Monday, June 11, 2007

From Panama to Tampa

This is us ready to go back to Tampa. Something funny to remember.....we always had to wait on the bus for people to be ready. This morning Dr. Cadena asked us to be ready by 10:30am and everyone was ready to go back home by 9am. We got to the airport around 11am and waited patiently till they started boarding the plane at 1:10p. We arrived to the Miami airport around 5:40p. We spent a long time going through immigration and customs then we headed to Chilli's where we had dinner together for the last time.

We finally left Miami around 10:40p and made it back home in 30 minutes (Waooo!). On arrival to the Tampa airport, we were the only ones on the plane applauding after landing. It feels nice to be back home!

Friday, June 8, 2007

Day 19: Our last day in Panama

Today we went to the University of Panama to do a presentation on the Panama's health system. We were divided in 5 groups: The healthcare system, Rural community health, Pediatrics, Women's health and Mental health. These presentation were presented to the University of Panama faculty, students, and the dean of the College of Nursing. They said it was great and that they liked it very much. They welcomed us to come next year and are very excited about coming to visit USF in November 2007. After that we headed to Albrook mall to do our last minute shopping and have some lunch. Then we went home to pack and then get ready to go have our last dinner together in Panama.

We had dinner at a restaurant on the causeway called "Pencas". Dinner was great. After that we spent a few minutes deciding on whether to go out clubbing or come back home. We were so tired we ended up coming back home.

We listened to some music, danced, chit chated then jumped in bed and went to sleep. We are all very excited about coming back home tomorrow.

Thursday, June 7, 2007

Day 18: Ciudad Del Saber/Hospital de Punta Pacifica

We started off our day this morning by visiting Ciudad del Saber’s (City of Knowledge) main office. There we learned about the history of the Panama Canal and how it relates to the economic growth of the country and the country’s future plans for expansion.

We then visited the UNICEF office which was just across the lawn. An employee from the facility presented a powerpoint on HIV/AIDS and how it affects the young population. It was a very interesting and informative lecture. We also got to learn about UNICEF and their goals for healthcare. We concluded our visit with a tour around their building.

Since we live at the City of Knowledge we were able to go home and rest before we set out on our next visit for the day. Our next stop was Hospital de Punta Pacifica, a branch of John Hopkins International. The staff members took us on a tour of their newly built digital technology hospital. The hospital has only been open for 1 year. Hospital de Punta Pacifica was quite impressive. Each room is catered for the specific patient. For example, pediatric patient rooms and consultation rooms are designed specifically for children. The patient rooms for the Labor and Delivery ward were amazing! They are all designed as suites with differences in painting in each room. A mere $1200 for 3 days and 2 nights of luxurious living peripartum.

The day ended with dinner and class discussion at my villa. We made fried plantains, red beans and rice, salad, broiled chicken (with a Hispanic twist of flavor), and fruit salad for dessert. The days are quickly winding down, but we are all pretty excited about coming home.

Wednesday, June 6, 2007

Day 17: Boca La Caja, Mobile Clinic

Today we arrived at 8:45 am to the health center at Boca La Caja and were broken up into five groups. Three groups went door to door inspecting for Dengue and risk factors such as standing water. A fourth group inspected a factory while the fifth group stayed at the mobile clinic. One of the groups that went door to door found that of the ten houses, only six passed the inspection. Of the four that failed one received a $10 citation which they will have to pay to the health center, Boca La Caja. The house that received the citation had three of the four stages of mosquito larvae. The fourth stage is the actual mostquito, itself. We actually were able to see the larvae moving in the test tube. Only one other citation was written today, which didn't go over so well as you can imagine.

The group at the mobile clinic was divided into three teams, the first of which gave the following vaccines: polio, MMR, tetanus, Hepatitis A and B, Influenza, Pneumonia, Varicella, and Yellow Fever. The second team took blood pressures while the third assisted with Pap Smears inside the mobile clinic of the University of Panama, which was donated by the Spanish government. While clients waited to be seen by the student nurses and Lourdes (our Panamanian professor), elementary school students performed traditional folk dances and sang songs for the entire community and their peers. So adorable! At 1:00 pm, we finished with the mobile clinic, but we could not return to the University of Panama due to riots. The campus was even closed for security measures. We then headed to the Multi-Center Mall for lunch and some last minute shopping. We left the mall just in time to avoid the daily downfall of rain that is similar to summers in Florida. We were very happy with our "hands on" experience and learned a great deal about community health and the Panamanian culture.
Next, we headed home to our villas to shower, nap, socialize, and catch up on our studies. Tomorrow is our last class discussion and group dinner here at the villas. We are finalizing our presentations for Friday at the University of Panama provided that things calm down there. Tomorrow morning we will stay here in the City of Knowledge to learn about UNICEF and then continue with our busy day.

