The General Hospital Day 1

Typewriter used to document los operacions

The Anesthetics Cabinet
(Below) Me and Kelly Scrubbed Up

Today was Day 1 at the hospital! Yesterday we came and received our gafetas (badges). Today we returned for our first day. In short, it was QUITE an experience. For the first time ever I almost blacked out during a surgery! (This was approximately my 8th surgery). I fought it off for about 30 minutes while my vision went gray and I got really hot. Finally I had my classmate take me to sit down and I ate a quesadilla that my host mom had packed for me. The rest of the day was fine. In Ob/Gyn I got to see: C Section, Histerectomy & Colnoplasty, Ectopic Pregnancy surgery. It was unbelievable. The operating rooms do not have doors, and I counted at one time 10 staff members in the room in addition to myself and one other classmate. Some of them were just watching. They follow similar techniques in regard to instrument handling and use of a scrub tech and anesthesiologist. However, sterility is extremely questionable in my book considering the open doors, people coming and going, dirty things placed on the floor,...

Room in the hospital is a great problem. We were in Ob/Gyn where the hall was lined with women on beds. In a open room to the side there were about 8 women. The birthing room also holds the babies so many people are coming and going there as well.

Thats all for now. My time is up in this cafe. :)

C.R.I.T.

Heres just a highlight post about our visit to CRIT last week, a center for disabled children. It was probably the most amazing facitily of its kind that I have ever seen...and I made many little friends and got a few wet kisses and hugs out of it too. :) The center has physical therapy, occupation therapy, water therapy, several specialists offices (orthopodology, neurology, urology, orthodontology, genetic counseling), art center, and so much more, all in a very nice builiding with very nice staff and happy kids.

Mitla para La Reunion

This past weekend was the highlight of my trip so far! Saturday at around 1 pm, 6 classmates and I found our way to the taxi center in Oaxaca, and caught a taxi to Mitla for the day. I had told them earlier in the week that I wanted to visit Mitla because that is where I have friends from church that I want to meet. They all decided that they wished to join me, and so off we went in our diesel maroon and white taxis! The trip cost 50 pesos each if I remember correctly, which roughly comes to less than $5 (40 minute trip). I had received a text message saying that the location I wanted to ask for was La Puesta Numero 50 al mercado, which I found out was the spot within the large market where I would find my friends. I met two kids there, the son and daughter of the friends I was looking for, who spoke no English. Our communication required a lot of hand signals, dictionary use, and headaches on my part. I finally grabbed a schoolmate for translation and found that they wanted to show me their house! So I went to their house, where I met their grandparents and darling shaggy little dog. This led to more headaches and miscommunication with my inability to speak Spanish, but learned that they invited me to stay the night! So long story short, I stayed the night in Mitla at their home, and my classmates went back to Oaxaca, slightly concerned that I was spending the night with some people I had never met. It was so special! Claudia and Carlos have meetings, special meetings, and conventions at their home. Being at their house and being in meeting (even though I hardly understood what was being said), was like going home for a moment. :)
La Clinica
Today was our last day at Centro de Saludad Numero 2 and by far the best for me. This is because I attempted more communication than I have other days, possibly because I have learned a few more words and conjugations. I got to be a bit more involved in office visits and exams with Doctora Liliana, and this was awesome. I havent had the chance to be as involved in the clinic as I would have expected, but not in a bad way because this means there are many well-trained Mexican medical staff doing their jobs. I would say that the health center we have been visiting is more organized and up to par than some of our clinics in the U.S. The nurses are very knowledgable and organized and nice. If you would like a comparison to American medicine, it seems to be about the same, but somewhat outdated (ie moving back about 8 years in time) but this is only because of the lack of funding as far as I can tell. This Fridays lecture with our director Dr. Tenorio is about the Mexican Health System and at that time I will be able to tell you more.
TOMORROW
Tomorrow will be a new opportunity in CRIT, Centro de Rehabilitacion Infantil, for one week. This is a Rehabilitation Center for Children with Orthopaedic problems. From what I hear, it is awesome, and Doctoro Tenorio says we will be amazed and find that we dont have something like it in the U.S. From what he said, the center has changed local societys perspective of families with disabled children so that the children and their families are accepted and able to go out in society and lead happy and good lives. Im excited to see it!
This is all...but I have posted all of my pictures at picasaweb.google.com/christianne.cobb so you are welcome to sift through those if you would like. Sorry theres so many but I dont have time to sift through them.
Buenas Tardes!

