Third Week in Bolivia

Rather late update, I know, but I figure I shall update for the third week when I went in the mobile medical units. The first day I went up to a school where we did general health exams on the classes of kids - most were under 10 years old. They all had horrible teeth, some were malnourished and had herpes skin outbreaks, a few had upper respiratory problems, and we were checking their fingernails since parasites in fingernails is a big way they enter food. We dispensed two de-worming pills per student, and returned the next day to extract broken teeth beyond hope of repair. I even have pictures this time! Since I had been watching the examinations closely the previous day, I volunteered to help conduct the exams the next day, so I got to do essentially half of the kids. I hope they understood my accent well enough.

Another point about their teeth - a lot of them had teeth so bad that they also had abscesses...poor kids. A few less typical cases include...tonsillitis and bronchitis. All in all, it was a very interesting experience and gave me a chance to get some hands on experience. I listened to the kids with stethoscopes and was able to discern bronchitis (and we were just listening through clothing too...you definitely let a lot of things slide when you're on the go in a third world country).

The next day in the ambulances was our last day doing hospital stuff and I went in the mobile unit that parks at various street locations and takes walk-ins for treatment. Most of them were all alcoholics or pregnant ladies, and the guys would stay and talk for 10-30 minutes at a time about their problems...got really boring, and I could understand what they were saying too. The stories just all sound the same after a while, and so we did very little actual medicine that day. The only good thing that came out of it was a female patient came by who had a mitral valve defect - mitral regurgitation - and we were able to hear the valve defect in the flesh so to speak. It was definitely more pronounced than the audio clips we had been given to listen to during our last examination.

That's about it for medical stuff in Bolivia - the next day we went to Lake Titicaca until Saturday, then I just hung around until Wednesday, when I got to leave for the Galapagos Islands with my family! I was so happy to return to the US when I finally got back - after being in Bolivia for 3 weeks, seeing familiar food, familiar settings, stores, etc. felt great. Anyhow, I shall soon begin posting on the various medical conditions I saw or heard about in Bolivia. Until then, off I go.

Second Week In Bolivia

Well I am into my third week now, but this post shall mostly be about last week. Last week was...interesting. I will briefly describe the weekend - we went first on this crazy hike up to the Muela del Diablo. It was quite neat. The next day we went on a bike ride, something like 55km down the Worlds Most Dangerous Road. Ended up going down from bout 14k feet to 3.5k feet into the rainforest where there was an animal sanctuary so there were lots of really friendly monkeys, birds, etc. Some insects too. No pics, alas, since these computers dont have memory card readers.

Anyway, Monday was fine, I followed Dr. Fernandez around for a while. Tuesday was more of the same. Wednesday I shadowed in Obstetrics and Gynecology, since we were all switching locations on Wednesday and I was absolutely miserable. Cannot stand OBGYN. First off, the sight of pregnant women, babies, breast feeding, etc. is definitely NOT my thing. Next, I know very little about pregnancy and complications. Finally, all the doctors spoke super quietly so it was near impossible to understand anyway. Then Thursday I tried to hang out mostly in ER but that got kinda boring, since it was mostly UTIs and women with abdominal pain. Friday we were going to leave early to go to Lake Titicaca for the weekend, but one of the guys in our group was feeling pretty ill from some bacteria, so had pretty bad GI upset... so we ended up not going. Me, the doctor, and the other girl in our group went shopping for souvenirs and went to the Coca museum, which had a lot of interesting information about the history of Coca in Bolivia and the world. Saturday...three was more souvenir shopping. As was Sunday, but we also watched a lot of partidos de futbol! Wednesday we had gone also, but it was just a local game and there was not as much skill as in the world cup. It is a pretty big deal here.

Anyway, this week we are spending mostly in the mobile units, checking out schools and kids in the streets. It is pretty neato, but I will do a full report later, since we have only done this for one day so far!

First Week in Bolivia

I would have written sooner but it's a little difficult to find time among all the things we are doing. We got in on Sunday morning at about 6am after flying to Miami and then La Paz. A lot of flying. Very long flights. We were met by Mr. Gonzalo who is our liason/coordinator for the volunteering we are doing. He helped us get a taxi which took us to our homestay. We are on the fifth floor of an apartment complex and staying with a woman named Olga. She speaks essentially no English but among our group of three (Nourah, Me, and John), Nourah and I usually are able to make sense of things. We were considering taking Spanish lessons, but we placed as intermediate/advanced so we weren't sure it'd be worth our money. Anyway, we napped that first day, then met Nathalie, one of our professors, at a coffee place in one of the plazas. We then explored the area a bit, did some shopping, that sort of thing.

The next two days were kind of a blur of meeting with Gonzalo to discuss the cultural and social climate here in Bolivia, discuss our role in the hospital, how we can contribute, that sort of thing. We also were joined by a physician from Touro, Dr. Mokari, who is hanging out at the hospital with us. We visited the hospital and were introduced to people but didn't stay long enough to do much else. Then we returned, have been eating out a lot and getting drinks, that sort of thing. We saw Prince of Persia the other day in Spanish, have gone on two bus tours, and the like. We're starting to get a pretty good feel of the city, including which taxis and minibuses are sketchy.

