A Volunteer’s Journal By Shannon Roberts

Mexico, the first week:

July 10th Day 1

I woke up at 5:30 am, unprepared for the day ahead. After saying our goodbyes, Mary and I boarded our plane in Miami for an interesting flight – let’s just say we met a fellow that wasn’t quite right. Finally we arrived in Tuxtla Gutierrez, Chiapas, Mexico where I met doctor Jesus Farrera Grajales for the first time. Nervously trying to go over Spanish words in my head, I said “hola.” From his friendly smile and attitude I knew I

would be alright. I felt relief as we all fell into small talk in English. A million questions ran through my head - from Chiapas’ culture and Mexican politics to how the clinic worked and who worked there. However, I kept them to myself knowing there would be plenty of time to ask later.

Next stop was SAMS CLUB for some food, and toilet paper for the clinic. Thirty minutes later we pulled off to the side of the road at a family run restaurant and sat outdoors at plastic tables and chairs. The awnings were made of palm fronds to protect us from the fine drizzle outside. The proprietor’s daughter made tortillas, he grilled, and his wife chopped

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the vegetables, with the grandmother serving the soup. Chickens scratched and pecked the dirt around our feet for crumbs as we ate. We rinsed our hands in a stream that ran next to the eating area. It was unlike any place I’ve ever encountered in the States.

Finally we moved on to the clinic. The doctor had an emergency gallbladder surgery to perform. I said hello to dozens of people who would soon be my new friends. Feeling both excited and nervous we headed into the surgery room. My eyes locked on the doctor as he made a huge slice into the patient’s abdomen. I felt utter shock as I saw the intestines of the patient seeping out of the abdomen. Dr. Farrera simply pushed them back in, casually. I didn’t realize by the end of the next day this would all seem normal. The gallbladder was finally removed and the patient was quickly stitched back up. I was able to feel the gallbladder, and then watched as it was opened and huge hard pebble looking objects emerged.

By the time I arrived at the doctor’s house, the morning flight seemed like days ago. I couldn’t believe how friendly and eager everyone had been to welcome us. The family at the restaurant, where we ate, showed me how tortillas were made, and the anesthesiologist at the clinic showed me the drugs he used in surgery. He also patiently attempted to explain (in Spanish, of course) how they worked as well.

July 11th Day 2

I was up at 7, greeted by Mary’s apologetic face. She had blown the breaker for our only hot water device – the light bulb hooked up to the shower to heat the water. After getting Heidi – Dr. Ferrara’s wife – to switch the breaker, I jumped into the shower. After 3 minutes of cool water, it was my turn to blow the breaker. Laughing at ourselves, Mary and I informed the doctor and Heidi for the second time, and again they switched the breaker. Neither of them was angry. They were more amused and apologetic about how the switch needed to be changed.

Since it was a Sunday, we headed back to Tuxula to go with the family to the park. There the two kids, Naomi,

age 2 – who looked exactly like the little girl in the movie, Monsters, Inc -- and Leo, age 5, played on the rides. We all played, taking the train around the park,

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watching a dance performance, and heading to the bumper cars.

On the drive back the doctor received a call about an emergency Cesarean section (also known as a C- section) and asked if I wanted to see it. Well that was an easy question, “OF COURSE!!!” Once back in the clinic surgery area fear ran though me when I saw all the blood the poured out of the incision!! I kept thinking there was no way someone could lose

that much blood and survive. I was relieved when the doctor, seeing my concerned face, explained that there was amniotic fluid in addition to the blood, and a normal occurrence. I watched the other doctor as he cleaned the white gunk from the baby, gave silver nitrate drops, a vaccination, and recorded the baby’s information. It was thrilling to hold the newborn and present her to the family.

Exhausted, I crawled into bed at 1 am.

July 12 Day 3

Trying to will the rooster into silence, I reluctantly woke up at 5 am. to a determined crowing. I finally accepted defeat at 6 am., and came up with a plan to not blow the breaker (never letting the water run more than 30 seconds). Mary and I both successfully took cool showers, and then walked to the clinic.

