Thursday, May 13, 2010

No habla espanol, mais je parle francais

I have struggled since day 1 to understand conversations happening around me. The people speak very fast here and many do no understand English. I am lucky that I have Jen, Liz, Staci, and Lisa at Hospicio - who all rock my socks off, by the way - they are so encouraging and supportive of me at our service site and really help me out with speaking and understanding the language. I am now able to comprehend much more, however, am unable to speak back in more than 3-4 word phrases. One of the many things that I have learned at Hospicio is that touch goes a long way. Even if I cannot speak more than a few words, the residents are so happy that I am there to interact, or to smile, or to go for a walk. We laugh at my comprehension struggles and keep trucking along. Today, as I was suffering from a case of bad dehydration, I had to lie down on a bench on the porch of the home. Many residents came up to me to hold my hand or touch my shoulder to make sure that I was ok. This touched my heart and I am speechless about it. As I could not understand their words, I could understand their actions and know that they were putting me in their prayers to get better.
On the flip side of not knowing Spanish, I had a treat when we visited Batey Libertad last week. Most of the people there speak English, Creole, Spanish and French. I asked around to see whom spoke French and decided to give it a try. Yes, I struggled a little, trying to piece things together for I have not spoken it in about 3 years or so; but I found myself talking and laughing and really enjoying myself. More and more people were getting the word that I spoke French and would come and talk to me too. I had a lot of fun with it! I learned so much about the people at the Batey and only wish I could stay in contact with a few of them to see how they progess in their studies and in life in general (also being able to keep up on my french practice).

Tuesday, May 11, 2010

Hospicio and other thoughts

Greetings everyone!  Right now I am sitting in the casa recovering from dehydration, which I must say is pretty dang scary.  Team Hospicio loaded the Guagua today and I was feeling fine, then all of the sudden as we were standing in the outpatient clinic I felt dizzy and weak all of the sudden and needed to sit down, I felt like I was going to pass out.  One thing that I have learned here is that once you are thirsty, thats when it is too late, and you are already dehydrated.  So Ive been pumping the fluid, both water and gatorade today.

Hospicio has been going well.  I will start with yesterday (Monday) at Hospicio.  We took our residents to the park and walked around, did some exercises and played a game.  This park is absolutely beautiful.  Honestly, I have never seen our residents so happy!  One of them commented on how nice is was to get fresh air and have different scenery because they really do not have the opportunity to leave the complex very often.  I am so happy that I have the opportunity to spend time with them.    They all have their brilliant personalities and quarks about them and are all so wonderful.  Keep an eye on them though, a few of them really want to explore or barter with local street vendors.  After the exercise class, we went to check in with a patient who is s/p hip surgery.  Liz and I checked in with Kenson in the out patient clinic.We saw Emilie for a little bit and waited for our other patient that did not come in today.  Our late morning was a little more frustrating.   We are having trouble understanding why our hip patient is NWB and still has his stitches in and are in disagreement with the nursing staff about this issue, as well as a couple of other things.  It is hard because we really want to help him and are afraid of things like infection and other co-morbidities and are unable to at this time.  The nursing staff is so caring and are really looking after him, as well as their other patients.

Also on Monday we had ILAC clinic, which is where people from the community come into ILAC and we diagnose and treat them.  We had two patients with UE BE amputations that we fit with prosthesis, as well as taught them how to use them for tasks such as writing, picking up a mug and taking a lid off a jar.  Ann, Erin and I were a treatment team.  Thank god Ann speaks Spanish, she rocks my socks off!  Next, the three of us treated a pt with L anterior knee pain, s/p L meniscus scope in January.  She presented with swelling, pain and decent strength.  We worked with her on exercises and wrote up a HEP for her as well.

After clinic, we had dinner and then the PUCC students came to our campus this evening for a lecture and case studies on amputations and prosthetics.  Nicki and I worked on a case with another PUCC student and we discussed the importance of the "Dream Team," came up with a plan of care, patient goals, equipment needed and future issues.  Niether Nicki or I speak Spanish, and the PUCC student spoke very limited English, so we did have some trouble understanding each other.  Sue translated for us for most of the session.

My spanish is coming along and I am able to say a few things.  I am able to understand more, which is nice. 

