Joanie Brumbaugh's Medical Mission Trip Journal
Saturday
Wow. God totally hooked me up today. It was the travel day, and things went pretty smoothly in Philly airport. There was only one security check, and I met some nice people at the gate. One of these people was a doctor from Lancaster who runs the medical campus of Lancaster General Hospital located 200 feet from my campus. He was super nice, and when we got on the plane, we were seated next to each other. So for the 2 ˆ hour flight, we chatted it up like crazy about medicine, our medical service trips, and seemingly everything in between. By the time we parted ways at the Miami airport, he had offered me a sweet shadowing opportunity in the O.R.!! I'm really stoked. Then at Miami, I met another ISL girl named Sarah. We talked for awhile before boarding. Then came the clincher: I got onto the plane-which, by the way, was enormous-and I am seated next to. . .an English-speaking native Costa Rican who was also a doctor. He was a true God-send. We talked the whole way, first of all, which was totally awesome, and I learned a lot. Then he helped me with my customs paperwork-since I was clueless-and gave me a lot of tips about the culture. Then, it's time to get off, and he stayed with Sarah and me through the passport place, baggage claim, and customs. He visited family there a lot, so he knew the airport and the language. I had told him about the bag of meds, so he personally took it through, talking to the customs guys in Spanish. They didn't even open it. It sailed through, no trouble. Then, as if that wasn't enough, he escorted us past the crazy taxi people and didn't leave our side until we were safely with the ISL people. I was so floored by God's provision. We ( the eight girls who arrived by then) then took a shuttle to the hostel where we're staying. It's pretty darn nice. Except we can't flush the toilet paper...that's bad news.
Evening: I ate the best spaghetti of my life tonight. This building is actually owned by ISL, and they hire a cook who is trained in sterilizing food. It was so awesome. We also had homemade fruit juice from a tropical fruit that I can't pronounce that I didn't even know existed-super good.
Hung out and got to know the girls-they're a really cool bunch.
And I finally got my wish: today had 26 hours in it..I always need just 2 more hours in the day, and today had 26.
Sunday
Today was a full day of training. We learned all about the diseases and parasites here, as well as ways to treat them and signs and symptoms. I am freaked about worms now- they do scary stuff to your body. We then learned how to take blood pressure and blood sugar, and the method of observing heart beat, lungs, and digestive tract with the stethoscope. We had lunch. (I love beans) and then a went for a walk around the neighborhood. The mountains are so pretty, and we saw a lot of plants and flowers that grow only here. Then we had a medical Spanish lesson with a translator. I don't know how much I retained, but luckily we'll have translators. Finally we went out to dinner and I tried fried plantains for the first time-they were really good! I also had beans (I love beans) and chicken. Then we came back home and split up the mounds of children's vitamins into little bags of 30 to give out at the clinic tomorrow. I'm pretty tired, and I still need to study my disease guide. I love the girls here, and everyone is getting along. Food is great, girls are great, Spanish is hard, and showers are cold. And I love beans.
Monday
Oh my gosh, today was so cool. First of all, we had mangos for breakfast which was amazing. Then we left for the clinic which was a bunch of makeshift cubicles in a one room church. We split into triage groups, and each group took a cubicle. We then worked as a team to take the patient's history and complaints. We then discussed the symptoms and came to a conclusion. We's then present as a team to the doctor who would challenge us with questions and tell us the real diagnosis. By the end of the day, we were getting pretty good, My Spanish is coming along, too. We saw a lot of patients and I learned so much from discussing the cases with the doctor. These people have such lower living conditions than we do, and today really gave me a perspective. It was really cool, though, because were getting to do what real doctors do. I got to listen to heart and lungs, and I took blood pressures and medical histories, and it was all so awesome. I'm a bit psycho about parasites now, but I guess it'll pass. We got to tour downtown San Jose which was cool, though the difference between the rich tourist downtown district and the community where we were earlier was so huge. I felt guilty buying postcards for an amount of dollars that these people would consider a huge amount. It was fun, though, and our group is getting really close. I love it here, and I feel like we're making a difference- even if it's little. We gave out a lot of free medicine and vitamins, and these people were so appreciative. We have another clinic tomorrow.