Unsure of what exactly I would be doing in the clinic, I started the morning shadowing Dr. Farrera, and watched some consultations.

Later, Mary, Rubin (a clinic volunteer) and I walked around the town during a lunch break. Talking to Rubin, we learned that he was a high school student who volunteered five days a week at the clinic, worked at his Dad’s barber shop, and played the guitar with a local group that performed in the bars on Friday and Saturday nights. Man did I feel lazy!! This all seemed normal to him. His life was work, but he always had a

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smile on his face and seemed to find joy in it.

After eating soft tacos in a tiny shop we walked several short blocks back to the clinic where I watched numerous surgeries starting with the C-section of a lady whose water had broke two days before. The public hospital had not wanted to treat her, and she was finally getting treatment here. The baby was in distress and had brown liquid in its lungs that had to be removed, but it will only have minor respiratory problems. Next was a patient whose belly button had popped out because the muscle didn’t hold the intestines back. The doctor performed a minor surgery and reattached the muscle, and the intestines went back to where they were supposed to be. A hysterectomy was next on the list. I watched the doctor quickly and easily remove the tumor filled uterus from a middle-aged lady. I also saw the 6th toe of a baby removed, followed by the removal of the drainage tube of someone who had recently had stomach surgery.

Between and after surgeries, Mary patiently taught me the basics of how and where to take a pulse. She also taught me how to monitor blood pressure, temperature, respiration, and heartbeat, as well as, where shots were given and why. Later I learned what the normal range for vital signs were. After practicing on her, I headed to the beds and took the vitals of the patients. All of them were great to work with, appreciative that I was there and patient with me when it took a couple of tries. I couldn’t believe the attitude of the patients. They were grateful for my desire to learn and

help, even though they were my guinea pigs to learn on. Both Mary’s and the patients’ attitude and kindness created a wonderful environment to learn in.

July 13 Day 4

The morning began with roosters crowing, music playing, dogs barking, and people yelling. During my quick, cold shower I could feel the pain radiating from my tired feet. Running to the bathroom, I realized my stomach had not yet adjusted to Mexico. Somehow, I still couldn’t help but have a huge smile on my face, in anticipation as to what I would see and learn that day.

I struggled to comprehend how hard people worked: from the doctor performing up to 11 major surgeries, along with consultations and minor

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injuries, to the wife taking care of the kids, cleaning around the house, and working as a nurse/anesthesiologist/receptionist at the clinic. I never heard one complaint about any of it.

I spent the day shadowing Betti, the main day nurse. She patiently walked me through the clinic and tried to demonstrate and describe the medicines, sutures, the basics about sterilizing equipment, and prepping the patient and surgery room. It was frustrating because I couldn’t understand everything, and couldn’t remember the names of all the equipment and sutures. I realized there was an incredible amount I needed to learn, and knew it didn’t help that I was learning in Spanish, so I had to accept defeat for the day. All I could do was to continue to learn a little more each day.

Later, I talked with the other nurses and volunteers, watching them prep and treat some of the patients, focusing on how they inserted an IV… determined to learn. I also helped them take blood pressure, pulse, and respiration. All the while we were joking and chatting. They patiently repeated questions and listened to my broken Spanish.

Along with a gallbladder surgery, I saw the removal of the uterus from a 400 pound woman. It was full of tumors. Because of her size the surgery was risky. After unsuccessfully trying to get a spinal tap, the anesthesiologist refused (with good reason) to put the patient under, and we had to wait for another anesthesiologist. At 10 pm it was time to try again. This time the patient was put under and her vitals were closely monitored. The worry on the anesthesiologist’s face was obvious, as well as the concern of Dr. Farrera and the internal medicine specialist. However the OR was still filled with laughter as we chatted and joked, along with the occasional singing of the anesthesiologist and internal medicine specialist. Finally there were smiles of relief when the surgery was completed, and the patient awoke from the anesthesia. Walking out of the hospital, I was greeted by the family. They thanked me and said “god bless you’

– even though I barely did anything – I was so touched.