First day in the hospital I chose to follow an infectious disease epidemiology specialist - of course - and we saw four cases of Dengue fever (apparently really unusual for this time of year), a case of gallbladder stones, and then discussed the etiology, causes, diagnostics, treatments, etc. Today I saw a patient with tuberculosis, got to look at his X-Rays and auscultate his chest. It was really interesting. I was also shown around the SUMI office, which is insurance for low income individuals and they keep tabs on the most significant infectious diseases or conditions including yellow fever, leishmaniasis, rabies, influenza, tuberculosis, dengue, AIDS, hanta virus, polio, rubella, measles, etc. We're going to do a survey on Monday, and this weekend our group is going to do a biking trip to the rainforest, hopefully! Until then!

Spring Break

Hooray for spring break and being done with blocks exams for the time being. I ended up going to Monterey for a week, and then down to San Diego for the remainder of the passover time we have off. I have done essentially no medicine-related stuff all break - a welcome change and break for my brain. Looks like we get to start out with venipuncture and the respiratory system next block. Makes sense, as we just covered the cardiovascular system. It should be interesting.

In other news, we're needing to raise some money for the Bolivia trip (as in, get money to buy supplies for the hospital, mobile unit, and for the impoverished down there). I'll be returning to my research soon enough, and want to exercise a bit more so I'll join in the weekly karate class and do pilates on the side. I also got a LASIK checkup and my eyes are still healing perfectly and there are no complications. I also need to start making my own food more often - as much as I like letting my parents cook everything, sometimes I really prefer my own cooking. Anyhow, back to enjoying the last couple days of leisure that I have...

Bolivia and Research

Things are progressing as usual at school. We're studying drugs for treating hypertension, dyslipidemias, arrhythmias, angina, etc. Essentially this is the phase where we learn how to treat the diseases in the renal, cardiac, and respiratory systems, which we learned about last block.

In the meantime, I've gotten started on some research, fortunately with the same professor who is going to Bolivia with us. I'm glad I am on good terms with all the faculty so far - I have heard of a few students who think certain professors dislike them, and I haven't gotten that vibe from anyone yet, so hopefully I won't. The research is related to bacteriophages, as I mentioned before, and we will be growing bacteria (Salmonella) and determining under what conditions their bacteriophages become most activated to the lytic phase (where they reproduce themselves and lyse their host cell, looking for more hosts, compared to the lyosgenic phase where they lay dormant in the host cell's DNA). The professor I am working with, as well as others in the lab, seem to be really laid back, It's kind of a "when you can help out, come on in - put your studies first" situation. After the high-stress environment of working in a hospital laboratory, and even the strict environment at UCSD, this is a welcome change.

Also, the Bolivia trip is beginning to materialize more. We are about ready to book our flight to La Paz, are going to put together a presentation of pre-research about Bolivia, and are getting materials ready for the trip. I'm very much looking forward to the experience - Spanish immersion, health education, learning how to diagnose and possibly treat diseases we rarely will see here in the US. Anyhow, back to studying.

Bolivia! It's ON!

Today was fairly straight-forward, though I forgot to drink any caffeine so the day started dragging down during the myelosuppressive disorders lecture. My group had two OMM sessions to get through today - the first we had a short quiz (easy) on muscle attachments and worked on some rib muscle energy techniques, then after lunch I had a semi-practical where I had to demonstrate upper thoracic vertebra muscle energy techniques - passed without a hitch.

Now for the good stuff - we had a Bolivia information session today with the coordinator, Dr. Garcia-Russell. I really cannot wait to go - we'll be staying in La Paz with a local family, two or three people per family, and the overall price of the trip looks like it'll be $2,000 - broken down, about $1,000 for air fare, $100 for entry visa because Bolivia hates America (no entry cost for non-Americans), $150 for accelerated Spanish course (50 hours), $100 preceptor fee that goes to the hospital hosting us, $270 for the room and board for 3-4 weeks, and a few miscellaneous costs here and there. It's amazing how cheap everything sounds like it will be - and some local attractions include Lake Titicaca, nature preserves, etc. I was expecting to be staying in a very rural area, so being in La Paz a surprise. Here is a picture of the hospital: Arco Iris.


Check the link above for information about Arco Iris. It looks like it'll be exactly what I was hoping for - a place in South America where they speak almost only Spanish (and a couple indigenous languages, like Amaya), in a climate that is perfectly tolerable to me (it should be cold and sunny at 12,000 feet), and I get to learn more medicine and get a valuable experience. We will be leaving at the end of May, right as our block exams finish, and be in Bolivia for 3-4 weeks, the last week being reserved for social work with an orphanage. Our clinical experience will be rather basic, but we spend a week in Obstetrics, Pediatrics, and Emergency medicine, as well as accompany a Mobile Medical unit that goes through the streets and to schools. Some of my family may come down at the end of my internship to spend time in Bolivia or a neighboring country. I'll bring more news later! Now to do more studying...

Oh right, and LASIK is happening, for real this time, third time's the charm - this FRIDAY!