Wow. God totally hooked me up today. It was the travel day, and things went pretty smoothly in Philly airport. There was only one security check, and I met some nice people at the gate. One of these people was a doctor from Lancaster who runs the medical campus of Lancaster General Hospital located 200 feet from my campus. He was super nice, and when we got on the plane, we were seated next to each other. So for the 2 ˆ hour flight, we chatted it up like crazy about medicine, our medical service trips, and seemingly everything in between. By the time we parted ways at the Miami airport, he had offered me a sweet shadowing opportunity in the O.R.!! I'm really stoked. Then at Miami, I met another ISL girl named Sarah. We talked for awhile before boarding. Then came the clincher: I got onto the plane-which, by the way, was enormous-and I am seated next to. . .an English-speaking native Costa Rican who was also a doctor. He was a true God-send. We talked the whole way, first of all, which was totally awesome, and I learned a lot. Then he helped me with my customs paperwork-since I was clueless-and gave me a lot of tips about the culture. Then, it's time to get off, and he stayed with Sarah and me through the passport place, baggage claim, and customs. He visited family there a lot, so he knew the airport and the language. I had told him about the bag of meds, so he personally took it through, talking to the customs guys in Spanish. They didn't even open it. It sailed through, no trouble. Then, as if that wasn't enough, he escorted us past the crazy taxi people and didn't leave our side until we were safely with the ISL people. I was so floored by God's provision. We ( the eight girls who arrived by then) then took a shuttle to the hostel where we're staying. It's pretty darn nice. Except we can't flush the toilet paper...that's bad news.
Evening: I ate the best spaghetti of my life tonight. This building is actually owned by ISL, and they hire a cook who is trained in sterilizing food. It was so awesome. We also had homemade fruit juice from a tropical fruit that I can't pronounce that I didn't even know existed-super good.
Hung out and got to know the girls-they're a really cool bunch.
And I finally got my wish: today had 26 hours in it..I always need just 2 more hours in the day, and today had 26.
Sunday
Today was a full day of training. We learned all about the diseases and parasites here, as well as ways to treat them and signs and symptoms. I am freaked about worms now- they do scary stuff to your body. We then learned how to take blood pressure and blood sugar, and the method of observing heart beat, lungs, and digestive tract with the stethoscope. We had lunch. (I love beans) and then a went for a walk around the neighborhood. The mountains are so pretty, and we saw a lot of plants and flowers that grow only here. Then we had a medical Spanish lesson with a translator. I don't know how much I retained, but luckily we'll have translators. Finally we went out to dinner and I tried fried plantains for the first time-they were really good! I also had beans (I love beans) and chicken. Then we came back home and split up the mounds of children's vitamins into little bags of 30 to give out at the clinic tomorrow. I'm pretty tired, and I still need to study my disease guide. I love the girls here, and everyone is getting along. Food is great, girls are great, Spanish is hard, and showers are cold. And I love beans.
Monday
Oh my gosh, today was so cool. First of all, we had mangos for breakfast which was amazing. Then we left for the clinic which was a bunch of makeshift cubicles in a one room church. We split into triage groups, and each group took a cubicle. We then worked as a team to take the patient's history and complaints. We then discussed the symptoms and came to a conclusion. We's then present as a team to the doctor who would challenge us with questions and tell us the real diagnosis. By the end of the day, we were getting pretty good, My Spanish is coming along, too. We saw a lot of patients and I learned so much from discussing the cases with the doctor. These people have such lower living conditions than we do, and today really gave me a perspective. It was really cool, though, because were getting to do what real doctors do. I got to listen to heart and lungs, and I took blood pressures and medical histories, and it was all so awesome. I'm a bit psycho about parasites now, but I guess it'll pass. We got to tour downtown San Jose which was cool, though the difference between the rich tourist downtown district and the community where we were earlier was so huge. I felt guilty buying postcards for an amount of dollars that these people would consider a huge amount. It was fun, though, and our group is getting really close. I love it here, and I feel like we're making a difference- even if it's little. We gave out a lot of free medicine and vitamins, and these people were so appreciative. We have another clinic tomorrow.
Tuesday
Today we had another full day at the
same clinic. We got there, and a line of people met the bus at the door.
