Day 5

Today was our first hands on experience in Panama. We started our day at 7 am and we split up into 2 groups - 10 students went to a clinic called Parque Lefevre with Dr. Johnson-Mallard and 5 students went to another clinic called Santa Ana with Dr. Cadena. Each of the clinics had different specialty areas that we were able to participate in. At the Parque Lefevre clinic we rotated through the OB clinic, Pediatrics, and an adult area doing a range of skills from injections, blood pressures, heights and weights, observing pap smears (2 students were able to perform one) and observing colposcopies. At the Santa Ana clinic the students had the same stations, but they also were able to go out into the community. They talked to people and familes in the communities, took blood pressures, and inspected their home surroundings.

There were many differences in the clinics here in Panama versus the clinics and hospitals in the States. One of the biggest things we noticed was that they do not use alcohol swabs before injections as we do. Instead they just use water to clean the area. Also, as far as the pap smears are concerned - here the nurses do the pap smear by themselves without even having a doctor in the room, whereas in the US the doctor performs them. Another difference is that they hardly ever wear gloves where as we wear gloves for everything. Mercury thermometers are also used here, as well as, the scale they weigh patients on is set for both kilos and pounds. Education is another major difference. Here in Panama the nurses seem to do a lot more education sessions with the patients one on one than we are used to.















We left the clinics around 12, and then stopped at Niko's cafe once again for lunch. We were able to come back to our Villa for some much needed downtime before we headed out to dinner.

We went to a dinner theater called Tinajas. We had a really great time. The dancers had beautiful costumes, the food was good, and we had front row seats! 2 of our students even got invited to go up on stage and dance with them at the end.















Tomorrow we will be going to Monkey Island for the day, and we are all looking forward to that!
~Melissa

Day 4

Today on our fourth day in Panama, we toured two universities, the university of Panama (a public university) and the Latin University (a private university). The public university was significantly cheaper and simpler than the private university. The private university was more technologically advanced, although their virtual lab consisted of only two beds and a dummy on which to practice skills.
Nursing school is a 4 year program in Panama. There is much focus on the community aspect of nursing as nurses serve both the general Panamanian population and the indigenous population.
At the University of Panama we had lectures from faculty and students which helped us to understand how university policies worked there and how students obtained the resources they needed in order to afford their schooling. Fortunately, we had our three wonderful translators (Sandy, Ida, and Mary…kudos!) sweating bullets to translate what all was being said!
Following the presentation we experienced the cafeteria cuisine of the University of Panama. Our food options were pollo, papas, gelatina, arroz, platinos and liver (chicken, potatoes, jello, and rice, respectively). The meal was only one dollar for a whole lot food. Most of us thought the food was good, but some were less than thrilled. Luckily for them, the private university served us food yet again! The nursing students there also pinned us at the end of their presentation. Pretty cool! Oh yeah, and at the University of Panama we got nursing caps because that is what nurses wear in the hospitals here. I’m thinking we need a group picture of us in our old school attire.
We returned to our villas to a torrential down pour. Some of us braved a run in the dark and were delighted to see lightning bugs! Then we did some more homework and went to Dr. Cadena’s and Dr. Johnson Mallard’s for spaghetti dinner. It was a lot of fun. We are very fortunate to be working under them!
Now it is time to hit the sack early because tomorrow we go to the clinics to do some hands on nursing work! Pap smears are a possibility. Until then…
*Amanda Neuman

Day 3

In addition to our technical difficulties in trying to put up pictures, I am having difficulty signing onto my blog account; therefore, I will be using my friend’s. With that said, today is our third day in Panama. Today we were able to get a little bit of a later start (at 11am). Therefore, some of us decided to hit the nature trail for our daily workout. Along the way, we even ran into our leader, Dr. Cadena, coming back from her morning walk. We went to the Arraijan clinic which is a local clinic for both insured and uninsured patients. The clinic is quite different from what you’d find in a clinic in the US. The cost for a consult at the clinic is ‘uno balboa (which is equivalent to one US dollar)’. Panama has a healthcare system where no one will be denied care when it is needed. The clinic was small, and not equipped with high technical equipment that we are so familiar with. This district had a problem with overcrowding. The rooms were situated such that there was a waiting room for all ages with all different problems (ie: there were no distinctions for chronic verses acute diseases/situations or for pediatrics verses geriatrics). The central waiting rooms were connected to a hallway with “specialty rooms (maternal health, pediatrics, vaccinations).” However, these specialty rooms were comparable to bedrooms; not the more spacious areas of the hospital we are used to in the States.
The procedures of the nurses were also quite different. For example, isolation precautions are not taken in Panama. Although tuberculosis and HIV are two very prevalent diseases there are no special masks, no gloves, or other protective clothing devices that healthcare members use in the States. Although most everyone in Panama would test positive for having been exposed to TB, the transmission rate is not necessarily as high as one would think. The compliance rate is quite good, and treatment is approximately 80% successful. The patients are given their medications for any disease, regardless of their ability to pay.
Another interesting concept was that HIV patients received their medications in the same room as the TB patients. This is of significance because HIV patients are susceptible to tuberculosis because of immunosuppression. It was very interesting to see how other places run their clinics.
Following the clinic visit, we went to see the Valle de las Rosas which is a picture of poverty amidst a breath-taking tropical paradise. It was quite sad to see where the squatters put up these shackles in attempt to shelter themselves. We will be working in places such as these to bring health services to this population.









