A River Runs Through It

This week's impressive number of participants served is made even more impressive when we consider the state of affairs in Pozos. The town may be famous for its pozos (wells), but it is currently rather infamous for its drenaje (sewage and drainage), which backed up and created a lake of sorts in front of the church. Luckily, the sewer is under construction and will hopefully be completed along with new paved roads before any future projects arrive.

We are also very humbled by the generosity of the people in Pozos. In one day, we were brought lunch by 3 separate people in succession, and then brought dinner by someone else before finally being invited to another person's house for dinner again. The local church delegate and his friend were also nice enough to provide transportation for us when we were stranded in the town one evening. This week has been an extremely educational experience and I'm sure we have each taken some vital lessons to heart. One of the most important: We can never predict when the tables will turn and the people we are helping will turn out to be helping us. There are remarkably dynamic relationships in this project, and everyone has something to contribute.

I'll finish with a picture of Kristoff and Dr. Steiner taking a needed break to do some studying after the screenings and consults.

¡Hasta el próximo!

¡Vamos PPS!

Hola Todos,

We are finishing a terrific week in Mexico, week three for the project 07. Let me fill you in with a brief update. First off, we lost our great ally from a different shade of blue, Joe. He returned to Duke on Wednesday for an ethics class, the ethics of which I think are questionable at best. He will be missed immensely, his love for public health, service, and Latin culture was a huge asset to the project.

We completed a successful week in Las Pozos, one of the larger communities we will be visiting this year. The group took the challenge in stride, I don't have the final tally quite yet but I know we ran out of supplies, a testament to the volume of participants we saw. Yesterday alone 54 screenings were completed by 1pm. Dr. Beat Steiner served as our attending this week, providing patient consults for all those participants with abnormal lab values . He provided sound leadership and expert advice. He was one of the founders of the Honduran Health Alliance, and thus has valuable experience from which to provide us guidance. Personally, I have been very impressed by the organization and maturity of the rising second years that are leading the project. But more importantly Dr. Georgette Dent, Dean of Student Affairs at UNC, who is visiting the project this week is also very impressed.

Dr. Dent has a long time interest in public health, and is helping to lead the initiative at UNC SOM to advance opportunities for medical students to work on international service projects. In her own words she claims to have "missed her calling" to work in public health. But I feel that the difference she is making as an administrator, supporting the growth of international service at UNC, will be far reaching and long lasting. Upon her return, Dr. Dent will be meeting with several of the other leaders in Global Public Health at UNC such as Mike Cohen, Doug Morgan, Martha Carlough, and our own Beat Steiner.

Prior to visiting el Proyecto Puentes de Salud in Juventino Rosas, Dr. Dent visited the PACEMD program, in San Miguel de Allende. She met with Dr. Haywood Hall, a colleague of Judith Tintinalli from UNC's Emergency Medicine department, and some of the leading health care administrators from the state of Guanajuato. This experience will help her to promote new opportunities for UNC medical students to do rotations with PACEMD in medical Spanish and emergency medicine and to experience the health care system from which many of our future patients first receive care. The program will be especially beneficial to students seeking to acquire a functional proficiency in clinical Spanish.

Check back soon for great photos from this week!

Cohetes

One of the first things that surprised us when we first arrived was the frequency of loud explosions. Actually, ¨surprised¨ is a light word; for the first two days or so, I was ready to duck under the table every time I heard them (and they were fired at least 3-4 times per day, usually on the hour). It turns out that the explosions are actually fireworks (rockets or cohetes) being launched in celebration of saints´ feast days. The situation reminds me of the retired navy captain firing his cannon from the roof in Mary Poppins. As one religious leader noted, ¨It´s always a fiesta here.¨ This week has been quiet as the feast days have passed for now, but I am sure the avid rocket-firers are busy hoarding up more explosives for the next opportunity.

It´s this spirit of communal celebration, I think, that has contributed to the support for Proyecto Puentes. People have been genuinely excited to push the project forward and contribute to the health of their neighbors. I am humbled by their work and I think it serves as a model for our own community commitments in the US. It´s a good thing we have so many people coming in this week for our work in Pozos, because given its size and level of interest, they will likely be quite busy.

More Newbies

We welcome Anita from Duke this week and also Dr. Steiner from UNC and his son. Their work is greatly appreciated! We are excited about the many physicians and students arriving today in preparation for our huge week in Pozos.

