Wednesday--> Thursday: Wrapped up in a mosquito net cocoon

Overnight trip to Delores and Otoxha:

We began our overnight journey with 2 packed cars, the mobile and the Rehab Nissan truck and a 2 hour drive, through Blue Creek, past Crique Sarco- basically into the dense forest near the Guatemala border (in which Niamh’s (one of the Irish Med students) travel adviser told her to avoid). But that was our final destination! The roads were outrageous- it had rained a lot the night before, so there were puddles everywhere- Carol did a great job getting us through the uneven terrain. When we arrived at Delores- we set up the clinic at their health post, in which Mr. Rudy (one of the drivers- and like a Dad for the group) broke the lock on the door to get in. We set up the clinic and began seeing patients around 11 am.  

Clinic in Delores

The overnight experience was difficult for the PTs. In this village, the patients who had back pain only wanted Tylenol, they wanted little to do with us trying to get them to do exercises and stretches to help decrease their pain.  I would attempt to perform an eval on a patient, and be unable to get her to stand up and bend over and backwards to see how her pain reacts.  It was a struggle for me.  I want to help these women, but they were uncomfortable with the PTs and I’m assuming how we were asking them to move their bodies? At the end of educating a woman on posture and what she should do when she stands up from sitting or working, I asked if she had any questions for me. Her reply was can I have Tylenol. I said I cannot give you that; did you talk to the doctor that you saw before me about it? No she replied. This happened to me multiple times.  It was quite defeating because I did not know how else to approach the situation. I want to provide the best care I can for all patients, but it is difficult when we could not figure out what cultural barrier we were hitting.  We brainstormed with the doctor that was with us, multiple times throughout the 2 days on mobile to try to discern the hesitation with PT. 

Needless to say, Caroline and myself did not see many patients during the day on Wednesday. When it was time for dinner, we went across the street to a local family’s home and were served caldo (which is chicken in broth and corn tortillas, and some interesting chocolate water, not many people were too keen on the chocolate water, so James(one of the Med students), who enjoyed the juice/water, drank 5 extra cups. After dinner, we hung around outside, chatted and watch some people messing around with a volleyball, waiting for the nightly discussion to begin.

In order to have lights for the night session, Mr. Rudy runs lights from the mobile vehicle’s engine.  One of the purposes of the overnights to provide a community education session on any specific topic, the topic for the night was nutrition and then the PTs did a blip about exercise. Well we attempted to/ had a lot of fun acting silly on the stage.  The audience was similar to our patients we had tried to communicate with in the clinic, not much audience interaction or participation, but they were laughing at us. We determined it was a nervous laughter, but we were still begging people to participate with us.  Caroline and I led a little exercise/ stretching bit- back leans, shoulder and neck rolls, marching in place and then of course jumping jacks! It was entertaining for all the students, as we had the med students on stage with us and then Carol in the audience trying to fire up the crowd! We had few participants. At the end we did a raffle drawing for all those who came out, for prizes that we brought with us.  

Then we all sat around and played games, looked at the stars, this has been the first night I felt like we could see the stars well, and then attempted to go to bed at 9pm! Wayyy too early, but there really wasn’t much to do in the dark.

Setting up our beds and mosquito nets was quite the task! We were sleeping on the floor of the clinic, so we brought along with us foam pads to use as beds and extra camping air mattress/ harder foam pads.  For some reason there were not enough foam pads, so I slept on my blow up air mattress and then the harder camping pad underneath it. good thing I practiced blowing it up in the living room dad! It was quite the experience of awful sleep. I have never used a mosquito net in my life- once we got them all tied up on a string, I climbed inside and wrapped the net around me, like a cocoon.  I'm not even sure that was the correct way to do it? anyways, I'm lying there with my feet holding down the bottom of it, with my hand straight by my side because my mat wasn't really big enough to be comfortably laying there- and then I coudln't move or I would shift the net. Then I began sweating profusely - But I can't shift positions without messing up the net unless I did a shift to my side then onto my stomach but THEN my legs were touching or my arms were stuck to my body because I was too sweaty. I had put ear plugs in since once everyone fell asleep the snoring began, and I'm laying there staring into the darkness, hoping I haven't trapped too many mosquitoes inside my net. and then I look at my watch- bad idea- 10 pm urghhhhh haha I had to stop checking my watch because it was always only an hour later. Needless to say, it was a long night

Caroline inside her mosquito net- My set up is to the right- the blow up air pad

Since it gets light here around 5am, Mr. Rudy and the two boys that came with us for intake and interpreting, were up early, chatting away. I held out until 5:30 and was able to step outside for a cool breeze since the door was closed for the clinic there was not a breeze at all. 

Mr. Rudy packed us breakfast, PB with bread and a yummy cereal. and of course, coffee! Then we packed up all of our stuff and drove to the next town where were we were setting up the clinic on Thursday.

Taking a morning stroll

On the way to the clinic, Carol, myself, Dave, Niamh and Michael were in the Nissan truck behind the mobile, and we noticed one of the tires getting flat. Then we went over a bridge and it was to the ground! Detour! we loaded up the Nissan with all the Pharmacy and intake supplies and then we walked about 3/4 of a mile to the clinic.

View from the top of the hill where the clinic was located.

We set up at the clinic and the women and children come pouring in to be seen by the doctors, not the PTs.  Today was more challenging than Wednesday. We only saw 2 patients. And that was a stretch.  I spoke with the Community Health Worker, someone in the community that refers patients to come to the clinic when we have mobiles. But this community health worker was very different than the typical ones we have interacted with in the other villages.  This woman, would have benefited from PT, and even after explaining to her what PT can do for so many people and how we treat patients and make their pain go away with exercise rather than Tylenol, she still wasn't buying it. I need to work on my convincing skills.
Then we had lunch at the clinic, and a lot of the kids and even older women and men stuck around to watch us through the windows at the clinic, It was odd to feel like people are watching you eat, am I really that interesting? I didn't think so.  It was difficult because we didn't know if we were to acknowledge the people or ignore them..... After lunch we packed up and headed back to Hillside! We were all drained, dirty, smelly, sweating and gross when we got home.

It was worth it for the experience; that's what this trip is all about. But I have never been so glad to sleep in my bed in Abby's house!