House Calls in the Mountains

I hope to post pictures about this shortly, but I just wanted to write very quickly about the exciting experience one other classmate, Priyanka, and I got to have yesterday. We were sent with a nurse/secretary of Centro de Saludad up to the rural parts of Oaxaca City to give vaccinations to small children and babies that are due for treatment. Vaccinations are given to children for free in Oaxaca, and I have not yet been able to ask who pays for it...whether it is the government or ? Each child has a health card indicating what vaccinations they have had. So we had a list of about 12 houses to visit and a map. We went hiking and walking about on dirt and mud roads on steep hills amongst houses made of sheet metal and cardboard, with dirt floors and sheets for dividing walls. We got to go into a few houses to give the vaccinations, and other patients were not home so we left notes at their doors saying that they need to come visit El Centro de Saludad No´ 2 where we are working this week. I did not give any of the vaccinations because I don´t yet speak enough spanish to communicate well with the nurse and give her confidence that I am able to do that, but hopefully in future weeks when my Spanish improves I will be able to get more involved! :) PS: The view was beautiful...we could see all over the valley where Oaxaca City is situated.
Also, we found out today that we get to go on another housecall on Monday before we leave this clinic! Hopefully we will be a bit more prepared for such an awesome adventure :) Woo hoo! Tonight we find out where we will be studying medicine next week.

Photos of Oaxaca

Santo Domingo Cathedral

With Andrea (Switz) y Jessica (oax)

Peppers at one of the Mercados! Maybe the Tisdales should start growing this size of peppers too? :)

Mi casa! On the left side

A Quaint Door Handle! (This picture is for Christine)

Im gathering a collection of quaint door photos because there are so many!

This is all for now. :)