Tuesday, June 5, 2007

Day 16: El Casco Viejo

Our day began with a change of plans due to the potential for rioting. Instead of visiting a women's prison we went to a museum that collected and displayed historic pieces, papers, and information about the Panama Canal. We learned about how first the french then the Panamanians and finally the United States struggled against the forces of nature to build the canal which is the length of the entire United States from Oregon to New York City, 55 feet wide and 10 feet deep. Amazing! We also learned that the Panamanian railroad equipment was imported from Pennsylvania.After our museum tour we did get to see some protesters; however, they were protesting the fact that there main street of business was closed by the government for construction and they weren't making enough money to eat.

Next we stopped for 45 minutes shopping and bartering session at Centro Municipal de Artesanias Panamenas where one could find all sorts of hand made arts and crafts. This was our third and final market, but we still found some little treasures. After our shopping spree we headed for lunch on the causeway, sound familiar? Even the name of the restaurant was Bucanero's! Maybe we do miss home... a little.

Finally we stopped at the Smithsonian Institute's Marine Research lab. In addition to a beautiful nature trail complete with wildlife, they had two awesome exhibits. The first included a movie about Isla Caiba (quite far from where we are staying) which became a national park and wildlife preserve that its only accessible by boat and quite costly ($100-200 to get there). Outside exhibits taught us about the different types of sea turtles, how they are protected here, and how far they travel. The Smithsonian is able to track sea turtles via satellite, and one turtle swam from Panama threw Costa Rica and up to Nicaragua in less than 30 days! We all got to hold a sea urchin and two different types of starfish.

There was an incredible view of bay, their research beach, and the city. A large out door tank the size of a swimming pool contained many exotic fish, turtles, and some nurse sharks. What a beautiful day! Tonight we have a class discussion and group dinner. We are all looking forward to our "hands on" experience with the University of Panama mobile health clinic tomorrow.

Monday, June 4, 2007

Day 15: University of Panama College of Nursing

Today's itinerary included a visit to the University Of Panama to attend classes with the Panama's nursing students and later attend a seminar from the Quality Air and Water Department at the university. During our visit with the Panama's nursing students, we shared techniques on clinical procedures. All of a sudden we were notified that we had to leave immediately due to potential rioting at the university. Within minutes, we boarded our bus and left the University of Panama. Then shortly after departing from the university, our bus driver received a phone call informing him of the protesting due to the presents of Secretary of State Condoleezza Rice from the USA. We returned safely without incident and hopefully will be able to re-schedule.

Sunday, June 3, 2007

Day 14: Chagres National Park and Embera Village

Everyone woke up this morning with their own ideas and thoughts about what it would be like to visit an indigenous village; little did any of us know that we were embarking on a miniature journey into the heart of Chagres National Park, home of the Embera tribe. Immediately stepping off of the bus, we saw Embera males dressed in their native garb, which included basically a cloth wrapped around the groin area covered with beaded attire. I think it’s safe to say that we were all a bit shocked. However, the shock quickly turned into excitement and curiosity as we all took our seats on the long and narrow canoes. The canoe ride in the river provided fantastical scenery; we were literally being taken into the mists of the rainforest.

The Embera men guided us through the forest on a well traveled path following a large stream. None of us had any idea where we were headed, but we were thoroughly enjoying our trek and the beautiful terrain surrounding us. At one point we climbed over some rocks and saw our destination point: a waterfall with a pool below it. Right then, we found ourselves caught in a rain shower, but that did not stop us from jumping into the pool and climbing onto the waterfall.

Back in the canoes, we traveled to the local Embera village where we were welcomed with warm greetings. We were led to the largest hut, otherwise known as the “Convention Center.” We were served fried Tilapia and fried plantains in a palm leaf cone. Their leader spoke to us about the tribe and their trades, mainly basket weaving and wood carving. Their tribe is open to visitors and usually hosts tourists every day. The women performed a dance and the men played instruments including drums, maracas, a turtle shell, and a wooden flute. They also had a marketplace where we were able to buy their handmade bowls, plates, jewelry, and wood work. Some of us even got a tattoo, but don’t worry, they only last for about eight days.

