Friday Night? Party at Hospice

Great news: we are almost done with our paper. Bad news: we aren't actually done with our paper.

With less than a week left, we are busier than ever. A group of doctors, nurses, and assistants just got here today to do hernia surgeries and some other stuff; we plan on working with them for much of the week (when we aren't giving presentations and doing final evals...). That means much less if any of our usual ventures to hospice, homes, and Pro-Life. Despite being way burned out on hospice, I realized I am actually going to miss seeing those patients. Luckily for me, we ended up having a mini fiesta at the hospice last night... to be honest my initial thought was that I would never be able to eat anything there (cake is at all fiestas) because of the various aromas and duties I have experienced there. The patients that were able (4 of them) came out for cake and music. Felix (he was pictured in a previous post) was absolutely loving it!

I would like to introduce you to Manuel:

He frequently yells, it drives some of the other patients loco. Really adds to the mood of the place.

Week 1: Manuel hits us every time we try to take his blood pressure or temp.

Week 2: We realize if we threaten to tell Padre Joe he sort of listens.

Week 3: Manuel is entirely inappropriate & sassy. But he is blind and can't walk so not threatening.

Yesterday: While I was at hospice in the morning we sang songs (he likes Call Me Maybe & La Cucaracha) At the fiesta he danced with me! (note how tall I look)

After our wild Friday night out, we had a relaxing morning at the spa... sort of. For reasons that will be forever unknown, we visited a "spa" at 9 in the AM. First the lady just talked really fast Spanish for like 20 minutes. Then we all stood up and did what was supposed to be Tai Chi and yoga. I usually like that kind of thing, but this was just weird and confusing. Once we were finally done with that we thought "oh well at least that's over with"... so wrong. We got put into separate areas and had "massages." Some of it was good, but the bad was just too overwhelming. We were put into weird positions and rocked/shoved back and forth. Some girls suction cups stuck to their bodies, others had to hold TENS units in their hands (these deliver a small electrical shock, often used for pain reduction) for "relaxation." It's all about experience I guess.

This afternoon we had off just to work on papers, a lot of progress has been made!

Here's some pictures from the last few days...

Anybody looking for a baby? She is looking for a family.

Braiding on a home visit. This patient had a positive Trousseau's sign (flexion of the hand/wrist when I inflated the BP cuff), which could mean she is very low on calcium.

More home visits

A couple nights ago they surprised us with a little "thank you" party. The dining room was decorated with blue and gold. They sang us a song and gave out cards to each of us. It was very sweet, some people cried. It's going to be hard to leave on Friday!

Papers & presentations are Tuesday night at 8 PM, so I will probably not post until after. We are all hitting the point of being a little homesick, but I think we're also going to be sad when Friday morning comes. I am already dreaming of how I'm going to sit in the Starbucks in the Lima airport for 13 hours...

¡Hasta luego!

-Hope

No mas violencia!

As predicted, my actual free time is starting to decrease a lot due to homework. Yesterday was my teaching project day (we were assigned dates on Sunday). Like I mentioned awhile ago, I had been planning on talking about violence against women. Initially, I was going to focus on sexual assault since that is where my knowledge mostly lies, but after being here for awhile I realized intimate partner violence (which can be a combo of physical/sexual/emotional abuse) is one of the biggest problems. This is not an easy topic to discuss in this “machismo” culture- where men are dominant and have power/control over women. While violence/abuse is not condoned, it is also rarely publicly discouraged. Then you add in the power and values of the Catholic Church in Latin America (where divorce or permanent separation are usually opposed) and you get a very delicate situation. I really did not know all this when I signed up to talk about this in May. I had to give the presentation in Spanish, which was hard but manageable. The main points I wanted to get across were that abuse is not OK and that there are resources the women can use to escape a violent situation (free legal, medical, & psychological services in addition to Casa Maria). I gave my talk and prayed with them, but no one had any questions... it was very quiet (another thing I expected). I had absolutely no idea if anyone was understanding what I was saying or not. When it was time to say goodbye, we hugged and kissed everyone. Two different women whispered thank you in my ear and said they needed to get help from the church- one was planning on heading over to the parish next week. If even one person is thinking about getting help, then I am thrilled I chose this topic and gave it a shot.

45% of women surveyed in Peru have suffered some form of intimate partner violence.

 20% of girls age 10-15 are sexually abused by family members or neighbors.

Clinical has been going just fine, but since we do a lot of the same stuff I've already talked about (hospice, home visits, clinic, midwife, etc.), you probably don't want the play by play of every single day (unless maybe you are my mom or nama). I had an interesting afternoon at the Pro Life clinic today- our first patient was a woman pregnant with her 2nd child, she had her 4 year old with her. Never in my life have I seen such an energetic kid, and that is really saying a lot. The exam room is very small, and contained 4 adults + him. He slowed down a little to see his hermanita on the ultrasound, but otherwise was a bull in a china shop! I ended up taking him into the hall... literally I was running at my full speed to catch him as he ran back and forth. His mom was actually taking him to the psychologist because she said he had no self control, aka ADHD. We also did some counseling on natural family planning and saw a newborn baby.