Most were for the dentist, but we all had a busy full day. I was with the
same triage group as yesterday which was great because we work really well
together. We were a lot better at figuring out what the people had, and my
Spanish is getting better. Our translator was so awesome. It was a good day,
and we had Costa Rican cookies for a snack, and I'm so addicted. I still like
beans which is good considering we eat them all the time. Last night we ate
at a sea food restaurant, and I ate octopus! It was really good! Tonight
we're going to a food court and then to a supermarket to get food for
tomorrow. We have a seven hour drive tomorrow, though it's broken up by a
rainforest hike to a waterfall, I'm pretty pumped. The drivers here are so
crazy! The median is crossable, apparently, and these drivers have no fear.
There are really only back roads around here and everything is a hill. There
are always mountains in the distance, and everything is green and
picturesque. That is, if you look above the houses, In the area where the
clinic is, the dwellings are literally made of pieces of tin nailed together.
Sanitation in some places is a luxury. Americans have it so good. Every
woman in the clinic was anemic, and most people come in with parasites and
infections. The average age for a first pregnancy is like 16, and there are
so many kids in poverty. It's so humbling.
Wednesday
Today was a travel day-seven hours in the party bus aka the van. But it really wasn't bad because we'd stop every two hours. The first stop was a hike through a rain forest to a waterfall. It was gorgeous. We climbed over a bunch of rocks to another fall. It is really pretty here with so much green. We got back on the bus for another two hours and then stopped at a craft village for lunch. It was neat though geared toward Americans. Then it was back to the bus and we stopped at a small zoo where I saw a toucan. We ate dinner a little while later, and finally arrived at the small hostel where we stayed, I roomed with Casey and Sarah and we had a lot of fun.
Thursday
I don't think I'll complain about any
aspect of my life ever again. We crossed the border into Nicaragua, and it is
such a culture shock. We drove to Riveras and were walked around the city.
It is amazing what the conditions are. The butchers hang the meat in open air
where flies can land on them. We went into an indoor market that didn't have
electricity, and the meat and fish smelled so bad that I felt sick. Horse
feces mix with mud on the wet streets, and they have electricity and running
water only at certain times of the day. Everyone is selling something, but
nobody is buying anything. Everyone stared at us, and all of us were so
floored by the conditions here. We ate lunch in darkness and got back on the
bus to go to Civite-the retreat center here we're staying. It's really cool.
It's a whole little community of buildings with dorm rooms, a natural medicine
clinic with an herb garden, a kitchen, and community house.
The whole thing is nestled in the
natural rain forest, so there is nature everywhere. It is really nice, and
we're hanging out on the porch. There are a lot of bugs and lizards. We're
all kinda drained emotionally from today, and we're all pretty scuzzy with the
humidity. Nicaragua makes Costa Rica look not that bad, Tonight we go back to
the city for dinner.
Thursday night
The second tour of Rivas was a lot better-I guess it was a nicer area. There was a huge Catholic church and the traditional accompanying park. We stopped at an "Internet Café" which had computers available for 20 American cents per 30 minutes of internet. So I wrote an email to my mom and checked my mail. We then went to dinner at this really awesome place where I tried a dessert called "Tres Leches" which is milk-sodden cake with creamy icing. Soooo freakin' good! We came "home" and showered-it was so nice to wash away that grimy layer. Going to bed now.
Thursday night
The second tour of Rivas was a lot better-I guess it was a nicer area. There was a huge Catholic church and the traditional accompanying park. We stopped at an "Internet Café" which had computers available for 20 American cents per 30 minutes of internet. So I wrote an email to my mom and checked my mail. We then went to dinner at this really awesome place where I tried a dessert called "Tres Leches" which is milk-sodden cake with creamy icing. Soooo freakin' good! We came "home" and showered-it was so nice to wash away that grimy layer. Going to bed now.