July 14 DAY 5

Today was slow day at the clinic. I spent the morning reviewing some of the things I had learned, practicing on the patients, and learning how to give injections, and the common medicines used.

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Having no other work or patients, we decided to visit the local zoo. Mary and I, along with four of the nurses/ medical students, climbed into one of the ambulances and headed out of town towards the mountains where exotic animals are housed and cared for by a local processing company. While chatting and wandering through the zoo, the volunteers taught us the names of each animal. I forgot most of them moments later. I was surprised at how close you could get to the animals. This zoo was completely different from the highly regulated zoos in the US. At one cage we shouted “cuidado” then laughed when one of the Jaguars snuck up on Mary, obviously intent on attacking her, while she leaned on the cage to take a picture of his mate.

Exhausted, I took advantage of the slow day and collapsed into bed early.

July 15 DAY 6

Today I learned how to clean/ dress wounds and remove sutures. One of the nurses and student doctors taught me, and the patient was actually a friend of theirs. He was a great patient, and didn’t mind that I was doing the procedure for the first time. He just laid there and chatted with us, while they instructed me. Afterwards, he gave us all crystal figurines as a thank you. Shouldn’t I have been thanking him?

That afternoon was day one of the Emergency First Aid class taught by Mary, Mario and Dr. Farrera. Everyone was excited and interested while taking it. No one had to be there but everyone that could was, all asking questions, volunteering, eager to learn.

July 16 DAY 7

Up next was a patient with a finger wound that needed cleaning. After I cleaned and dressed the wound, I gave my first shot, right in his butt. With the med student making sure I gave it in the right spot, we finished up and I told him goodbye and thanks for being the first person I gave a shot to. Laughing he

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answered anytime. Minutes later he came back with sodas to thank us for taking care of his injury. Again… wasn’t I the one that should be thanking him?

I then tried and failed at my first IV. One of the nurses, seeing that I was eager to learn, volunteered to let me try on her. I pierced right through the vein and instantly learned that you don’t put the needle all the way in. Although a little discouraged I was eager to try again.

Later I attended the remainder of the Emergency First Aid class and the practical (practice) part of it. Putting us together in teams of five, we would drive off in the ambulance; receive a simulated call and description of the scene. Then it was up to us to find out what was wrong and stabilize the patient. We all laughed when Dr. Farrera started convulsing (just pretend of course) and spitting up water at the volunteers working on him. A little later it was my turn to participate. I got to help save our ‘patient’. Finally I became a gun shot victim suffering from shock.

After we all received diplomas and left for the night around 8 PM.

July 17 DAY 8

Dr. Farrera’s family, Mary, and I took a long drive on curvy mountain roads into the countryside for lunch. An hour later we ended up at what looked like a park. There was a lake with water the color of mud, a path to walk around, a playground, and little boats to rent. The restaurant seemed more like a mini resort… which we later found out it was. After playing on the seesaw – way too much fun – we chose what fish we wanted from a tank of live ones, and they fried the whole fish, head and all. It was the best crispy fish I ever had.

On the drive home we inadvertently did some sightseeing. We saw a cow lovingly bathing a pig (with its tongue), and a very drunk man attempting to drive a horse drawn carriage – quite unsuccessfully it appeared to me.

PART 2...

July 18 DAY 9

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Dr Farrera, Heidi and the two kids departed Villaflores with Mary and me at 5am for the hour drive to the airport. Mary was leaving for home today. The roads were a mass of curves blanketed with extremely thick fog this morning so the airport was closed when we arrived. Luckily there are two international airports in Tuxtla Gutierrez so Mary was shuttled by taxi to an alternate location for her departure.

We spent the rest of the day in Tuxtla, shopping and then relaxing at Dr. Farrera’s sister’s house. On the way to the sister’s house we stopped to purchase movies. I was a little surprised to discover that those illegal copies that you can download in the States are sold at stands on the streets in Mexico. Kids are not allowed in the movie theater here, so this is the only way for the family to watch new movies.