We have four days left here and I still cannot believe all of the work we are doing with the Dominican people.  Everyday I seem to learn something about myself and something about one of my patients or about the culture.  As most dominicans do not speak English, they are all very understanding because we are at least trying to communicate.  I still rely more on demonstration, especially when working with a patient alone with no translator.

I have made some transformations and realizations during my trip here.  There are so many things that I take for granted in the US, such as electricty, paved roads, personal space, access to good healthcare, screens on windows, relationships, certain foods, clean water, communication, etc.  The dominican people are so simple, so loving and live off of the land, rely on relationships (with God and family on the forefront).  They use the resources they have, which sometimes scares me when the resource is meat - we saw a pig being walked down the road on the way to work the other day, and we see chickens just running everywhere).   Then there is the poor, which is very prevelant here, as well as the rich, with nothing in between.  For example, the Batey's.  These communities strive off of their relationships with their family and with each other and really enjoy life, even though they do not have much to live on.  Reflecting back on my experience at Batey Libertad, I am touched by how wonderful this community is and how loving and accpeting they are of us visiting and learning about their culture and community.  Poverty is apparent to the eye by looking at the housing and the bathrooms and sometimes unclothed babies, but it is not apparent in their hearts, which are so giving, to their community and to us.  I think about how simple life is here and how nice it is sometimes just to be.  I have realized that there is so much I want to give but cannot even begin to give everything that I want to give.  I can only help so much, teach so much, collaborate (with the PUCC students and others at Hospicio).  There are things that make me nervous here as well, revolving around healthcare and how limited their resources are.  For example, in the US supplies like gloves are readily availible and we throw them away after each use.  Here I learned that they may only get one pair a day.  I have been impressed with aspects of healthcare toom such as how caring and knowledgable the staff are at all of the places that I have been, as well as how nice the facilities are and how they are working on improvements to better serve their people.

On another note, we all look like lobsters with the chicken pox - sunburned and getting bites from the "no see-um" bugs.  We are all going to look so great for graduation - hahaha!

Sunday, May 9, 2010

Photo Blog

Hi everyone!  Things are going well in the DR!  We just got back from a nice weekend of R&R up in the mountains, where the roads that we drove up are pretty comparible to the superior hiking trail if any of you have been there.  We left for the weekend on friday after clinic and began the two hour drive up the mountain.  I believe we were up about 4200 ft.  I have never been up in the "real" mountains before, so this was a treat for me!  ILAC has a retreat center up on Jochilito in which we stayed at.  Spend friday evening just relaxing, playing cards and having reflection.

Saturday morning we woke up, ate breakfast and then hiked up and down the mountain to a very beautiful stream.  The hike was awesome, beautiful and the pictures that I am taking up here do absolutely no justice to how it actually is up here, but I tried.  Speaking of photos, here is the link to my kodak site!  I have 3 albums to look at, enjoy!

http://www.kodakgallery.com/gallery/creativeapps/photoPicker/albums.jsp#

This river was very beautiful, as I said.  Kelsey and I started running around the water and the rocks right away!  We jumped off the rocks into the little pools and had a great time.  Ironically this was the first time that we were all exposed to the sun for a long period of time, so I got quite burnt along with a few others in the group.  We relaxed here for an hour or so, just taking in the great scenery.  We were also graced by a few locals who were swining from trees and falling into the water and jumping from higher places than we were allowed to jump from. Those guys were crazy!  We hiked back up the mountain for lunch, and Kelsey and I decided to even run up a hill for some momentum on the way back. 

In the afternoon, we hung out with some locals between the ages of 15-21.  We shared about our culture in America and they shared their Domincan culture with us.  We learned to Merengue and some other dominican dance as well.  So guess what, they asked us to teach them some american dances.  Hmmmmm, the first thing we thought about was how we dance in the clubs.  Not so appropriate.  Well we taught them to swing dance and how to do the electric slide.  No great shakes.  Its interesting because they have specific dances that represent their culture, but we really do not.  It was kinda difficult for me, but I'll get it with more practice!    We also learned about animal sounds - yes, sounds rediculous, right?  Well it kind of was, we were all assigned animals and walked around with our eyes closed making the animal noises and tried to find the other people with the same animal.  We learned that the US and the DR have different sounds for the same animal so not everyone was able to find their matches.