Friday
Today we were awakened around 5:30 am by roosters outside our windows. I was able to get back to sleep, but there were like 4 roosters competing to be the most obnoxious. We held a clinic from 8 am to 4:30 pm in a rural church in Rivas. I did triage until lunch, and after lunch, I was in a 3-student team that conducted "house clinics". We go to houses in the area and conduct public health surveys. We went to six houses, asking if anyone needed a doctor and inviting them to the clinic. I got to see first-hand how these people lived because we conducted these surveys inside the homes. The first home we stopped at was made of boards nailed together. It had a dirt floor, and there was no electricity. In all the houses, pigs, dogs, and chickens wandered through at will, and there was not much furniture. All the homes were stifling hot. The toilets and showers were outside, and they were so basic. Everyone we interviewed either had renal pain, UTI's and/or parasites, mostly from contaminated drinking water. It opened my eyes to what poor means. The light in this one woman's eyes was gone-she looked so defeated, and her two daughters looked just as sad. Another family had an infant that was to dehydrated from diarrhea, and he was rushed to the clinic. Even poor, these people gave up their chairs so we could sit. I felt so humbled by it. I wanted to take pictures, but it's rude so I didn't. We went back to the clinic for more triage. The desperation and thankfulness in these people's eyes is sometimes harrowing. We're now going for an hour to an Internet Café and then to dinner. It is so humid, and I am tacky and quite attached to my scrubs.
Friday night
We went to dinner and then came back to a very dark compound. Apparently, the power company is in a big fight with the Nicaraguan government, and as a temper tantrum, they randomly turn off the power to random parts of the country for various periods of time. Luckily for us, it came back on about 15 minutes after we got home. Tonight's shower felt so good. It is hot and close, and a cool shower was more refreshing than words. Tomorrow we're back at the clinic for half a day, then we take a ferry to an island at the center of Nicaragua's largest lake. We'll be staying at an orphanage there.
Saturday
Today we had the rooster call and had breakfast then went to the clinic. My group saw some varied cases today, including a really awesome 62 year old who had diabetes, glaucoma, hyperthyroidism with goiter, tachycardia and high blood pressure. We had to take his blood sugar which entailed my pricking him in the finger. For such a small task, I was so nervous for some reason. He was cool about it, and it all worked out, but poking that guy was a new experience. As it (sadly) turns out, he probably has thyroid cancer and needs a series of expensive procedures that he can't afford. Basically, these people are trapped and doomed by their poverty in cases like this. I also saw an undernourished 13 year old who was 7 months pregnant. She was so tiny. Later, I helped at the pharmacy, and we ran out of so many things including iron pulls and medicine for urinary tract infections. I felt so awful telling a woman who was suffering from a UTI "no mas" and sending her away without relief. In America that would never happen. Luckily, we have plenty of children's vitamins and pediatric cold medicine, because there are many cases of undernourished kids whose immune systems can't handle many germs. I am so glad that I came. It has really opened my eyes.
Now we're on the ferry headed to the island called Ometepe. When we get there we'll be transported by bus to the orphanage where we'll be serving for the next few days.
Saturday night
We're getting tired and OCD. The orphanage is in a picturesque setting, but the bugs in the dorms and the beds have pushed us all over the edge of OCD. For instance: I sprayed my bed with 100% DEET. I think I might get cancer or something, but hopefully the fleas won't attach to me. We're all tired and sweaty, but despite the conditions and our waning stamina, we're all getting really close. We lit a mosquito repellent coil and gathered around it and told ghost stories like in old school slumber parties. On a brighter note, this afternoon we played with some of the orphans here. I played tag and skipped stones with some of the cutest kids ever. They were so happy. We collected small white shells at the lake shore and then painted them with T-shirt paint. This girl named Catelina made me a shell and I felt so honored. I'm laying in my bed, and I'm feeling guilty about finding negative anything about this experience. I get to return to my cushy lifestyle in a few days, but this is how these people live. I think we're all physically and emotionally drained, and mud on the volcano slope is preventing tomorrow's hike which is bumming us out. But we're here to serve, not be served, and I think I see more clearly now than ever before the magnitude of what Jesus did when he got down and dirty to wash his disciples' feet.
Sunday
This morning we got up for breakfast, and after we ate, we all sat in a circle and had a worship service. Our team leader, Louis, is a pastor here in Nicaragua, and he gave a message that re-centered me on why I'm here. The timing for all of us couldn't have been more perfect. Then we sang some worship songs in Spanish and English. Louis compared what we're doing to the kind of compassionate healing that Jesus did. That really brought me up short, but it was really cool at the same time. Then we piled into the vans and went to a beach. We arrived at this beautiful little bed and breakfast place. We went to a pool made by a natural spring which was really clean and cool and refreshing. I ate oatmeal and fruit for my lunch back at the B & B. It came with this fruit drink that was hot magenta in color. It was so good. I can't pronounce the fruit it's made from, but I really liked it. We then went and relaxed on the beach. Today was so relaxing and perfect. It was also so perfectly timed to revive all of us for the next 3 days of clinics. We played some beach volleyball and went in the lake which felt like bath water, it was so warm. To end the visit here, we all ordered ice cream. It was a nice relaxing day to re-center ourselves.