July 19 DAY 10

With the help of a nurse I performed my first IV (intravenous) on a patient and later was able to remove some sutures on my own.

I also had my first patient die… a premature, brain dead baby. The sonogram had shown that the baby’s brain had not developed properly. The baby was delivered by C- Section and died almost immediately after the umbilical cord was cut. Although we knew the baby would die, it was still heartbreaking to watch.

July 20 DAY 11

Another busy day at the clinic filled with the sterilizing of equipment and the cleaning of the OR. Around five, after the surgeries were done, I left the clinic with some of my new friends and colleagues to spend the afternoon checking out Villaflores. We first

stopped at the park, then the cemetery and finally made it to the center of town. Afterwards we played some foosball and attempted – unsuccessfully – to play a game pool.

When I returned home it was time to do laundry. This time it was not the simple task of throwing my clothes in the washer… it was a whole different

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experience. Using a baby bath tub I would run the shower (in the dark of course) and hand wash my clothes. Then dry them by hanging them on hangers, strategically placed around the room.

July 21 DAY 12

Again waking up to aching feet, knowing half of it was from the afternoon fun of the previous day, I got ready for another eight to twelve hours at the clinic. Lucky this was a day I got to sit a lot and always took advantage to rest my feet.

Starting the removal of sutures on a six year old girl I stopped and asked the medical student to take over because the girl was in pain. I had thought it was because I was doing something wrong, having just learned how to remove sutures, but as I found out when the med student removed the sutures, it was just painful because of the way the sutures were in. Then I made a mental note to trust myself when I knew I was doing something right but it doesn’t hurt to ask for help when in doubt.

Later some of the staff decided to head out to a local restaurant with a pool. I figured out real quick – seeing everyone swimming in shorts and tank tops – that a bikini wasn’t exactly normal dress, but that’s all I had brought with me. Eventually got over my embarrassment and swam. When we returned from the restaurant I quickly made way to the OR to watch the reconnection of the fallopian tubes of a lady who had changed her mind and wanted more children. With my clinic work done for the day I decided to head home on foot for the night.

July 22 DAY 13

I quickly moved from one patient to the next as I removed sutures, cleaned and dressed wounds, and helped prep patients for surgery with the other nurses, each of us taking on different tasks (blood pressure, weight, respiration, pulse, solution lines, IVs, etc). After a busy morning, the surgeries began. Beti, Adriana, and I sat on the side of the OR, set up a mock assembly line of supplies, and wrapped gauzes for sterilization. Listening to 70s American disco music, we laughed as the doctors would randomly break into dancing. We chatted and sang as we did the tedious job; every once and a while standing up to observe an interesting part of the surgery or to hand the doctors some needed supplies.

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After each surgery, it was time to clean the OR and the equipment, and then prepare for the next patient.

Watching Herman (an ambulance driver) get two buckets of water, one small and one large, head to the bathroom and take what I guess could be called a shower, I learned that my cool showers were a luxury.

I also learned that both Dr. Acosta and Dr. Perez (the two interns) lived at the clinic, were on call 24hrs, M-F, and worked all night and all day. I understood why they looked so tired!!

It was a busy day for me. We’d had a heavy patient load at the clinic. And once again, I marveled at the grace and dedication of the people I was working with.

Later that evening, I was mildly self conscious as I walked through the dim streets and returned to the clinic at 7 pm so I could watch a hysterectomy. Everyone’s eyes turned to look at the ‘gringa’. During the procedure, salsa music played in the background. Erica (the night nurse) and the Anesthesiologist danced, as the patient moaned –side effect of the drugs. Dr. Acosta struggled to tie the last suture with the little line there was left, but he completed the task with a flourish.

July 23 DAY 14

Leaning over, I concentrated on the patient’s abdomen and listened closely as Erica instructed me on the correct technique for removing c-section sutures. With Erica supervising my performance of this newly learned technique, I began removing the sutures, then cleaned and re wrapped the wound. I was surprised at how much simpler (the already easy) task of removing sutures had become. After finishing, I headed to the patient rooms to remove catheters and IVs.