Also another way to follow our trip is on our class blog at:

http://www.ptcrossingboarders.blogspot.com/

Thursday, May 6, 2010

Team Hospicio!

I cannot believe that it is already day 6 on our trip in the DR!  

We have now completed two days of clinic, and I am on team Hospicio.  Each day has been full of great learning experiences for me, as well as me trying to let my guard down with the language barrier.  The first day was a little rattling for me, but I have learned that even though we may not understand each other, a hand hold or hug goes a long way here.   This city is so crammed full of people and there is a serious lack of personal space, however this makes for a learned environment of everyone being very close, looking out for each other and in general very affectionate towards each other.  Right now we have a group exercise class in the mornings for about 10 residents, then we work with a few patients in the home, as well as in the outpatient area.  I find it interesting that there is really no patient charting at the place that I am working.  We know nothing about the patient when we meet them, no history or anything.  However this is making us more confident in our ability to find out important information in short periods of time and come up with diagnoses and appropriate exercise programs for patients.  I am currently working with a male who has a T11 spinal cord injury and finding it more difficult that I thought to work on strengthening exercises for him.  The challenge lies in the fact that the Dominican has a lack of healthcare resources, such as plinths and mats at appropriate levels, for patients to work with.  People with disabilities in the DR are seen as non-existent.  There are no handicap ramps on corners.  The coutry views them as invalids as if there is nothing that can be done the help them.  For example, if my pt were in the US, he would be able to be fit for a wheelchair that would allow him to transfer independently from WC to mat or bed or chair.  He would have more opportunities for transportation and rehab facilities and in general because of the resources we have here, this man would be able to live an independent life.  So it is hard for me too see someone with so much potential not able to have these things.  Our focus with him is to make him as functionally independent as we can with the resources that he has here.  We will continue to work with him the next week!

We made it to clinic by ourselves on the guagua today (day 2 of clinic) - yay!  Group exercise was much more dynamic this morning as well, with more participants.  Everyone seems happy to be there and try things out.  Again, our resources are limited but we come up with some very creative things to do!  The group is quite hilarious, really! 

Kenson is one of the people that works in the outpatient area and he has been very helpful to us, and getting me to practice my spanish (or lack of) and show me that I do understand some.  And actually right now I understand quite a bit more, but I cannot form the right words to speak it. 

I will write more later about my moving experiences at Batey Libertad soon!   Off to bed - these long, but rewarding days are killing me!

Tuesday, May 4, 2010

Clinic tours

And then we saw a RAT!  Yes a rat in between our casas on the ceiling.  I was not afraid, for I figured that my mosquito netting would protect me! 

Well last night the power went out, which apparently happens quite frequently here!  Everyone piggy backs off each others power and grids get shut off!  So I woke up in the middle of the night sweating and not being able to sleep.  The power was still off when I got up to go for a run.  We have a little track on campus here, a little figure 8, and its nice.  I did run in a monsoon this morning (which had started the evening before)!

Today was a busy day in which we toured all of the clinic sites that we will be working at.  We also toured the Rehabilitation hospital, which I am very impressed with.  All of the staff is so nice and helpful.  They gave us a great tour in which we had the opportunity to meet staff, patients and the PMR docs.  This outpatient clinic treats up to 800 pts a day (as long as it is not raining outside, for people do not come to clinic when it is raining). I will be working at Hospicio, which we also toured.  It is a long term care and outpatient facility.  I am starting to pick up on some Spanish, but I have a problem speaking it back.  Tonight I will be spending some time making up some cards to put in my pockets to help me out tomorrow!  The residents and staff are very nice here and I am excited to start work there tomorrow!  We also toured a community healthcare site, which is where community people are trained to do rehab for children in Santigo.  It is a very neat program and they currently treat 320 children in the area.

Tonight we are discussing case studies with healthcare professionals.  More on this later!

Sara

Monday, May 3, 2010

Days 1-2

Travel Day

I arrived in Santo Domingo on Saturday evening around 1100 PM.  What a long day of travel for everyone!  Thank god that the time zone difference is only 1 hr.  Upon arrival in the DR, I am happy to find out that everyone's luggage made it to the DR after 3 flights!   Our driver, Elfie, from ILAC where we are staying now, picked us up at the airport and took us to our first bugalow in Santo Domingo.  We all settled into our cramped abode to get ready for the next day!  The place we are staying at is owned by a women named Bettey. 