Going to the Chapel

On the right is a picture of the chapel in Romero where we held our first health fairs. Romero is a very beautiful town in the mountains. It also has no cell phone service, no running water, no bathrooms or outhouses in any of the homes, essentially no access to education beyond primary school, and virtually no young men (they are all gone working in the United States, usually referred to as just ¨allá¨). Nonetheless, the people were extremely kind and glad to have us there, and we stayed in a very nice room with real beds and a real floor that is usually reserved for traveling teachers. On the left, you will find a picture of (left to right) Lorene, the person in charge of the chapel, Kristoff, another gentleman who was around the chapel at the time, Charles, and Dr. Dan Reuland. And we´ll finish up with a photo of Charles keeping some children entertained (and vice-versa) near the chapel in Xoconoxtle. We tested over 75 participants total in the two communities and gave a ¨health chat¨ in Xoconoxtle about cholesterol, blood pressure, diet, and diabetes. Despite our study focus on cardiovascular disease and a small screen for depression, we were really wishing we could have a psychiatrist, a dentist, an OB/GYN, and a pediatrician with us given the kinds of issues that came up repeatedly.

First Week Reflections

Thanks to Lorene for contributing this post:

It has been a great first week. We got to Juventino Rosas on last Saturday and were taken to have lunch with the Padre at the parish here in in JR. It was the first of many meals that seem to begin and end with tequila. It´s a cultural sin to have an empty glass, so I have had to learn to SLOW DOWN when drinking. We went that evening with the Padre to a festival in one of the neighborhoods around here, and then to Celaya, a nearby town where we had a nice dinner. The next day, we were invited to meet the mayor of the town (El Presidente) and have lunch with him. We walked to the center of town, and were surprised to find a stage, microphones, and seats for about 100 people. It turns out they were having a welcoming ceremony for us. We were all given a token of their appreciation--- miniature wooden violins for the boys and a shawl for me. The violins are a symbol of the city, since Juventino Rosas was named after a famous composer who was born and worked here. As part of this surprise, I had to give an impromptu speech, microphone and all. I basically stammered in Spanish as quickly as possible, but it seemed to go over well. In the days since then, we have visited the community hospital, a nearby technological institute, and several of the communities that we will be working in. We have eaten lunch (the biggest meal of the day) every day with a different member of the local delegation supporting us. The food has been awesome, and only one of the tequila lunches completely wiped me out. (Lesson learned: no soy un pollo de primavera (I`m not a spring chicken) and don't try to keep up with Mexicans).

We are renting a house in Juventino where we will be staying on the weekends. We have been outfitting it with various things-- one night we even tried to cook, and it was very good (although what started as beef tacos turned out to be pork quesadillas :) ). Anyway, it has been fun.

Tomorrow, we leave for the first community. It is called Romero. It is very small and has very limited resources, so our work there will be well appreciated. It is far into the mountains, we have to borrow a large van to be able to get there. We will be staying there for two nights and then moving to Xoconoxtle (pronouced Ho-Co-Nose-Clay), also a small town in the mountains. We have all of our supplies together, and have practiced all the tests on each other. It should definitely be an adventure, but we are thrilled to get started with the work that we´ll be doing here.

Road to Romero

We recently went to the very remote towns of Romero and Xoconoxtle, to see the chapels and meet with the delegates who will be providing local support for the health fairs and chats in the first week. The closer we got to the towns, the drier things appeared (though the wet season is apparently right around the corner). Here, you can see the beautiful countryside from the road to Romero.

New Hospital

Here you can see the entrance to the shiny new hospital in Juventino Rosas, with Shannon, me, Kristoff, Lorene, & Charles in front. Past participants in Proyecto Puentes will be amazed at the new building, and I assure you it is even more impressive inside. It´s touted as a model community hospital for Mexico and offers more services than most hospitals of comparable size that I´m aware of in the U.S. The new building doesn´t solve the problem of rural residents lacking transportation to get there, though.

New Crew

Greetings dear readers,
I am happy to be able to update you all on Proyecto Puentes 2.0. Our initial crew, including Lorene, Kristoff, Charles and myself, has arrived in Juventino Rosas and been quite overwhelmed with the warm welcome here from the parish and municipal government (We were even recognized at the town hall meeting!). Since last year, the city of Juventino Rosas has been able to build a brand new and very advanced hospital. We are busily reviewing the target rural communities for this year and preparing for the fairs. More beautiful pictures should be coming once we get better at using the camera!