This evening was yet another fiesta in a village. Officially it was for the church group that is currently here, but today is also LISA's 21st birthday! Lots of dancing & confetti. And more cake- everyone is so concerned about me losing weight while I'm here, but I really have more cake and ice cream here than I do back home so it's really not going to be a problem!

In other news, I have decided to adopt a family. This means I will give a yearly donation that will cover a good portion of their food, school supplies, or other needs. I also hope to be able to write to them. I haven't met them yet, but will post pictures when I do.

This is the family Marquette sponsors- Christian, Erika, Jessica (named after a student), & Kiara

This is baby Maria- she is 3 months old today! She & her mom live at Casa de Maria

I have high hopes for the next few days being very productive as far as our aggregate project, so I'm not sure when I'll post an update again. Also, all my pictures are on facebook so if you want to see more look me up! Buenas noches!

Casa Maria y Construcción

Saturday, July 7-
The group of 50+ high schoolers left early in the AM. It is now peacefully quiet, which is strange and kind of nice. There is another group of missionaries from Oklahoma that arrived today, but they are all adults and there are only 15-20 of them.
This morning, we got a good start on our aggregate project. For the project, we take a specific population (through a parish organization) and learn about them so that we can appropriately determine interventions to improve the wellness of that group. This culminates in a 25 page paper & presentation on July 17 (in 10 days, yikes). Our group of 5 students is doing our project on Casa Maria, a transition home for young girls and women who are victims of domestic violence. Casa Maria houses two floors of young ladies- one for university students to live during their schooling (1-2 years), these girls mostly come from Madre del Redentor (the girls' home I talked about in a previous post); and one for women who need shelter from domestic abuse (for a couple months, longer if they are pregnant). While the community knows that Casa Maria exists, few know its location for safety purposes. One woman who has been there for a couple months is totally unable to leave the home because her husband is out looking for her and lives nearby. The women are responsible for cooking and cleaning, but have financial help. They receive all of the parish's free services- especially legal, psychological, and OB/GYN stuff. A lawyer and psychologist visit Casa twice a month. My initial thought is that they need way more psych support than they are getting... support groups? coping technique training? meds? PTSD management? We still have lots more to learn and research.

Also, we helped one of the moms give her little baby a bath :)

Some of the women/children and director of Casa Maria

We officially had this afternoon free. However, some of us heard that there were some food deliveries and a clothing drive, so we wanted to go with social services. In the end, we ended up at a construction site, building a chapel in La Legua. At first we were absolutely no help, but we all ended up doing some hammering walls and pouring concrete floors. 

How the chapel looked by the end of the day

The fun part of the day was playing with the kids in the area. The scary part of the day was when a 5 year old was bit by a wild dog. From a distance, we heard a scream and looked over to see the dogs way too close to a little boy. He had been running around playing and they chased him. We headed over to make sure he was OK... The dog bit his leg and broke the skin. I cleaned it as best I could with the alcohol wipes available (this wasn't a clinical day so no one really had supplies), put some bandaids on, and told him and his family he needed to go to the hospital to get a shot for rabies. They asked if it was "the pink medicine that goes in your tummy through a needle." So apparently this isn't an uncommon thing in the area- I looked it up after we got back, the vaccine is indeed hot pink and used to be given on the abdomen so as to give several injections in several spots. A few other kids had scars from dog bites. Who knew I would learn something when not in clinical?

 I know I post like a billion pics of Peruvian kids, but they are just really cute.

I am now officially up to date on blogging and am ready for bed, we get to sleep until 9 tomorrow!

¡Buenas noches!

Catching up

I apologize, I realize I'm a few days behind on blogging! Just a heads up- we legitimately have homework now so I'm thinking this might be a consistent pattern.

Thursday, July 5th-
Lauryn & I were in the Pro-Life clinic Thursday morning. A nurse named Cecilia sees patients here all day- many patients are pregnant or in between pregnancies, but we have seen a couple older women post-menopause. I have had a few OB  rotations here now, so I'm starting to feel pretty comfortable with finding baby's heartbeat, understanding what I'm seeing on an ultrasound, and determining the baby's position in the uterus. There is almost no concept of birth control here, as there is no separation between church & state (Peru is very Catholic)... many women have lots of babies very close in age. Unfortunately, it is also very common for fathers to abandon the pregnant mothers, especially if they are young. Cecilia serves as a huge source of support for these women, and refers them to psychological services if needed. We spend a lot of time at the clinic preparing women to be mothers.