After this we went back to our villas and jumped into our business casuals to go to the University of Panama. We were introduced to faculty of the University (which was an intimidating event due to the language barrier and the Panamanian big wigs (President, deans, etc) in their formal business attire).
Now alas, at about 6:00pm we are back in our villas, sheltered from the rain, and doing all the coursework we must do and scratching up some food for the night. Watermelon for dinner anyone? Until tomorrow then…
*Amanda N.

Day 2

We woke up at about 7:30am and took a shower with cold water, at least most of us. It was pouring rain all morning, but we went to the Panama Canal anyway. We were able to see the ships go through the canal and watched first hand how the lock system works. Then we went to see a short film on the past, present and future of the Panama Canal. Did you know that there will be another lock system completed within the next 7 to 8 years? We then went to the museum, which was 4 floors, all about the canal. Some of us bought a few things at the gift shop, like a guide book about the history of the Panama Canal and post cards.
By this time we were hungry so we went to Nicko's Cafe and ate really good desserts, coffee sandwiches and natural fruit juices. We took a ride to the three islands called the Amador Causeway (because the islands form a causeway) and stopped to watch the yachts and shop in a duty free (tax free) mini plaza.














After buying more souvenirs, we drove through an area of poverty, we saw the Mayor's house, the plaza major and the Panama cathedral. We saw the townspeople and their homemade beaded necklaces, bracelets, bags and pictures. Then by this time we were hungry again and were taken to the local mall, which is much nicer then you may think.

They amazingly had many modern stores like Calvin Klein, Levi's, Kenneth Cole, Tommy Hilfiger. We ate huge steaks for less then 10 dollars, had gellato (ice cream), and one store had undergarments for 35 cents!!!!!! Then we stopped at Rey's Supermarket AGAIN because, of course as a group of mostly girls, we had more things to buy. We got home at 5pm and had a group meeting. Then we went back home and worked on our homework and assigned readings. We ended the night with a group of us trying to stay a little in shape while we are here and doing a few really cool 80's style workout videos. One student just observed and took blackmail pictures. She says pictures will come soon, but we will see.... We are still trying to put pictures up, but we will see!
*Sandy

Day 1

We finally arrived in PANAMA. Yeah!! The flight was a little over 2 hours and it wasn't too bad. At the airport we were welcomed with USF Health signs and a white bus, not too shabby, at least it had an air conditioner. The luggage guys took most of the luggage to the bus and looked around after they were given a 5 dollar tip, so a few of us gave them another 5 dollars and we left. The bus driver took us to Rey's Supermarket to buy a few food items to eat for breakfast and lunch the next day. By this time most of us were starving and hoping to eat as soon as possible. We then arrived to the Villas at Clayton Army Base in the City of Knowledge (Ciudad de Saber). We were given 3 duplexes that each contained: 1 couch, 2 chairs, 1 coffee table, a TV (but only 5 channels that work and only 1 channel is partially English music videos), 2 desks, 1 dinning table with 5 chairs, one group has a stove, another has a full sized refrigerator, some have pots, pans, plates, and cups, some have internet access and phones, some have hot water and others are not so lucky, 2 twin beds in each room, but on a good note we all have central air conditioner, some have holes in their front door, 1 room doesn't have a working toilet and they have to take the toilet top off and pull the chain every time they go to the bathroom, some don't have light in the bathroom, BUT at least they had toilet paper for us. We then got settled in and went and ate at local restaurants on the base. Some of us had subs and others pizza or salads. We got a whole 16" pizza for 8 dollars and a can of coke for 70 cents which is a great deal for a college student studying abroad in Panama. We came back to our villas and sleep till the next morning.
*Sandy