from being as fluent as Christine's. I look forward to practicing and improving more over the next few months, and I hope that I can be effective if I am put into the position of translator. I was expecting one patient whose chart had a number of notes from previous Global Healing clinic interns, but the patient never came to the clinic. The boy had some sort of seizure/muscle spasm disorder for which a previous intern considered coordinating an expensive surgery in San Pedro Sula, but the charts say he is responding well to seizure medication. Although I never saw this patient, it reminded me of the "case manager" portion of the orientation packet.
Christine and I decided that we will work most effectively if we each have a large chunk of time at each clinic, so for the next month and a half I will work in the Global Healing clinic each morning and Christine will work in Clinica Esperanza each morning except Wednesday (when they're closed), and then we will trade places. I think this will provide the most continuity for each clinic and will allow us to get to know each place well.
In the afternoons we have mostly been getting to know the area and swimming a lot. Because Peggy has been out of town, I feel like our "public health project" questions haven't been getting very straight answers. I know it is up to us to arrange something, so we will keep asking around and exploring possibilities, but it may take a little while for us to find a project even though I think we both would like something to keep us busy in the afternoons. It seems that Edwin was playing/coaching basketball with Dr. Raymond's team in the afternoons, but we got rained out while he was here and now I don't know where the courts are and I'm honestly not much of a basketball player. Shelli (the long-term volunteer living in Peggy's downstairs apartment) has mentioned several times a tutoring project she is starting up, but I don't know when that will come to fruition. Also Peggy mentioned via email the possibility of us teaching a health class, but she's not here now and I haven't heard anything about it from anyone else. We will keep asking around and I hope that by the end of the week we'll have a better idea of how we can contribute to the health of the island with our afternoons. For the time being we are learning a lot about how things work here and enjoying some fabulous snorkeling (swam amongst a pod of ~30 dolphins this morning, including at least 4 babies!).
The White Diamond Luxury Apartment is very luxurious and probably the nicest place I'll live in the next decade. It's a little more than Christine and I were expecting to pay, but the landlord is nice and we'll just have to have a lot of guests. The clinic seems to be in generally good shape and I am looking forward to meeting the Gruber's and Nurse Peggy soon.
Tonight we are having several volunteers over for dinner, so we've got some cooking to do, but if I left out any pertinent information or used a completely inappropriate format for this email journal entry, please let me know and I'll change it. I imagine that in the future I will present more case studies and reports on my projects outside of the clinic, but for the time being I'm still just getting my bearings.