Before we knew it we were back on the canoes and headed back to where our bus waited for us. I think everyone was happy to be traveling back home because we were all sopping wet, although the cold air conditioning on the bus made the trip back slightly uncomfortable.

Later on we went out to a local restaurant in the city. Some of us ordered Tapas which can be described as small plates, almost sample size of certain foods and everyone shares. They didn’t exactly fill our stomachs but they were delicious nonetheless.

Needless to say, we had a very exciting and adventurous day today that none of us will forget.

Day 13: Free Day

To wrap up the weekend, everyone took advantage of the free day. Most of us enjoyed sleeping in to recuperate from our late night out on Saturday. Our free time was spent catching up on projects and homework. Some people took a trip to the mall for more shopping, others relaxed and watched one of the three Spanish channels on the television. By the evening, we were ready to head out again. Several people had dinner at the Hard Rock Café.We took delight in the All-American food and had our fill. After Hard Rock, we walked around the mall, even though all the stores closed 30 minutes too early. We found ourselves ending up at the only place that was open, the Casino. Sandy started to play the nickel machines and ended up winning almost $15! She shared the wealth and the rest of us played off her winnings. As we left the mall, we came across a mechanical bull. Laura, the adventurous one, was the first to ride. Most of us took at turn on the bull, but we could hardly last longer than 5-10 seconds. It was all about making the memories! The night ended with a quick taxi ride home to the villas. Tomorrow, we are back to work in the Panama community.

On the BULL:






Friday, June 1, 2007

Day 12

It was off to an early start today! We all had to be ready to leave the villas at 6:30am. Our first stop was at the only children’s hospital in Panama, Hospital Del Nino. The hospital cared for children of all ages up to fourteen (whereas in the U.S it is age 18 and sometimes up to 21 depending on the Physician). It included many specialty areas and units such as oncology, burns, ICU, PACU, and dialysis. It also had an emergency and surgery room, and a place for outpatient care. We saw babies and children under all types of conditions: on respirators, with NG tubes, under incubators and ultraviolet light, and with trachs. I think the favored area was where the premature babies were because a few people actually got to pick the babies up and play with them. One thing that was interesting to learn about the hospital was that it had a school area located in it because some of the children that received dialysis had been living there for up to five years. The nurses said that the children actually became like part of their family because their own family may only get to visit every 6 months or once a year (because of distance, money, or other problems).
Our next stop was at the Nursing Association of Panama. Here we received a quick presentation on the association and some refreshments to revive us. To end the presentation our speaker sang for us. I find people in Panama to be a lot more open than people in the US.
Now, back at the villas, some are sleeping, exercising, reading, or working on projects. As for tonight our plans are dinner and maybe a movie at the mall! It should be our first adventure with taxis here so wish us luck.


Thursday, May 31, 2007

Day 11

Our day began with a trip to the Oncology Hospital. We took an extensive tour through the facility and discussed many aspects of care for the oncology patient in Panama. The hospital used to be an American military hospital, but was turned over to Panama in 1999. Cancer is the number one killer of Panamanians, but unfortunately this is the only hospital for patients to go to. Treatment options depend on the protocol for the particular cancer. One of the positive differences for patients who have head or neck cancer is the wire face mask for radiation therapy. Instead of making permanent marks on the face, doctors can use the face shield to mark the target area with tape on the shield. Another difference with cancer in Panama is the leading types of cancer. In the States, lung cancer is the top killer. For Panama, cervical cancer and breast cancer for women and prostate cancer in men are of great concern. Panama keeps lung cancer rates low by targeting kids in elementary schools (ages 4-6) with smoking education. The expensive treatment is covered by a combination of social security, the ministry of health and the institution itself. Our time at the hospital was informative.

For a lunch break, we ate at Nikos Café. After lunch we spent more time at the Universidad de Panama. While we were waiting for Ms. Lordes (our guide), the students offered their computer lab for us to catch up on email. After the lab, the students welcomed us into the classroom for an introduction and picture time. We were given a tour of their clinical labs, both the adults and women/children's. We also discussed our plans to visit again on Monday.The university is so welcoming and we look forward to strengthening our ties. As a parting gift, we were presented with a cake and key chains. We used the cake to celebrate Sandy’s birthday. Right before the birthday party, we had a brief class discussion. The day ended with the party and an early night to bed in preparation for an early day tomorrow!

