Saturday January 5, 2019-Today we went to the Rio Grande communitaria hospital for a 5 ½ hr observation.  We are lucky to get this opportunity, thanks to Dr Enver , he works there, so got us in.  This hospital is very small, it has an ER and one ward, here were 7 patients on the medical ward, 6 adults (5 OB and one medical) and a baby with early sepsis.  It was hard for me to understand the nurse on the ward so Kylie and I read through the chart and was able to translate the spanish.  We did not understand some of the abbrevations.  Laura brought us almuerzo we went to observe in the ER. The nurses were making masks so we helped them.  We  noticed that the nurses wear masks when caring for the patients.  We were told to protect themselves especially that it is winter now.

One of the ER nurses gave us a tour of the OR, birthing room and PACU.  The equipment is not as modern as ours. 

After the tour, we got a GI bleeder in the ER with systolic pressure in the 60’s.  The ER nurse expertly placed an IV and started fluid, boy did that make a difference.  The ER doc consulted the internal medicine (IM) physician (who we know from the Corbana clinic).  The IM physician explained to the diagnosis with the patient  and I was able to follow in spanish, maybe because I am so familiar with the diagnosis.  The nurse drew the blood for analysis and gave the three tubes of blood to the patient’s brother who took these along with a form to the lab in Rio Grande, 10 minutes away as the hospital’s laboratory was closed (perhaps because of the holiday).  I noticed that the lab tubes were not labeled and they were not in a biohazard bag.  Some other differences I noticed

-The suction apparatus is much different

-There were four shared rooms and one single room.  A lady who lost a baby was sharing a room with 2 ladies who delivered babies.  I felt kinda sad for the lady who lost her baby. 

The nurses document all their notes on paper.

The doctors entered the orders in the computer and printed them.  However, when the computer was not working, the doctors typed the orders, yes using a typewriter.

The nurses rotate to both ER, OB, and the ward. They usually work 8 hours but during the holiday, they work 12 hr shifts and get 5 days off.  The nurses in the ER was super nice, and willing to show us how they do things here.  The visit was insightful just seeing how health care is delivered in rural Mexico. Having seeing what I did today in the hospital makes me very grateful for the resources that we have in the US and how fortunate we are.

We went back to Cacalotepec then back to Ernesto ‘s cafe for a mango smoothie.  After comida, we took a little siesta.  We then went to the public health department and did our diabetes teaching.  I started off the session, the group was divided in dyads and presented the AADE7 selfcare topics of healthy eating, being active, taking medication, problem solving , healthy coping, monitoring, and, risk reduction. I felt we did well and there were a lot of good audience questions. It also emphasized to me even more that the population here is low or no literacy, there are some with disabilities (such as blindness from diabetes), so one has to be very mindful of of this when providing education. I was able to conduct a short interview with the clients (with diabetes) after the education session. Evening well spent, everyone did an amazing job

Friday January 4, 2019-Today Dave drove us 50 minutes to Tututepec. Dave was our tour guide as we visited Palacio Nacional. There were murals on the wall depicting Mixteco, Chatino, and Afrolatino culture and heritage in this area. I felt so informed after this tour, thanks to Dave. We also visited the Catholic Church in town which used to be the old palace.

We had lunch at the “corner” restaurant /Comedor Cortes which is family run business.  For comida, we had delicious frijoles, tortilla( a given, served with every meal), chile rellenos and Jamaica (hibiscus) tea.

After the van stalled on us, Randy and Dave tried to troubleshoot but no luck. Dave had to get a mechanic from one town over who eventually fixed the problem.

In the meantime, we hung out in Cortes Comedor and had ice suckers, then eventually moved to the plaza where it was much cooler. 

We got back to Roca Blanca mission base in another van, thanks to Jesus and Chano late in the afternoon. We inhaled our afternoon meal (comida) and was able to make it to Manialtepec Lagoon for a bioluminescent boat tour.  While on the lake, we were surrounded by a mangrove, a lot of birds but no crocodiles on the lake, thank goodness. The boat took us out to the ocean where we had a coconut and  watch the sunset which was amazing.  The sunset here is beautiful. After the sun went down, we went to view the bioluminescencia.  All nine of us along with our driver Johnie jumped in the lake, the water was so refreshing.  We were very fortunate because the bioluminescent was  glowing, we had so much fun making streaks in the water to see the plankton.