Heading back into the minor surgery/wounds room, I watched as Dr. Farrera made a small slice into a man’s armpit. Puss slowly seeped out of a gland infection. Never having seen a gland infection, let alone what was inside causing it, I was surprised at how much puss came out, and how horrible odor was. It stank! Having to let the infection finish seeping out, the wound was to remain open for 3 days, and then it would be sutured. All I could think was ‘that has got to hurt!’

Being that I was tired, and the clinic was empty I walked back around 5. Later, as I attempted to crawl into bed, I was interrupted by spiders, grasshoppers, and

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all sorts of other unknown bugs, that had wondered in through the open windows to hide from the nightly rain. I resigned myself into accepting that I was their midnight snack. Sure enough, when I woke the next morning my legs were covered in weird little bites.

July 24 DAY 15

I awoke to the smell of eggs and chorizos. Heidi had cooked an amazing breakfast for the family. Later, we all headed to Villa Hermosa for the weekend.

Beautiful mountains created the perfect backdrop for the wide open ranches. The only thing separating this land were fences - made from barb wire and tree branches-, an occasional misplaced palm tree - standing alone surrounded by endless grass -, or a small tin house – that looked like it was barely standing and no bigger than someone’s living room. I watched as two cowboys’ herded cattle across the road and felt like I was in an old western.

As the car sped down the road, in and out of lanes, and I was flung from side to side; the throbbing of my head and stomach interrupted my thoughts. I tried to sleep for the rest of the ride to take my thoughts away from the car sickness.

After picking up food from Walmart—yes, it is popular in Mexico too—we finally arrived at the Best Western. Manual (Dr. Farrera’s nephew) and I headed to our room. We relaxed the rest of the day away.

July 25 DAY 16

Jumping into the HOT shower, I felt like I was in heaven. I knew this was the one thing I missed most.

Heading to the Zoo/ Mayan ruins, I marveled at how old and huge the ruins were. They were also in good condition and looked more like statically placed sculptures, making it hard to imagine how old they really were.

July 26 DAY 17

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After a sleepless night, filled with Naomi crying, and the dog barking, I slowly got out of bed and headed to the clinic. When Dr. Farrera arrived later looking half dead, I learned that Naomi had been sick all night. When I asked what was wrong with her, I was informed that her head was slightly hot but the problem was in Naomi’s head. Naomi had felt neglected so she made herself sick (at least that was what I understood from the description). For treatment, raw eggs were cracked on Naomi’s head and she was left with her grandmother, where she got lots of attention. (However, I’m not sure I understood what they were describing correctly—I was puzzled at this explanation, especially from a doctor.)

While walking back from getting ice cream, Brenda, Adriana, and I helped a light-headed girl from her car to the clinic. While waiting for a doctor to become available, the girl fainted in the hall. The doctors immediately hurried over to her, gave her smelling salts, and checked her out. The diagnosis – she was making it up! Well maybe not making it up on purpose, but it was all in

her head – a cry for attention, or something else. I soon learned that this was not an uncommon occurrence at the clinic– usually the patients were young girls with problems at home.

Later that day I tried to insert an IV and failed. Having missed on the first try, I asked Rodolfo (a medical student) to insert the IV for me – not wanting to put the patient through anymore mistakes. He quickly inserted the IV, while I did other tasks to prep the patient for her C-section. Moments later Dr. Farrera told me I was going to assist in the C-section!

Barely containing my excitement, I quickly changed into scrubs, and followed Dr. Acosta’s lead as he showed me how to wash my hands, and change correctly to keep everything sterile.

Dr. Farrera sliced into the patient’s abdomen, and I held the flaps open so he could get to the baby. Once the baby was out, I cut the umbilical cord and watched as the baby was handed to Dr. Acosta – to be taken care of. Then I helped as Dr. Farrera stitched the newly created wound. I finished by cleaning

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and dressing the new sutures. I was so excited to be given such an incredible opportunity, I was happy my hands didn’t shake too much, and a little relieved when the surgery was over and I hadn’t made some hug mistake. For the rest of the night I was filled with the high of excitement.