Miercioles, la dia numero 5 de Oaxaca

Buenas Tardes,
Post #1 on Day #5! Im sorry to say that my posts are going to be scarce because I have very little time free... and the time that I am not doing school, or clinic, I feel that I should be studying Spanish... but I have only found one time so far to study..and instead ended up spending it watching the Espana vs. Allemane game de Futbol because my British housemate was greatly engrossed and kept exclaiming loudly. :)
To answer a few likely questions in short, heres a hopefully brief rundown. Please excuse any missused letters because I am using a Swiss computer. (yes..living in a Oaxacan house with British and Swiss and Oaxacan girls.. very interesting!).
Medical Experience: Yesterday was my first day and it was... frustrating and nerve wracking. The kind doctor in charge, Dr. German Tenorio met us at the hospital where he works and drove us to the site where we would work (we being me and one other girl with CFHI). There are 8 of us total, all girls, 6 from the U.S., two from Toronto. We will have week rotations at each site. This week is at Centro de Saludad N2. Outside there is a waiting area, and inside there is a waiting area. If I understood correctly, the clinic is open 24-7. There are several doctors, and a vaccination area where babies and others go for treatment. There is also a bed there for suturing, casting, etc procedures. After meeting the head doctor in the facility, (and understanding almost none of what was going on) I was taken to a room where the doctor and nurse were seeing a patient and told to observe. I sat there for about 4 hours watching patients come and go, having little idea of what was being said until exams and tests were performed. I was unable to say much, particularly when asked what type of student I am because there is no such thing as Phycian Assistant in Mexico. The doctor was a young woman. Some things I observed I think:
man with kidney infection treated with antibiotics
Woman with contraceptive implant in her arm (yes.. that was a new one for me)
Toddler with intestinal problems treated with antibiotics
Elderly lady with discolored skin due to skin disease (think Michael Jacksons disease)
Elderly lady who fell and injured ribs, elbow, knee
Couple with a new baby
Today I observed some vaccinations with my classmate and then was sent to observe another doctor. Im not sure how Im so lucky to always get to watch the consultations (particularly because shes the medical student and Im not) but anyhow, this doctor was an older woman. She was kind and lent me a book of Spanish Medical Terminology and let me read the charts. Something to observe is that all equipment is outdated compared to the States. The doctors use a type writer to write their reports and prescriptions, but I think this is actually better than even some doctors in the states that still use handwritten charts. It takes quite a bit of time though. Tomorrow I am to arrive at 8 am and I understood from the other student that the head doctor of the facility is going to be showing us some things.
Living situation: Its great! I have a simple room in a house owned by a Oaxacan lady and her three daughters, who are around 25, 22, and 16. One works at a university in town, has a degree in Psychology now working in administration. The 22 year old is a medical student here! I need to become better acquainted with her. The mother, Claudia, is a wonderful cook, very kind, and runs a little restaurant in the house at lunchtime (thats how good it is!), and also I understand caters some parties as well. I learn the most Spanish from her because she speaks no English. My housemates who are also Spanish students are are really great and I would be lost with out them Im afraid. Both speak much better Spanish than me and one has lived here before so she has really helped me find things and shown me around...and right now is letting me use her laptop. The highlight of the house is un perro loco de nombre Tasha! She is truly loco, especially at night. Last night two of the girls and I went for a run at the park nearby. After giving her a good jaunt, I thought I had worn her out because she was chewing on her leash! But no, we came home and she proceeded to act crazy. The most commonly heard exclamation in the house is Ah Tasha!! She definitely has character.
School is Monday through Friday, 5 to 7 pm. Its barely anything and since I dont have other time to study besides actually attempting to speak, I dont feel Im using it yet. tomorrow I have scheduled a private lesson for 1 hour. I hope that will help some. :) School is about 8 minutes away, and the walk through town is unbelievable. Passing the historical Santa Domingo church and famous pedestrian streets with brick. We learned today that Oaxaca has been established since 1520 and because it is surrounded on all sides by mountains and rivers, the original establishment has been changed very little and for that it is very valuable for the culture that has been maintained.
What else to say? I feel safe here. Obviously we need to be cautious anyhow, and there are some pickpocketers. However, the people here are kind and they are not a staring culture. They dont seem to care too much about looking at tourists. In the clinics the patients are interested to talk to me and ask about how I like Oaxaca and where I come from, but it is in a polite friendly manner. I understand from the locals that in past years there have been some problems with drugs, but the police are very good and keep that problem away from our area.
This is all for now... This weekend I have plans to go to Mitla and have a tour by Carlos y Claudia, the friends that I have yet to meet! Mitla is an area of old ruins.
Hopefully I will post pictures shortly.

Thanks to My Supporters!

I have been pleasantly surprised by the amount of support I am receiving for this trip. Just this morning I received a call from the supplies department at Arroyo Grande Community Hospital to find out what supplies I would like for them to pack up for my trip! This was all thanks to the hospital CEO Rick Castro. So (security and customs permitting) I will be going with a nice supply of gloves, sutures, stethoscopes, sphymomanometer, benzoin, thermometer, hand sanitizer, wound wash, arm slings, etc. In addition to AGCH's support, I have received tremendous help from my boss, Dr. Fow. He sent me off from my last day of work yesterday with a well equipped pack including nice medical tools for wound care, suture removal, blood pressure monitoring, suturing, laceration, etc.
My last night in SLO (yesterday) was spent on the mountain peak above Avila at dusk. It was gorgeous! We truly live in one of the most beautiful places!