Wednesday, May 30, 2007

Day 10

Today we began our day visiting the Santo Tomas Hospital. We spent our time in the maternity center. It is known as the most popular hospital for patients who have no insurance or little money. It was different than the hospitals of the United States in that there were no private rooms. All the patients shared a common area with 50-60 beds per floor. One of the more interesting floors we visited was the high risk pregnancy floor.

The highlight of our day was the labor and delivery experience. We were all fortunate to have been able to see the birth of a child. The hospital was very busy and it was a challenge to get us in but the nurse managed to find a place for us. We all went in groups of about 3-4 students per delivery room. The first two groups of four students witnessed very quick deliveries and the final group had the opportunity to watch a lengthy delivery, placental removal and the suturing of an episiotomy.

In the postpartum period the hospital emphasizes a lot of health education about breast feeding. We passed by a section where mothers are taught to breast feed and care for their newborns. Our maternity clinical day exceeded our expectations because from the beginning of our trip we did not anticipate being able to observe the labor and delivery process.

After the hospital we had lunch and some people did laundry. We then headed to the Pan American Health Organization (PAHO) in the City of Knowledge. This agency functions as the disaster relief program for the Americas. PAHO is the regional form of the World Health Organization. We had an interesting presentation which focused on PAHO’s role with hospital disaster management.

The day concluded with a quiet evening spent at our villas.

Tuesday, May 29, 2007

Day 9

We started off the day at 8:30 a.m. and headed for Panama’s only mental health facility. Unlike in the U.S. the institute had a variety of interventions in treating their patients. The five areas of focus were: therapeutic gardening, self-image/self-esteem building, art therapy, psychoeducational groups and occupational therapy. The art that some of the patient’s created were for purchase and the money raised went back to funding the mental health center. Some of the art was very impressive, it looked professional. As for the self-image/self-esteem building, patients are encouraged to participate in manicures, pedicures and hair styling. Among the many addictions treated, gambling was one of them. The focus seems to be that they want the patient’s to go back to there families after the 30 days treatment. Just like in the U.S., medicine compliance is a problem. Not for financial reasons, but because the patients believe that that their conditions aren’t chronic and that after therapy they are cured.
After, the mental health institute we stopped by the grocery store. Tonight it was Amanda W., Mary, Jolene, Brittany and I’s turn to cook for the group. I wish that I could have helped more with dinner but couldn’t due to there being a respiratory infection going around. We made Tacos and attempted to make rice, but the rice turned out a disaster. However, the rest of the meal turned out great, everyone enjoyed it and overall it was a good group effort.
Towards the end of the night, Amanda and Brittany had trouble with their laundry. Since there is only one washer and dryer, another individual took it upon themself to take their clothes out of the washer and dump them on top of the dryer. They were not very happy campers and will be up late tonight making sure that there laundry gets done properly.

Monday, May 28, 2007

Day 8

We started off our day with breakfast at the El Valle restaurant and some last minute shopping at the market. I must admit, it was nice to buy fruit this morning for 5 cents. After that we packed up, left the hotel, and went to the only clinic located in El Valle called Centro Materno Infantil de El Valle de Anton. Some people travel from 6 hours away just to go there! There are only two doctors and two nurses for the whole clinic. One of the things we learned while at the clinic was that there is no health prevention or health teaching for the community as of yet, but it is one of the goals they are working toward. We were also able to see Kevin, a new baby just born at the clinic 5 o’clock that morning with his mother. We learned at the clinic that they only do natural births because there are no types of anesthesia available. They also have to send mothers 45 minutes away to another hospital if they have any complications with their delivery. After the hospital we went to a nursing home, Casa Hogar, run by a local church. Everyone found it interesting because it was run very different than any of the nursing homes in the US. The church members would actually go out into the community and find older people that needed more assistance than their families could provide for them. They would then ask the families permission to put them in the nursing home and provide extra care for them. For the people of El Valle it was free. The residents of the nursing home consisted of 7 men and 2 women who all shared the same room together. After the nursing home we all had lunch together at Sla Librada. The dish of choice was mostly Sancocho, a popular Panamanian style soup with chicken, yucca, and cilantro. I can say the Sancocho was good, but trying out new things here has definitely been an adventure! After that it was a two hour bus ride out of El Valle and back to the City of Knowledge. It is good to be home :)

