What's better than good?

"What's better than good?   Not doing harm."

It could be my background in Anthropology, but I couldn't get that thought out of my head  as we were in Ensanada a small community of ~350 Ngöbe people in Bahia Azul.

In addtion to running the mobile health clinic, we had a public health team perform a survey to assess the level of understanding in the area regarding HIV/AIDS transmission.   Our most excellent public health team went out door to door.  We crossed  the bay in a kyukas, traversed across logs, went into the mangroves, trekked through swampy mud , and got attacked by large black ants during the day and blue crabs in the middle of the night.  Some houses would welcome us in, sharing snacks or bananas.  Other houses were understandably skeptical and would turn us away.

Most excellent public health team

Gift from a home I visited

There was a Peace Corp worker in Ensanada who at least twice a day would gently remind our group that our goal should be to "make sure everyone felt good about us coming to visit even if they learned nothing about HIV/AIDS".  It was the best advice.  Sending love and opening ourselves to this community was a demonstration that we can be trusted, which will pave the way for the next public health team that goes out.  

The long-term goals of this project is to get this community tested for HIV/AIDS and then get treatment for those who need it.  Currently, there is a confirmed case of HIV with a 3 year old girl.  Her mom died last year from AIDS.  A total of 3 deaths in the community last year are thought to be from AIDS though this is not confirmed.  However, AIDS is of particular concern in this community where the Ngöbe people are tolerant of infidelity and there is essentially no access to medical care.  Women are aware that their husbands, who leave for work for weeks at a time, will have relations with other women.  While men and women are using condoms some of the time, it is not happening consistently because there are not condoms readily available.  If they are using condoms they may not be using them correctly.  One Ngöbe man said that he was using 3 condoms to be extra safe.

Interviewing a house

Of course the primary goal of this trip was to hold a mobile clinic.  This was going on while the public health teams were out in the community.  The clinic team consisted of two doctors, two nurses, and a future medical student.  I am not sure what the final patient count was, but I believe they saw around 120 patients in 2 days.  Everyone did an incredible job especially the two doctors.  Seeing how hard they worked for 10+ hour days in 90 degree heat gave me a new-found appreciation for the medical staff at Floating Doctors.

After a full day in the clinic the clinical team made house calls to see patients who were too sick to walk to the clinic site.  I need to emphasis that these "walks" to the house calls are not leisure especially if you are going after dark where footing can be misleading with only a headlamp.

"Leisurely" walk to a Ngobe house

One of our doctors working with a Ngöbe woman

After the long days we had some fun with my camera and I took some long exposure shots of the stars which turned into some shots of kids running around with headlamps/flashlights.  I also had the amazing experience of swimming in bioluminescence which cannot be captured on my small point and shoot - but, of course, I still tried.

Abundance of stars!!

"AMOR"

Bioluminescence.... of course!  

Bahia Azul Preparation

Today was spent in preparation for our trip tomorrow out to Bluefeilds (Bahia Azul).  We had to get food, shelter, and medical supplies packed up for a 4 day trip.  We plan to hold 2 full days of clinic for this remote population. While we are there I'll be going out with a team to provide educational materials on HIV.  

(Thanks GoogleMaps!)

I have heard that it is going to be a choppy ~5 hour ride over there in our panga so it should be interesting with the crew of 13 + supplies.  Regardless, I am looking forward to it.  We will be primitive camping in hammocks on the beach so I will not be taking my computer.  I'll be sure to flood you with photos when I return on Wed June 20.  I have been told it is very beautiful.

Here is a photo from the local grocery.  This little fellow was just hanging out in the store.

So much depends upon the can-opener, glazed in water, in the kitchen

After a long flight, and multiple longer bus rides I made it to Bocas del Toro a little over a week ago.

Since then I've been getting settled in and learning more about the Floating Doctors organization.  It has already been a busy week and I can see that things are only going to get busier.  This group is incredible and very generous.  I can see why in only 3 years they have been able to build so much success.

This organization largely runs on volunteers which is unique and new to me.  My first thoughts on this are that (1) everyone working here is as excited and motivated as I am, (2) everyone here has a big heart and has gone out of there way to be here and make a contribution, (3) the burn out rate is non-existent since everyone is transitory for the most part, and (4) no one knows where to find a can-opener.  

Why is the location of the can-opener important you ask?  There are 8 volunteers on the boat right now and I'd hedge my bets that there are only 3 people who know where it is.  From a management standpoint, if you have volunteers coming in and out of the boat (sometimes in as little as a week) then organizing and following procedures becomes a daunting task.  

This is one of my great tasks - how can we make procedures and organization so obvious that someone fresh off of the street will easily jump in and know how to help?  Also, how we encourage everyone to follow protocol and practices because- yes, that data point is important to collect and yes, returning that bottle back to the shelf where you got it is important.  These details which are not immediate gratification are difficult to instill in people especially when they will not be the ones to gratify from the extra work.  

On another note.  Here is my photo of the day.  It is the "Southern Wind" the boat I'm currently writing from.  I snapped this photo on the way to Red Frog, an amazing nearby beach.