What was really liberating was that while in the lake, there were no “selfies, “we all just have a special memory  of swimming in this phosphorescent lake in Mexico.

I enjoyed talking in Spanish to Johnie, he spoke slowly and clearly, I had no trouble understanding him.

We ended the evening by celebrating Eddie’s birthday with the happy birthday song in spanish and a tres leches cake.

We visited a museum of Mixtec History this morning in Tututepec, Oaxaca. Dave, our tour guide took us to the city hall were murals were painted that depicted the Mixtec, Chatino and Afrolatino’s history. First, we viewed the murals that depicted Mixtec history. Dave spoke about the Mixtec people’s origin story and the serpent god Quetzalcoatl that many indigenous people in Mexico worshipped. There was also a mural of a fertility goddess and warrior named Iya Nacuaa Teyusi Ñaña who eventually became an emperor. His palace looked over the town of Tututepec where the Catholic Church now stands. Learning about the origins of the indigenous people in this area was so interesting, and gave me a better understanding of their beliefs. Although my family are descendants of Caxcan and Chichimeca indigenous groups, I’ve never learned the history of my people or of any other Mexican indigenous groups. For this reason, learning about these indigenous people’s history made me feel empowered and proud to be a Mexicana with such rich history.

In the evening we traveled twenty minutes east to visit a lake that has naturally occurring bioilluminescents. Once it was dark, the group and I dived into the glowing salt and fresh water. With ever motion the water glowed, and our skin glistened. This is easily one of the most beautiful places I’ve visited, and an unforgettable experience.

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Hoy visitamos un museo de la historia de Mixtec en el pueblo de Tututepec, Oaxaca. Dave, nuestro guía nos llevó al palacio municipal del pueblo donde pintaron murales que representan la historia de los Mixtecs, Chatinos y Afrolatinos. Primero vimos los murales que representan la historia de los Mixtec. Dave nos contó de la historia de origen de los Mixtec y Quetzalcóatl un dios que adoran muchos indígenas en Mexico. También nos contó de una diosa de fertilidad y Iya Nacuaa Teyusi Ñaña un guerrero. Iya Nacuaa Teyusi Nana eventualmente se volvió el emperador de el imperio Mixtec. El palacio de Iya Nacuaa Teyusi Ñaña mira sobre Tututepec y es dondela iglesia católica está hoy. Aprendiendo de la historia de estas personas indígenas fue muy interesante y my ayuda entender sus creencias. Aunque mis familiares son descendientes de indígenas Caxcan y Chichimec, nunca he aprendido la historia de mi gente. Por esta razón, aprender las historias de estos grupos indígenas me eso sentir empoderada y orgullosa de ser Mexicana.

Por a tarde viajamos viente minutos al oeste de Cacalote a visitar una Laguna que tiene bioilluminansias. Cuando oscureció el grupo y yo nos metimos a la Laguna a nadar. Con cada movimiento brillaba la agua y nuestra piel. De seguro, fue una de las mejores experiencias que he vivido.

I have always lived a fast pace life. The goal has always been to go from point A to point B as fast as possible, but having the consequence of not paying attention to the little things that life has to offer. Oaxca is different. In Oaxaca there is time to literally smell the roses, to stop and get a coconut, cut it open and drink the juice and still arrive on time to point B because there is no set time of when you should arrive to your destination. I may be exaggerating a bit but you get the point.

Being here has definitely made me live in the moment and part of it is due to having limited WiFi and cellular service for 90% of the time. One of the things you will find in Oaxaca is the fact that you will mainly get service if you are in a major city or if the place you are staying at has WiFi. Majority of the time you don’t have service and if you do, than you will be lucky to load a page by next year. It’s refreshing seeing nobody on their phones (locals included) and watching everyone walk with their head up having a conversation with one another, rather than with their head down on their phone.

By being disconnected we appreciate one another more. We are more connected not only with one another but with our surroundings as well. What might of seemed impossible (not using your phone) now becomes desirable to me. Although, the phone allows you to connect with a lot of people across the globe, it hinders your connection with the people right next to you (most of the time being the people you love and care about). What was once missed or overlooked, due to being stuck on my phone, is now appreciated and valued. Oaxaca has showed me what it means to sit at a dinner table and have a genuine conversation. What it means to give someone my undivided attention and what it means to truly bond with people you care about. I am constantly surprised by the fact that I keep learning new things about everyone every day. There is always something new to learn, all we have to do is listen and pay attention.