Since this was my first surgery, it was tradition for me to buy a pastel (cake) for the staff to thank them for all their help. Unfortunately, it was after 10pm and all the pasterlerias were closed. Exhaustion set in and my temporary high started to fade. The clinic was quiet, so I decided to call it a night.

July 27 DAY 18

In the morning I prepped and then observed two c-sections. Afterwards, two of the soccoristas drove me in the ambulance to pick up a pastel. I said “Gracias” to Dr. Farrera and the staff, and we ate the pastel. However, my simple words couldn’t express the depth of my gratitude. I’ll always remember my first ‘assist’.

Next, we headed into the OR to watch the C-section of the ‘Big Baby’. Before beginning the surgery we had a poll estimating how much the baby weighed. Beti won weighing in the newborn at approximately 9 lbs. To celebrate the win, Dr. Farrera bought pizza for Beti and the rest of the staff.

Later that afternoon Brenda, Adriana, and I headed out. We stopped at Adriana’s mother shop where I bought two handmade shirts. Adriana’s mother sold different styles of shirts that she sewed in her house. We then grabbed a taxi and headed to Villacorzo. I looked around at the small village; it looked like a smaller version of Villaflores, with the same central parks, dirt roads, and quaint homes. We stopped at Brenda’s house first. In the center of her square home was a barn like area, separated from the house by a wooden porch door. There they kept the dogs and the chickens; however there were only 2 chickens. I asked what had

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happened to the rest. I learned that they had been used… like the chicken soup we had just eaten. I amused Brenda by apologizing to the two chickens for eating their sister. We then headed to Brenda’s parent’s ranchero.

We arrived at the ranchero to see four men attempting to control the ranch horse. This horse was not the best behaved. When they wanted it to do something it took a little convincing. While the horse teased the men, Brenda, Adriana, and I headed to the cow field to try and ‘hug’ a little calf. The calves however didn’t want a hug, and their mother cows weren’t happy about us playing with their babies. All the cows started mooing and heading towards us from the other fields. Although there was a fence between us and the angry mothers, it wasn’t a very big comfort.

After Brenda’s cousin and father tried to lasso a calf, we finally gave up and took a picture, with the calves in the background.

July 28 DAY 19

Exhausted I crawled out of bed and headed to the clinic. It was another busy day filled with four C-sections, one hysterectomy, 1 gallbladder removal, and the removal of an ovarian tumor. The ovarian tumor was filled with hair and teeth!! I had never heard of anything like it, and here I was able to touch it and look at the hair and teeth after it was cut open. I found it fascinating.

July 29 DAY 20

Waking up and feeling ill, I headed to the clinic. It was a quiet day with barely any patients. Since I was feeling sick, I headed home early.

July 30 DAY 21

Another quiet day in the clinic spent chatting with Adriana and Jessica (a high school volunteer). Around four, Adriana and I left. We headed to her Mom’s store to check on the shirts, which weren’t ready yet. I arranged to get them another day. Knowing that I was still sick and couldn’t eat much, Adriana took me to the local fruit market to buy some ‘sick’ food. After buying some fruit and yogurt I said goodbye.

I didn’t realize how much I would miss my new friend until that moment.

I headed back to the clinic at 7, for a goodbye party for Beti; she had finished her

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one year internship, and it was also her last day. Everyone said their goodbyes, and we handed out gifts. A piñata, of a nurse, had been set up in front parking area of the clinic. We hit the fake nurse with a stick and scrambled for the candy that fell. After saying my goodbyes to Beti, along with Brenda and Rodolfo (medical school students), I watched an ovarian tumor being removed and headed home.

Final Mexico Journal

July 31 DAY 21

I spent a pleasant Saturday in Tuxtla, shopping and visiting with Dr. Farrera’s sister.