Sunday, May 27, 2007

Day 7

We had an early morning start with our day that consisted of visiting a quaint mountain village. The drive up to el Valle took two hours of snoozing away the miles. The highway from Panama City to the mountain village was flat and straight. When we entered the foot of the mountains, the roads changed from calm straight-away to a zigzagging, body shifting nightmarish drive with a beautiful backdrop of mountains with clouds melding with the peaks and forest covered mountain sides.
Our instructor had warned us not to expect too much of the hotel that we were suppose to stay over night. However, when we arrived at the hotel, it was much better than we expected. It was a three story building with vibrant colors and its own restaurant. The rooms were small, but decorated with the local artworks (tree trunks with pictures of birds in flight). Some rooms had two beds while others had a queen sized bed and a bunk bed that roomed three people. Located on the third floor was a rooftop patio, half-covered by a roof and the other half was open to the sky. Under the roof covered area were multicolored and very comfortable hammocks, hardwood tables and chairs. While standing on this rooftop patio, you can appreciate the full beauty of the small community within the mountains. You can almost feel the mountains looming above. One specific section of mountain peaks was a main topic by the people in el Valle. They say that the mountain peaks resembled a woman lying on her back with one arm resting on a side of the mountain and the other arm supporting her head on the ground. Some of us saw this woman, but others could not.
The village had many things that you could visit, for a cheap price. There was the zoo that contained many indigenous animals from panama; animals ranging from avian species, reptilian species, and some mammals…some of Panama’s flora were also included in the exhibits. The only disappointing thing about the zoo was that they advertised a golden frog, with all the walking we did that day throughout the zoo; we did not see a glimpse of this supposed golden frog. The admission cost for the zoo was only a dollar, which balanced out the disappointment from not viewing the golden frog.
Another activity we truly enjoyed while we visited el Valle was the zip line above the rain forest floor. Twelve of us decided that we would do the four lines, which were so high above the ground that we had to drive up the mountain and walk 10 minutes within the forest to reach the first pad and pay $47.50 to experience it. The scenery within the forest was surreal. We even saw those ants that chopped up leaves and carried them in this single filed line from a tree trunk across the path to another tree trunk. Amazing! Something that is usually seen on television came to life before our eyes during a great adventure within the forest. Another amazing event was the waterfall we were able to take pictures of while we hung hundreds of feet above the river bed below us. That was a truly breath taking view of the waterfall while exhilarated with adrenaline.
And then, the group was very excited to jump into the “hot springs” for some relaxation after the exciting flight through cable within the forest canopy. I must say that the best part of these hot springs were the volcanic face mask that cost a dollar, the .50 cent admission price, and leaving the hot springs! These springs were pools of dirty brown water layered with body gunk. You could not even view the bottom of these pools with the use of the Hubble telescope.
With that being said, our experience over all was great! After a full day of fun, we all sat down for a great dinner at the roof patio while accompanied with all the bugs of Panama. And tomorrow is another day of adventure and fun.

Saturday, May 26, 2007

Day 6 - Monkey Island

Well, today was a pretty relaxing day. It was a wonderful
day to sleep in and get some much needed homework done. We left for the Gamboa Resort at 12:30 this afternoon. When we arrived to the beautiful resort we had some time to walk around and admire the gorgeous view of the rain forest surrounding the Panama Canal. Several from the group went and ate at the Resort's restaurant (which took an incredibly long time and made them nervous about missing the boat tour) while several others walked down by the canal and explored. We then took a shuttle to the docks to load up our boat. When we got all of us on the boat and headed out the engine stuttered a little bit. We had turn to turn back to the shore while they fixed it pretty quickly. Then we were off to Monkey Island. It was about a twenty minute boat ride through the canal out to the first island. We saw several White-faced monkeys in the trees.

On the boat, ready for our adventure!

The tour guide would make a calling noise and eventually they jumped down onto our boat. The cutest was when we saw a mother with her baby on her back. They came onto the boat and ate food from the guide's hand. After leaving that island, we went to a different island to see the Howler monkey. We could not approach this island because the Howler monkeys are more aggressive, so we just saw them from a distance. After our rainforest adventure, we headed back to the house to work some more on projects, readings, and laundry!

P.S. Our internet is struggling so we are having some troubles posting (especially pictures). We will get the posts up as we are able! Makes us a little more appreciative of our wonderful technology back home!