Cecilia & I at the clinic

Listening to heartbeat- this baby was all the way on his mom's right side and moved around a lot!

(Don't even pretend you aren't jealous of my animal scrubs)

In the afternoon, more home visits. I'm amused at the things I'm starting to consider normal, such as:
-Chickens running across my feet while I'm taking vitals
-Having to walk around dog fights
-Nothing being clean, much less sterile
-Killing bugs myself
-Blood pressures over 200
-Muchos besos (kisses)
-Everyone wanting me to hold their child
-The paparazzi (everyone taking pictures of the gringas, which is actually an endearing term here I guess)
-Trudging through dirt and sand to get to a patient
- Bug spray as perfume 24 hours a day
I'm sure there are more, I'll add to the list at some point...

Friday, July 6-
We only had clinical in the morning on Friday, and class in the afternoon.  I spent my morning translating for a pediatrician from Arizona. This was interesting because I am still not fluent, especially in medical terms. We made it though, with a little help from a Spanish-English dictionary. My brain was definitely in overdrive from 9-1. By the end of the day I was getting much better than at the beginning. I have added lots of words about breastfeeding, vaccines, cold/flu, and child development to my vocabulary. Shoutout to my 2-year-old at St. Francis Children's Center (I volunteered there last semester) whose first language is Spanish: I appropriately used "kaka" many times (which means poop) thanks to her. I frequently heard "Hope, I kaka" during these last few months.
We mostly saw colds with bad coughs. One girl had recently had toxoplasmosis and came in to make sure she was still doing well. A lot of patients come in with a stack of papers of labwork done elsewhere for us to interpret. A baby came in with hand missing some bones- we took pictures to send to a surgeon who is coming down in August.
Another interesting case was a girl whose mother brought her in because she hadn't been talking much, especially for her age of 7. The ENT (ear/nose/throat doctor) removed some lovely chunks of earwax, so maybe it was partially a hearing problem which is what he thought. The psych major in me is kind of convinced she may have autism... 1. Her mom says she prefers to be alone when I asked if she plays with other kids at school or home. 2. She seems to hear and not respond to her mom. 3. She began talking at a normal age and was using sentences but no longer seems interested in talking. 4. She seemed more fixated than normal on playing with her fingers during the exam and didn't look us or her mom in the eye. OK maybe this is only an interesting case to me. And maybe I am wrong and have taken too many psychology classes/service learning (only one more til I'm done with the psych major).

4th of July

This year was the most I have celebrated the 4th of July ever, and I wasn't even in the U.S.! The kitchen/dining room was decorated red, white, and blue when we came down for breakfast.
We started off our day with a fiesta at a local school. The little kids formed a huge receiving line, they were all waving American flags and cheering when we arrived.

The kids (age 3-16 I think) put on a show for us with singing (Proud to be an AH-MEH-REEE-CAHN, national anthem, etc.) and traditional dancing. The highlight for me was the last act, where a group of 5 year olds dressed up like cowboys/girls sang and danced to Old McDonald in Spanish. It was sooo cute! I do have a video of it but I'm having trouble getting it to upload.

Even though it was a holiday we still had clinical in the morning and afternoon. Once again I was at hospice and did some home visits. Some of the patients at hospice are now recognizing us and are happy to see us. While hospice is probably the most tiring for me, it's good to see them when we go. One of our patients (a 22 year old with severe & multiple disabilities due to prenatal drug abuse) who is often fairly unresponsive gave us a huge smile when we got to him! He really likes when someone holds his hand. 

This is Felix- he loves having his picture taken. He is very happy hanging out listening to his radio all day. He has cerebral palsy and lives at the hospice because he requires too much assistance to live alone.

This is the hospice courtyard. The patient rooms surround this area like a square which you can kind of see on the left. All rooms have cement floors and would probably never pass a JCAHO inspection.

We did some wound care on home visits, always interesting. An elderly man with either epilepsy or Parkinson's (I know these aren't even close to the same thing but all we got was a description of symptoms) had taken a bad fall and sustained cuts on his face and legs. Hypertension, hypertension, and more hypertension.

Mass on the 4th was a healing mass, which meant doctors and nurses got up and prayed for the sick and had a candlelight vigil. The church was packed (which is really saying something because it's huge).

After mass, we headed to ANOTHER fiesta for some dancing and fun. In other news, I ate a burger and fries last night. Very American, very delicious.

Holy crap!

Anyone remember when the answer to one of Kevin Siebenlist's questions on a biochem exam was holy poop? This was my morning at hospice with Lauryn. We spent much of our time with a patient named Guadelupe. She had a stroke a while back and is paralyzed on the right side of her body. Additionally, she has lost much of her mental capacity. She currently has pneumonia and is receiving end of life care at the hospice. We got to use some of their masks (which are very in demand and limited) as it is possible that she has/had tuberculosis. Sadly, she has to have restraints on all the time because she pulls out her NG tube. She does have a urinary catheter but is incontinent of stool. When we got to her she was very soiled, as was her bedding. As a nursing student I have dealt with a fair amount of incontinence, but for some reason today takes the cake for one of my grosser experiences (including when I had to take a c.dif stool sample). Other interesting experiences at hospice include being swatted at by one of the patients while trying to get a blood pressure, more background recorder lessons, and lots of besos.

