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Week 1: The Beginning

Week 1: May 17-28

To introduce the beginning of the project and our trip I have to choose a place to start. As I have explained the purpose and some of the development in the previous post I will jump to May 17 when we finished our final exam for Microbiology and Infectious Disease. The rush of finishing our first year of medical school quickly drained away as we realized after putting off for weeks the final preparations for the drive to Mexico, we had only three days left to pack and prepare. This included organizing a kick off dinner on Friday May 19. Luckily most of the preparations for the dinner were taken care of by Katy. Unfortunately finalizing responsibility for who would bring which supplies was not taken care of, which turned out to be a challenge for all of us over the next several weeks.

Rushed preparations were made and in our free time we said goodbye to our families, much neglected over the busy medical school semester. At 4 am Sunday morning the car was packed, we said goodbye to Ms. Lindsay, Tripp’s mom, and left Charlotte, NC with the sunrise. We made good time all the way to New Orleans, our first layover. The damage from Katrina was still evident in missing street signs, roofs, and other logical objects that most cities would have; in New Orleans things were just missing. It was easy to imagine the severity of the damage immediately following the hurricane. It was the first time either of us had visited New Orleans so we spent the afternoon and evening visiting some of the famous sights and districts.

The following morning we left early for the shortest leg of the trip. The drive from New Orleans to San Antonio was a direct 550 mile shot on Hwy 10. We stayed the night with my cousin and prepared for the border crossing and 12 hour drive the following day.

As anticipated the border proved to be a frustrating experience. However, we were glad the frustration stemmed from acquiring the proper documentation and not from a hassle regarding the medical equipment we were carrying. We had official letters of explanation from both Mauricio at UNC Hospitals and Father John at St. Thomas Moore. The letter from the church turned out to be our key to attaining a work visa in Mexico. The official would not grant us tourist visas because we naively disclosed our purpose in Mexico was to conduct a health project. In the future I recommend avoiding the hassles and just tell the officials you’re a tourist.

After several hours in Nuevo Laredo acquiring the proper documents for our car and ourselves we left for the 10 hour drive to Guanajuato City, Guanajuato, Mexico. We were pleasantly surprised by the quality of the roads and road signs, which we basically followed all the way to our destination (our only road map of Mexico was tragically inadequate). Our journey through Mexico went smooth; the countryside was out of an old western flick.

I was Robert Redford and Tripp was Paul Newman from Butch Cassidy and the Sundance Kid as we arrived in the hills just outside of our destination, Guanajuato City. The sun was setting; casting cactus shadows over the road as we passed through tiny Mexican pueblitos. Multigenerational families sat together on concrete porches, watching the two gringos pass in their Japanese automobile.

We were a mere twenty minutes from Guanajuato City and 3000 miles from home when a tope (Spanish for speed bump), jumped out in front of the car. I was driving as cautious as possible in a foreign country, but nothing could be done and we slammed through the tope at 40 miles per hour. It was about 50 feet down the road before I realized the source of the metal on pavement scraping sound. My rack holding two bicycles, formerly attached to the trunk of our car was now being pulled behind us like a water-skier behind a speed boat, tumbling summersaults in the wake of our car. I had to stop the car in the middle of the narrow village street stopping all traffic behind me as the Mexican children laughed and pointed at the crazy gringos hurriedly trying to lash their bikes back on the car. Tripp laughed along with them thoroughly enjoying the situation… It wasn’t till I repaired the damaged bike that I could enjoy the comedy of the situation.

Proyecto Puentes de Salud: The Mission and Purpose

Our founding goal is to serve as a “health bridge” between underserved Hispanic/Latino communities and needed health services, to ameliorate health care inequalities. To achieve this we are working with community members of Juventino Rosas, Mexico to provide free services to underserved and disadvantaged municipalities surrounding Juventino Rosas. We are conducting primary research through survey and data collection to better understand the risk factors for cardiovascular events and contraction of HIV in the Hispanic/ Latino population both in Mexico and the large immigrant population in the US where the project will continue in the fall of 2006. Our interests our bimodal; we have selected these two topics based on an early investigation in Juventino Rosas where doctors and lay health workers were interviewed about the primary health concerns of the region.

We are currently working to provide accessible HIV screenings to the communities of Juventino Rosas and are presenting original public health classes about HIV and Sexually Transmitted Infection. Our free consults consist of a primary risk assessment followed by the the Oraquick® Advance™ Rapid HIV-1/2 Antibody Test and a discussion of risk reduction strategies. During this interaction we complete an anonymous questionnaire to learn more about the knowledge base and risks of HIV in this population. We are also specifically looking at the relation of risk in the local population and immigration as the majority of the men in the communities we are visiting are working in the US.

With the help of Dr. Mauricio Cohen we were able to add a thorough cardiovascular component where we provide Blood Pressure, BMI, Blood Sugar, and Lipid screenings, as well as counseling and education about diabetes risks and prevention. Following the screening participants are giving a consult regarding their results. During this session we talk about about the risks of hypertension and heart disease, and ways they can improve their health through diet and exercise. When there is immediate need for medical intervention present we are able to directly refer participants into the local medical system. We have close contacts in both the public and private sectors of the local medical services. At least twice a week we are offering classes on Cardiovascular Health.

This project is intended to promote the long term Sister-City relationship between Juventino Rosas and Carrboro, NC, and to establish a long term medical affiliation between UNC School of Medicine and the medical community of Juventino Rosas. Our project will allow medical students motivated to work with Hispanic/Latino populations in North Carolina to experience the culture and medical system of Mexico (where many of their future patients first experienced health care).

We hope to reduce the incidence of new HIV infection among the underserved populations of JR by providing culturally sensitive HIV/AIDS prevention education, community outreach programming, and HIV screenings. We hope to strengthen and facilitate knowledge and understanding of the risks of diabetes and hypertension among Juventino Rosas community members, by providing free screenings and consultations. Finally, we hope to reduce the risk of a cardiovascular event and reduce the complications of long term diabetes for the hundreds of participants that will benefit from our screenings.