Sunday night
We came back, showered and had dinner. Then most of the girls came back and we played large group card games. I really love these girls. Clinic tomorrow.
Monday
Today we had a full day clinic. In the morning, I manned the pharmacy with Katie. We put out an example of each medication on this long table, and when the patients came with "prescriptions" from the doctor, we filled them and gave the dosage directions in Spanish. It was really fulfilling giving these people medication that they so desperately needed. There were a lot of kids at the clinic today, and when there were no prescriptions to fill, Katie and I entertained them. I became really popular for my "balloon animals" which actually were inflated rubber gloves with faces added via a sharpie. I also got to hold this adorable little baby. The kids call us "gringos", and they loved the attention. It was a hot day in the clinic. After lunch, I gave another kid the opportunity to do pharmacy and I did triage. I saw a lot of arthritis and ear infections. And parasites. Almost everyone has parasites. At 4 we packed up the clinic and went to a seminar on natural medicine taught by this Nicaraguan woman. She talked about natural healing through massage therapy, and then demonstrated on Sarah. She also had a pretty extensive herb garden in her back yard, and she explained what herbs were used for various remedies. I'm not sure how much of this medicine actually worked, but it was an interesting experience. The cooks a the orphanage prepared us an "all American meal" of hamburgers, french fries, and coke. As much as I like rice and beans, I was thankful for the break from them. I have deeted my bed and body, but the fleas and bugs are still biting. It all comes with the experience, and it makes me appreciate my bug-less bed back home. Nicaragua is beautiful, though, and I will definitely miss the palm trees, vibrant colors, and constant greenery. Being down here has shown me quite a different standard of living, though when it comes to picturesque backyard views, these people have it made.
Tuesday
Today we had a full day clinic in a different place. I did triage in the morning, then in the afternoon I did dentistry. I watched two extractions and then I got to do a cleaning al by myself! Out in these clinics, a cleaning consists of our scraping the tartar off their teeth with a metal instrument. I also met this little kid with a year to live because of a heart defect. He needs a surgery that's available only in America. We're going to find him a surgeon and sponsors and bring him to America to get the surgery. He has blue lips, fingers, and feet. I really want to get this kid surgery (pronounced "see-doo-hee-az")
Tuesday night
OK, so there was drama in the girl's dorm tonight. The squeaks in the ceiling that we thought were mice are actually bats. How do we know? Because one of them fell out of a crack in the ceiling over the shower into the shower while our adult leader, Carman, was in it. So, she naturally freaked out, and the next thing we see is Louis and the doctor tromp in with a toilet plunger and a broom to stun the thing and sweep it outside. So that was fun. We have also coined a new verb: DEET. To deet something is to spray it with your 100% DEET to hopefully ward off bugs that land and bite you to oblivion. Most frequently deeted objects are your bed and yourself. 'To deet" can also apply to the spraying of an insect with your deet so that the bug all but disintegrates. It's sadistic, but we're all so flea-bitten that we find a strange joy in killing bugs now.
Wednesday
Today was a half day in the clinic. I did triage until we stopped for lunch. When we had packed up the clinic, the wife of the pastor of the church (where we held today's clinic) spoke to us. She thanked us for serving and told us that ISL clinics bring people into the churches, and that many people have been brought to Jesus because of it. It was really cool. We ate lunch and got on our bus to go to the ferry back to mainland Nicaragua. We are all really tired. We then had a 2 hour ride to Managua where we eventually arrived at the ISL guesthouse. After a quick move-in, we went out for a late dinner at a Mexican restaurant. The food was very good, and there was live music. It was a good last day of the trip, and I'm really going to miss these girls. The guesthouse is really nice, and we don't need to worry about fleas or mice or bats. It's nice, and the beds are really comfy.