On a side note, today I spent my birthday in Oaxaca. I’ll be honest, I didn’t know what to expect but what I received was way more than what I could of asked for. I was blessed with amazing people that I have the honor to work with and tons of sweets (kit Kat’s and cake of tres leches). By the end of the day I’m pretty sure I turned pre-diabetic, so you know I celebrated it pretty well. I can honestly say that this birthday will definitely be one I will remember and one I will cherish for as long as I live.

For the entirety of this trip, I have been experiencing jaw dropping moments, whether it be about the beautiful landscapes, the unspeakable poverty and everything in between. Tonight was no different. Since our arrival to Oaxaca, we had been planning to take a trip to a lagoon called Manial Tepec, for a boat ride to see bioluminescent plankton. All of us were anticipating a lovely evening, but none of us were sure what to exactly expect.

The adventure began as we boarded a 10 seater boat and enjoyed a ride along the shoreline, birdwatching and relishing the beautiful, marshy scenery. I was amazed to see many white, grey and multi colored egrets, which are birds common in the United States— a nice reminder of home.

Eventually, we came up on a beach and enjoyed the sand & waves as we watched the sun settle and set across the horizon. We spent time taking photos, laughing and being silly.

After the sun had set, we reboarded the boat, and set off to find the bioluminescence. I found myself unable to draw my attention away from the stars, as it seemed every moment I spent looking into their depths, more and more stars & universes were revealed. My trance was broken as the friends around me began pointing and speaking with awe. It was then that I saw how the water had changed— it was glowing.

Never before have I experienced something so mysterious and mesmerizing. The driver stopped the boat, we strapped on our life vests (safety first am I right) and as we jumped, the water lit up all around us. It appeared like someone spilled glow sticks into the lagoon, creating a soft and gentle hue.

With every movement of the water, it was as though it awakened the organisms within, beckoning them to make their presence known. Whenever I lifted my hands from the water, I could do nothing but stare in pure amazement. As the water ran down my bare skin, it was as though my hands were a mirror, reflecting the stars and the universes I was staring at earlier. There on my fingers, was my own tiny galaxy.

It was more beautiful than I could have ever imagined.

This experience and this place was nothing short of magical. As we swam in the water, the glisten of the bioluminescence was also present in the eyes and faces of my friends. We laughed, smiled and played in the enchanting water. All of our burdens, all of our worries and all of our struggles became weightless as we swam and floated in the gentle lagoon. Eventually, the time came to leave, and I know every single one of us wished our time never had to end.

Afterwards, while I reflected with friends, we discussed how stirring the experience was, as every movement and every single thing we did had an effect, turning once dark water into beautiful light.

I found myself taking this experience and expanding it further. It made me think about how in everything we do, whether it is in a secret lagoon, in our classrooms, at work, or wherever life takes us, our movements and what we do, has the ability to create beauty as well. However, so often, it is easy to get caught moving, and living in ways that are stagnant, like the untouched water. Although it is calm, it has the potential to be SO much more beautiful. Personally, I know I will be thinking about how I can use my movements more deliberately and more intentionally to bring illumination to my own life and the lives of others.

P.S.

This experience definitely ranks in the top 3 of my whole life. The amazing part is that the entire outing only cost 150 pesos each, which is about $5.50. Yet, it was one of the best things I have ever done.

It will be something I remember for the rest of my days and it will be a memory that the nine of us will always share together in our minds, and in our hearts.

Double P.S.

“When you fart, the water glows.” -Anonymous

I’m finally adding to this worthwhile blog. 

The day before yesterday I began earning my keep by seeing some physical therapy patients. I’ve been a PT for almost 24 years, so I know my way around the human musculoskeletal, neuromuscular and neurological systems. I am, however, greatly hampered by my ability to speak only the most rudimentary elements of the Spanish language.  I can count to 10, order off a menu and ask ‘where is the bathroom?’. With this level of language skill, it is impossible to take a history. I therefore relied heavily on Eddie and Jazmin’s translation skills. 

The physical therapy patients I encounter at Roca Blanco fall into two major categories: simple or complicated. A simple case would be the single-joint orthopedic patient. The complicated case is the 3 weeks s/p dense CVA with hemiplegia. Since I don’t have as much as a reflex hammer here, I do the best I can with my brain and my hands.

