Argentina Week #2

I had a great second week in Salta. We were able to spend time at two different public health clinics in two poor communities on the outskirts of Salta, where we saw many more pediatric patients and participated in public health efforts, including vaccination campaigns, home visits, and a class on preparing for labor & delivery...all things I am interested in and enjoy.

I don't think Lori was as excited about these days as I was however...

• Public Clinic #1: where we went with Dra. Oliva, she spends most of her time working in public clinics, but also works 1 day at Savia

A poster in the clinic encouraging breastfeeding, it essentially says: "Want to give your child what is best? Breastfeeding is all that is necessary until 6 months."

Breastfeeding is extremely important for nutrition in these poor communities, and is much more natural and open here--as it is in most countries--than it is in the US.

(There was also a much more graphic one showing a mom breastfeeding right after birth, but I knew some of the blog readers wouldn't appreciate it as I did)

After clinic, we went door to door in the community with Dra. Oliva and one of the nurses looking for men between the ages of 16-39 who hadn't yet received the Rubeola Vaccine (last year's campaign was for the women these ages). We vaccinated people at their homes, walking down the street, in their place of work...including at the butcher shop. It was hot, but a really great experience (and a little scary because of how they handle their sharps...they recapped them and put them with the rest of the trash in a plastic sack)!

Lori putting alcohol on a piece of cotton to clean the arm Me giving a vaccine

Each Wednesday morning, we attend English class with the residents...Andres, the boyfriend of one of the resident's, who is a vet, is the teacher.

• Public Clinic #2: at this clinic we didn't actually spend any time in the clinic, but spent two days going out with the community health workers on home visits. We checked on people who were ill, pregnant women, and kids who were underweight and nutritionally malnourished, and we gave rubeola, yellow fever, and tetanus vaccinations.

The community health workers carried backpacks with a cooler for vaccines and all the supplies to prep the vaccines, things to measure height & weight, oral rehydration salts, packages of vegetable seeds to give to families, and huge binders as they were extremely meticulous in their documentation (and much safer with their sharps--they had small sharps containers). In their work room at the clinic they had these elaborate display boards of how many women in the community were pregnant, which nutritional category the children were in, who had TB and which stage it was in, etc. and a large village map, all colorfully divided up by which healthcare worker was responsible for which parts. This was also a really interesting and great experience.

Two of the community health workers with their backpack and scale deviceWeighing a little girlMe giving another vaccinationHomes in the community

Below are more posts about the more touristy things we have been doing in our spare time...

Central Plaza & Its Attractions

The Central Plaza, Plaza 9 de Julio (Argentina's Independence Day): the Cathedral, several museums, a theater, and many restaurants form the square around this plaza. Conviently our apartment is just 1.5 blocks away. There are always lots of people and dogs hanging out in the plaza, so its a nice place to be.

Museo de Arqueologia de Alta Montana (MAAM)- museum about Inca culture and the Andes mountains; displaying the mummified bodies Incan child sacrifices found in the nearby mountains.Salta's Pink Catedral and altar

The Plaza's Christmas tree
Lori & I enjoying dinner on the plazaIglesia San Francisco- another nearby landmark church We joined the residents for an evening out in happening night area of town...this street was packed with tons of people...the evening didn't begin until midnight, and when Lori & I left at 2am the dancing part of the evening had yet to begin...This is one of the residents and her boyfriend with Lori

Quebrada de San Lorenzo

a cloud forest reserve near Salta in San Lorenzo...with hiking trails and bird-watching

with our host, Dra. Nora Diaz

Changing of Guard

at Cabildo de la Ciudad in the Central Plaza

Honduras

I had the opportunity to go on the fall Baylor Shoulder to Shoulder trip to Santa Ana, Honduras October 25th - November 6th for another international medical rotation with several of my classmates. The Baylor Family Medicine Department takes faculty and students to the village two times each year and is working in conjunction with the community and Dr. Carol Gomez, a local physician and her pastor husband, to build and staff a clinic there. It was a wonderful opportunity and we had a great time!

You can read about the Baylor Shoulder to Shoulder Foundation here: http://www.bcm.edu/familymed/international/s2smission.htm

We flew into the capital city, Tegucigalpa, and then traveled by bus for approximately 9 hours, mostly on mountainous dirt roads to the village, near the border with El Salvador. The new clinic was at a stage where we could use it this trip, which was exciting, but also a lot of work! We had a medical team consisting of 3 attending physicians and 9 medical students, 1 dentist, 1 optometrist and 3 optometry students, and 4 translators (from Tegucigalpa). We held clinic for 8 days and saw 455 patients in just the medical clinic, from Santa Ana and 31 of the surrounding villages. We also set up and ran the new pharmacy, and had the opportunity to work in the dental clinic giving anesthetic injections, pulling teeth, and prepping fillings. In addition each afternoon, we sent teams on village visits to see patients who were unable to leave their homes and do some community health education. We also sent students to continue the Justa Stove Building projects--building stoves that vent to the outside so that there is not smoke in the house--and held a day long nutrition course for the local community health workers.

Beautiful mountains (scattered with little houses) on the way to Santa Ana.

Colomoncagua- the nearest town, where Dr. Gomez and her family lived. It was around 3 miles from Santa Ana, but at least a 45 minute drive!

Santa Ana & the walk to clinic each morning-scattered with people, cows, horse, pigs, chickens, dogs, and cats
The New Clinic in Santa Ana, still under construction, but usable by Honduran standards. It will be very nice when finished and will include a dormitory for visiting brigades.

The Clinic waiting room (note the gigantic ladder in the middle of the room, sometimes also visited by dogs & a patient consult room

The Pharmacy &
The Lab, from which we were able to do a few simple tests: hematocrits, gram stains, wet mounts, UAs, and urine pregnancy tests

Me pulling teeth...Dr. Johnson probably pulled hundreds of teeth!
Where we slept- in a house in tents, for protection from mosquitoes

The Pila: water is Honduras is a precious commodity...so they fill up these concrete basins, called pilas with water, and then use it for washing dishes & clothes and bathing. There are clean buckets and dirty buckets; only the clean bucket goes into the water and you use it to fill the dirty buckets and use the water from the dirty buckets for whatever the task is. The girls were lucky enough to have an actual shower (very cold) out behind the house, but the boys had to use the pila for bucket showers.

How we got around on the rough dirt roads, to village visits, etc.: piled in the back of small trucks....banging into each other and holding on very tightly over all the many bumps and steep hills. One of the roads we frequently traveled
On Sunday, our day off, we were able to visit a beautiful waterfall near Colomoncagua. This is the medical team in front of it.
Crossing the bridge across the river dividing Honduras and El Salvador on an afternoon hike.

And finally, my favorite picture from the trip...a home visit to an older woman suspected of having chronic osteomyelitis. We were all gathered out in her dirt courtyard, with her husband and her many grandchildren, and animals. In this picture Dr. Pierce and Kjirsten are explaining how she should take her medicines. I love it because it really captures a piece of what the experience was like--out in very rural country, with very limited medical resources, serving a very poor population.

The plan was to begin treating this lady with antibiotics, and then hopefully she would be able to get a ride to the nearest hospital for after the rainy season when the river went down for x-rays and further treatment.
(Not in the picture, but present in the scene was a pig...who kept trying to eat the skirt one of the granddaughters was wearing!)

Below, more pretty Honduras scenery...we saw some gorgeous sunsets (The pictures are not great though because they were taken from the back of a bouncing truck)