Mototaxi ride to get to clinical- this little cart is attached to kind of a mini motorcycle.

In the afternoon we went on more home visits. We were mainly doing blood pressure screenings. A lot of the people we saw today bordered on being hypertensive, so in a couple days someone will be back to take BPs again. I was feeling great since I'm like normal height here (Peruvians are pretty short!) until once again I was told by a patient "You could be 15" in espanol. I am 21. No big deal. Anyways, one of the elderly men we saw kept kind of asking us to live with him. After much deliberation, we figured you would all miss us too much if we stayed in Piura. Oh well. Our last visit included giving an older woman a haircut and cutting nails. She lived with several generations of family, and they were very inviting and wanted to talk and take pictures of us. So inviting that they gave us some homemade juice to drink. It's super rude to decline when offered food/drink. So Lauryn & I are kinda nervous about how our stomachs are going to feel about that juice tonight. We ended the visit by praying with the family and snagging another mototaxi back to the parish.

 

Hygiene Care

  Our last patient & her little grandson! All the babies I see around are really chubby, it's great.

After dinner tonight we walked to get ice cream. They had my favorite flavor that I can never find in the U.S. (coconut)

July 1 & 2 (warning: description of childbirth)

It has been another busy couple days in Piura!

Sunday started out with a bang, or should I say an HOLAAA! As previously mentioned, 50 missionaries (mostly high schoolers) are here this week. On Sundays, we usually get to sleep in an extra hour. The new group arrived a little on the early side... but they are very nice and will be doing awesome work here, mostly building houses. They actually remind me a lot of my youth group mission trip days.

After mass, we all (as in 65ish of us) went to Catacaos, a village just outside of Piura, to do some tourist-y shopping. We didn't buy a whole lot, but it was fun to walk around and see the area.
We spent much of the afternoon at Madre del Redentor, a home for at-risk girls who are mostly 12 and up. They may be identified as vulnerable because of neglectful/drug abusing parents, an environment in which physical/sexual abuse is likely, or inappropriate behavior themselves. The girls live and go to school at Madre. As soon as we got there, the girls grabbed our hands and wanted to get to know us. The girl I spent the day with is named Blanca, a shy 13-year-old. They danced with us (Shakira & La Macarena of course), and performed local dances for us. I hope to go back to see them again soon!
Sunday night it hit me. By it I mean traveler's illness. All that careful eating & brushing my teeth with bottled water didn't do the trick. I think at least half of us have been down with upset stomach problems since we've been here.

I woke up this morning significantly better but pretty dehydrated/dizzy. I was originally put on social services for the day (which would have been building a house), but thankfully someone was willing to switch with me while I was sick. I got to go to a clinic to be with a midwife for the morning. Marisol (the midwife) taught me to do Leopold's maneuvers (feeling where parts of the baby are sitting in the uterus), measure fundal height (to see how baby is growing for how many weeks gestation mom is), find & assess fetal heart tones, and check the cervix/do vaginal exams. I am about 86% sure I want to be a midwife at some point so this was very exciting! Most of the patients were in for prenatal wellness checkups, but in another room was a woman in labor with her 3rd child. 'Precipitous labor' is an understatement. We left her at 5cm to see another patient, but the appointment was soon interrupted by a nurse frantically pounding on the door. If my Spanish is correct, she said something about how the woman was going to deliver within 5 minutes. After rushing to gown up, we got there just in time as she was brought into the delivery room. Fathers are very rarely in the delivery room in Peru, so I gave her my hand. Also, epidurals are never used unless the delivery is by C-section. The baby was born in two short pushes, it was un hijo (a boy)! My instructor & I got a little splash of amniotic fluid in the process. Not to be gross, but a beautifully intact and large placenta followed. Unfortunately, the heat of the gown and dehydration was starting to catch up with me and I started feeling sick. Faint count is still ZERO, but it was a close call (I have POTS- google dysautonomia if you are really curious).
After our siesta, I was in the Pro-life clinic for the afternoon. A nurse named Cecilia sees women of all ages here for prenatal care, wellness visits, and any problems someone may have. When a pregnant woman comes to her and is unable to take care of her baby, Cecilia assists in setting up an adoption. Ashley & I did some exams and learned more about the women in Piura. All in all good day. Again I have no pictures, a combination of my camera dying on Sunday and it being totally inappropriate to take pictures today at the clinic.

¡Buenas noches!