We missed our work in the clinic this afternoon, but not because we wanted to…

     The van broke down

There was no lack of help from the locals eager to lend a hand to a van full of pretty American girls (and a couple of guys), but 5 people scratching their heads was no better than one person doing so.  The starter was Jerry rigged to begin with. The starter fuse had been bypassed by wrapping the starter wire around a fuse prong and shuving the fuse into the appropriate terminal. But the fuse popped out and Dave didn’t know where it came from. Then one of the helpers dropped the fuse somewhere in the abyss of the engine compartment. Eventually, Dave left in a taxi to pick up a mechanic from the next town over. A different van came and carried us back to mission base. And that’s how it goes in Mexico. 

This evening we visited the bioluminescent lake. The glowing water and sparkling hands were surreal. You can’t take a picture of it and you can’t take a sample home. You can only take a memory of the experience. 

I’m thankful that the local variety of mosquitoes do not seem to be attracted to my A-positive blood.

The last few days have been filled with assisting locals with their various health problems, mixed with what feels like a 5-star destination vacation. The mission base is beautiful. Our accommodations are nothing short of stunning. It’s so quiet and wonderful here. Yesterday, we set up a mobile health clinic in a village church near our base. We saw many patients that are indigenous to the town of San Martín. Attempting to understand and communicate is not always easy, but I already feel my confidence with Spanish in the medical context improving. At the clinic, we are able to provide physician assessments, write prescriptions, physical therapy recommendations and nutrition education, among other things. 

During the day, I helped determine the ailments of patients via interview questions and lab testing, the latter of which was a first-time experience for me. With the help of translators, I am able to utilize the skills I’ve learned while at Chico State Nursing School. Being here in Oaxaca gives a whole new meaning to healthcare, though. Witnessing the absolute generosity of the gente de Roca Blanca is inspiring. They are truly impacting these people who cannot necessarily afford the help they require. This clinic, and all the commodities, are free services provided by missionaries and others (like our team) who donate time and supplies for the villages. The pastors of the church fed us a delicious lunch of chicken soup in the afternoon. Once we left the village, we spent the end of the evening at a nice little restaurant close to the mission. It was a long but wonderful day.

… As I sit and think about this trip so far, I can’t help but feel immensely lucky. I never thought I would be able to afford a trip like this, much less while concurrently funding nursing school. But here we are in this wonderfully untouched part of Mexico and utilizing our education in a most humbling way.
I’m having experiences I never thought I could or would. Tonight I night-swam with my friends in waters that literally glowed all around us. Tomorrow I will be working in a rural Mexican hospital. We’ve visited museums that depict Chatino legends and history, and explored the plaza of a town called Tututepec while figuring out what to do when your van breaks down in Mexico. I’m getting to practice a lot with my camera, depicting the happiness and culture I am witnessing all around me. I’m furthering my Spanish language skills in a much more immersive and applicable sense than I ever did in a classroom. I’m watching my classmates shine in their respective areas such as translating and patient care and compassion and fellowship. School and “la vida diária” can be so challenging, boring even and exhausting. But here in Oaxaca I feel anew. 