Day 1

The first day in Santo Domingo was humid as all heck!  We sweat at night as well as during the day. 
Bettey made us breakfast in the morning, very good breads, fruit and coffee.  We started out our day by taking the ILAC bus to Bataye Caracoa.  A Bataye is a community that started by sugar cane workers in the 1500s, many of the residents Haitian's as well as DR residents.  Bataye Caracoa is assisted by a man named Eduardo, whom also works with other Batayes in the area.  His mission work to improve the conditions of the current Batayes is very inspiring!  Caracoa is the first Bataye to be improved, and it includes a brand new school, church, medic building and houses. 

As we pulled into the Bataye, the residents were very curious and welcoming at the same time.  I struggled because I do not speak any Spanish, however, everyone tried to help me understand.  Eduardo gave us a tour and as we are touring many children come running up to us, they want to interact and to play as well.  We were carrying two soccer balls around and brought them as a donation to the Sunday school program.  As the kids approached, we gave them the soccer balls.  I have never seen so many children so happy just to run around a kick a ball.  They really got into it, and continued playing through the rain!

We attended a church service, which was all in Spanish.  As I did not understand everything that was going on, I did understand some things.  Since Church is universal I was able to identify creeds and prayers that are familiar to me as a Lutheran.  An interesting fact about the church is that the structure was build to withstand hurricane winds, the side walls are open, in theory the storm will blow through and there will be less to repair.

After the Bataye, we went to the beach.  I enjoyed my first Dominican Presidente on the beach with my classmates.  I really enjoy getting to know the other girls in my group that I do not know so well!  Funny thing, we had to pay for the use of chairs on the beach. 

The weather here is very humid and very unpredictable.  Its so humid you want to die one minute and the next minute it is storming.  Rain coats are pretty optional here in the rain, for the rain really cools us off!

We did a walking tour of Santo Domingo on the second night there.  I took many pictures of the monuments and buildings (such as Christopher Columbus' house) and the little crazy streets that our ILAC bus is whipping down.  We walked to the ocean and along a popular strip with tons of things going on and did our reflection of the day down there.  We talked about our roses and our thorns.  I stated that my rose is getting to know the doctorate students and how accepting they are of both me and Kelsey into their group and their service project.  My thorn is that I wish I knew Spanish and that its humid.  I know that will get better!  We ended up at a little restaurant by Bettey's, where we finished the evening out.

As a reflection of my first full day I have many emotions! 

Day 2:

We woke up again to have breakfast at Bettey's and then packed our things to move into ILAC.  ILAC is the Institute for Latin American Concern in Santiago.  We drove from our ocean side town of Santo Domingo through the moutains into mainland.  The pictures that I took out of the bus window do no justice to the beauty that I saw.

ILAC is a beautiful place, as you will see in some of my pictures.  We settled into two rooms at the center, enojyed some lunch and then had an orientation to our new home for the next 2 weeks.  After our orientation we exchanged our dollars for paso's and headed out for our first Guagua (bus) ride.  Seriously, they pack people in these things!  There were 27 of us in what appeared to be a 15 passenger van, wow!  Oh did I mention it was HOT and HUMID!  Hahaha.

We took the Guagua more into the heart of Santiago where we split into our service groups (mine is Hospicio) and did a scavenger hunt to learn how to get our way around the city better - learn how to order things in Spanish, get directions, get off at the right Guagua stop, barter for cheaper prices, etc.  Let me just say that this was very nerve wracking for me.  I found myself timid as I was trying to speak the language and Im not quite sure why.  I hope to get over this shyness of speaking Spanish because I am really going to need it with my patients the next coming weeks!

We ended our scavenger hunt by meeting at a little restaurant for a drink and reflected on what we found out from our experiences that day.

After dinner this evening, back at ILAC, we discussed our day tomorrow. 

I am finding that I am drinking tons of water, so much that I think that Im getting sick of it, but know that I need it to survive down here.  More to come soon!

Sara