August 1 DAY 22

Since it was Sunday, I spent the morning relaxing and reading. During the afternoon, I headed to the clinic to watch an appendectomy. Dr. Farrera was surprised to discover, the patient didn’t have appendicitis after all, as the public hospital had stated. The appendix was not inflamed or infected; looking in the area Dr. Farrera found that the small intestines were where the infection was. (The symptoms of an intestinal infection and appendicitis are very similar and without expensive scans it is hard to differentiate). However, the appendix was still removed. Appendicitis is a common problem in Villaflores and since removing the appendix does not cause harm, the patient was already in surgery, and the intestinal infection could lead to an appendix infection, the appendix was removed. After the surgery, the patient was given antibiotics to treat the intestinal infection.

August 2 DAY 23

Up early, I met the five new nurses at the clinic. They had come to work for a year, a kind of internship.

That morning, I inserted a catheter successfully, prepping a patient for surgery. I then headed to the OR for a C-section. I cleaned the patient’s skin, and attempted to insert another catheter, but was unable to find the correct opening. Dr. Perez helped me. I learned that during pregnancies things look very different because of the pressure created by the baby, even from patient to patient.

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After the C-sections I helped teach the new nurses how to sterilize the equipment. I continued to help teach the nurses how to prep for surgery, and clean up/ sterilize equipment throughout the remainder of the day’s surgeries; a C-section, gallbladder removal, hernia, and

hemorrhoid. It felt good to actually be teaching someone something, since everyone in the clinic had worked so hard to teach me.

August 3 DAY 24

The morning started slowly, with the only major surgery being a hernia operation.

Later that afternoon, a fifteen year old boy came in with a mangled finger. Five days ago, his ring had cut into his finger when the ring got caught in a machine. Because the finger hadn’t been treated properly, it had started to rot. He’d gone to the public hospital and was tossed around for days.

Dr. Farrera checked to see if the finger was still alive. It was. The boy would have to wait until the tissue was dead, and there was no blood circulation. He would then have two choices: The finger would either be amputated, or the tissue removed and the finger stuck into the stomach in order to graft new tissue onto the finger.

Even if the finger was saved, the finger would have no nail, but at least the boy would have a functional hand. I felt sadness for the boy, and frustration in knowing that if he had come to the clinic five days earlier the injury would have been cleaned, stitches given, and the finger would have been fine. I felt anger toward the hospital at the callousness of those who worked there.

August 4 DAY 25

Walking down the street, I watched an OX drawn carriage roll by me. Glancing at the little houses and streets, I knew I would miss this place. The easy, laid back feeling, the hardworking people, the friendliness given, and all the things it taught me.

It was a busy day at the clinic. I watched as one poor lady’s eyes filled with pain as Dr. Perez attempted another IV. First nurses, then several doctors tried

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inserting the IV into her collapsing veins. The clinic had received sonogram results that stated she had an ovarian tumor, and had been bleeding for two weeks. Because of the blood loss, her veins kept collapsing, making the job nearly impossible. Finally, after a total of 10 tries, Dr. Perez was successful! Relief filled the room.

During surgery, I noticed a puzzled look cross Dr. Farrera’s face. He discovered the tumors were not in the ovary, but in the uterus. The sonogram results were wrong. Quickly getting permission from the family to remove the uterus, he completed the surgery.

We also operated on a 36 year old man whose foreskin got stuck when he was cleaning his penis. A circumcision had to be performed. As he lay on the OR table, I cleaned the surgical site. The poor man was obviously uncomfortable at being sprawled out on the table with four female nurses prepping him, and very nervous about the upcoming surgery. I couldn’t help but feel sorry for him, but there was little I could do but murmur words of comfort and lightly joke, helping relieve some of his tension.

August 5 DAY 26

The next morning it was time to leave. No good at saying goodbyes, I hugged Heidi and the sleeping kids, and then walked into the airport. There, I said my goodbyes to Manual and Dr. Farrera. I gave Manual one of my hair ties (I was told it is a tradition to give something you use to be remembered by). I thanked Dr. Farrera for all his kindness and patience. He thanked me for the same.

I knew I had made friends with this amazing family. Filled with both sadness and excitement, I headed home, knowing this was one trip I would never forget.

Shannon Roberts

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