This trip has exceeded all expectations. I am extremely thankful for this opportunity. Each day has been filled with priceless memories. The first day was mostly spent on a plane due to weather delays. We finally made it to the mission base at 7:30pm on Sunday and were welcomed with dinner, which was much needed after a full day of travel. The day ended with 2 rounds of “go fish” (not to brag, but I won both rounds). The next day we were given a tour of the base and oriented to the clinic. After helping in the clinic for most of the morning we went to have an afternoon meal at the orphanage. We celebrated the 16th birthday of one of the girls with 3 milk cake and a game of soccer with the kids. The day ended with a bonfire on the beach and swimming in the ocean. So relaxing and we each went around and said our new year’s resolution! The next morning we went to a nearby beach called Roca Mar to swim and surf. I got to talk with some young girls from Mexico City who wanted to practice their English. It was difficult to communicate because of their limited English and my limited Spanish, but it was fun getting to practice while we swam in the ocean. After the 25 minute walk from Roca Mar to our mission base we drove to Rio Grande and did a couple home visits. It was a very humbling experience because the woman Jazmin, Jackie, Anya, Laura and I visited had Sclera Derma. It is an autoimmune disease, which makes her skin very taut and is accompanied by respiratory problems, tachycardia and other complications. She had two sons and told us she had eaten a tortilla an hour prior to our visit, which we assumed is all she had to eat. Then we drove back to the base and finished the night with some card games while listening to the waves and having meaningful conversations. Yesterday we drove to a town up in the mountains called San Martin and set up a clinic in their local church. I spent most of the day taking vital signs, while the others listened in on consults with the doctor and physical therapist. It was very organized and ran very smoothly. We were able to help a lot of the indigenous people get consultations, medications and education. The local people thanked us by making a delicious lunch for us. I was talked into tasting a Chile Piquìn and instantly regretted it. It was a tiny pepper with big taste. I instantly starting sweating and turned bright red. We finished the day at the beach. Lindsey, Brooke and I ran 2.5 miles along the water. I am thankful to have running buddies here! Today has been spent in Tututepec learning all about the Mixtec history. As we were pulling out of our parking space the van broke down. We ended up having an extra 4 hours in Tututepec while we waited for another van to come pick us up. When we made it back to the mission base they fed us a quick meal and we left for our next adventure. Tonight we took a boat ride to a private beach to watch the sunset. Once it was dark we swam in the river, which is known for having bioluminescent organisms. The water would glow and sparkle around us! It was easily one of the most incredible experiences I have ever had. Tomorrow we go to the local hospital and I am excited to shadow the nurses there. 

The past few days to say the least have been humbling and inspiring. The 3rd of January we drove 20 minutes on dirt roads surrounded by jungle and small homes to the chatino village in San Martin. I was able to spend the whole day with Betty in the pharmacy working on my Spanish and educating people on how and when to take medications that they were ordered by the doctor. This experience has given me confidence to now explain medication to Spanish speaking patient estados unidos. A couple ladies in the village made us a delicious chicken soup for lunch and the best hand made tortillas. Once getting back we all headed down to the beach and had wonderful conversation. I love getting to know everyone on this trip and forming deep connections. 

Around 8:15pm we all walked over to a little restaurant that was run by a man who is a local but after talking to him in Spanish for 10 minutes he spoke English all of a sudden. We asked him how he had such good English and he said he grew up in Washington and moved here because it is tranquil. He is not wrong, Oaxaca may be the poorest city in Mexico but it is one of the most beautiful places I have ever been and I’m so blessed to be here. 

On the 4th of January we had an early morning starting at 7am. Kylie and I got to the 4th floor of the house and watched the sunrise over the ocean. We drove up to Tututepec for a day of history and understanding where these city and these people came from and how the beliefs arose. The murals were stunning, colored with bright and vibrant energy! As we hoped back in the van at 12pm ready to go the van dies…the ladies in the restaurants offered us a place to wait and a hibiscus flavored juice. We made the most of our time waiting by having great conversation and enjoying the scenery. (Eddie also played some great music)

Update…a new van came and picked us up at 3pm and we rushed back to the mission to eat a quick lunch. We then went to a lagoon and got to look at some beautiful birds and then relaxed on a beach that connects to the lagoon. When it got dark we got back into the small boat that took us to a spot in the lagoon where we got to swim with bioluminescent plankton. Swimming in that water was top 3 most amazing things I have ever seen, as we swam around the water glowed around us and made our arms sparkle. Today was full of adventure and I loved every second of it. 

We went to the village of San Martin today where we set up clinic in the Iglesia Cristiana Evangelica Mision Victoria.  We saw a total of 42 medical patients, adults and children.  Randy saw 6 physical therapy patients.  Jazmine and I break away to interview this 82 y.o. Chatino lady and her daughter about diabetes.  We had the interview in the kitchen which a separate single building beside the house.  The lady and her three daughters share the kitchen.  There is a wood fire inside, a corn tortilla stone and the ladies were making fresh tortilla.  They were very simple people but super nice.  The pastor’s wife made us chicken soup, the chayote was delicious.  This was a hot and tiring day for me.  Did a few consults with Laura interpreting for me. 

Once back in Cacalote, Laura and I conducted two more diabetes interviews at the clients’ homes. 

After dinner we went into el pueblo for snacks at the green shop.  We stop at a restaurant, greeted by a nice man who made us mango smoothie, a coconut,  and a bocadilla 

Today was very well spent, our team provided care to 42 clients!