Monday, June 29, 2015
Last Thursday in León
Thursday, June 25th
How could fifty patients feel like less then forty four? Probably because of the extra exam area (we have started running five exam rooms) and the fewer procedures. Today only one LEEP, I think only three or four cryotherapies.
We switched around rooms, and everyone had fun, as far as I could tell. I enjoy the heat and kept up on fluids, as I believe everyone has learned to do. The small room was hot, but had a fan (always a plus). Helping with a LEEP was great fun for me. The vacuum worked well for clearing the smoke after it was well charged the night before.
The OB /GYN residents stayed with us. One had a test to take and left for some hours. They unfortunately only have one day with us. They are gynecology residents, and have seen colposcopies, but starting over each day with a new set, making sure they understand PINCC, takes a bit of time.
The nurse trainees and the one general physician are really enthusiastic, and very good.
Friday has almost arrived.
Dr. Carol Kimball, Family Medicine, PINCC volunteer in León, Nicaragua
Thursday, June 25, 2015
Leon, Nicaragua on Wednesday,
Leon, Nicaragua, June 24, 2015
Wednesday:
On the way back from the Beach--it's only 7:15pm and it
feels like midnight because it is dark and Nuria is
exhausted --some didn't make it to the beach.
The day started more typically. We had several patients waiting at 8am, no one was missing giving a talk, and we had nurses, a general physician and OB/GYN resident trainees. There were three women needing LEEP and five or six cryo's. Perhaps forty patients total. Dr. Ilana Addis Medical Director, was running around checking all abnormal exams. We got enough behind because the LEEP room was used for LEEP that we came up with a fifth exam area in the air conditioned room.
Our goal was clear: teach, help people, and be ready for the beach by 4pm. A few stayed behind, too exhausted to go.
So after seeing several adorable dogs, a beached puffer fish, and amazing waves of warm water and eating great seafood, we are heading back to León. The bus too noisy with chatting for anyone to answer the question: What do you want the blog to say?
Dr. Carol Kimball, Family Medicine, PINCC volunteer in León, Nicaragua
The day started more typically. We had several patients waiting at 8am, no one was missing giving a talk, and we had nurses, a general physician and OB/GYN resident trainees. There were three women needing LEEP and five or six cryo's. Perhaps forty patients total. Dr. Ilana Addis Medical Director, was running around checking all abnormal exams. We got enough behind because the LEEP room was used for LEEP that we came up with a fifth exam area in the air conditioned room.
Our goal was clear: teach, help people, and be ready for the beach by 4pm. A few stayed behind, too exhausted to go.
So after seeing several adorable dogs, a beached puffer fish, and amazing waves of warm water and eating great seafood, we are heading back to León. The bus too noisy with chatting for anyone to answer the question: What do you want the blog to say?
Dr. Carol Kimball, Family Medicine, PINCC volunteer in León, Nicaragua
Monday, Tuesday in León,
Monday/Tuesday in León, June 22 - 23, 2015
Monday:
If you don't understand a word Carol says, you understand that everything is ok. So we learned that we could not work in the Clinic where we had originally planned to work, but we understood we had a place that maybe would have one or two rooms to work in. While the week before they were short of providers, this week we have five plus our Medical Director, Dr. Ilana Addis.
So Monday comes and we walk a block from Hotel Real to Asociación Mary Barreda, an NGO where the focus is on working with victims of violence and preventing violence against women and children. There is an ante room, then a step into the back area. Like most buildings in Leon, it has the idea of an inner courtyard that is open to the air. Each room is off that courtyard.
We walk into a room that is perhaps 11 x 20 and thankfully has a small wall air conditioner unit and two fans. This turns out to be our cryotherapy room and command center. We do the teaching, the computer entry, storage of bags and general planning in this room. There is a rope with a sheet to divide it into an exam room as well.
There is a small exam room that Dr. Alborz uses and this is also the LEEP room. Then an open kitchen like area that is divided into two exam areas, in the open air half is the sterilization area.
The first day we see nine patients--thanks to Carol wanting to make sure the day went smoothly. It really did go smoothly.
In addition to the usual teaching activities, Dr. Alborz Alali gave a lecture to the four OB/GYN residents who came, and it was well received. Dr. Eduardo Zapata interpreted for him.
Tuesday:
Original Plan Dr. Alborz gives lecture at 7am or 8am to students and faculty about cervical cancer, but Monday night in an attempt to learn the real time, we find it was moved to Friday. This morning starts, only two nurse trainees are here before 9. We get a call at 8:30am asking where Alborz is--there are 70 people waiting to hear his talk....
Breath... The lecture went well.
Ended seeing 14 patients in the morning and at least one in the afternoon. Three cyros and one LEEP were done. Teaching of three OB/GYN residents and three nurses and one general physician in two groups for the afternoon
Evening plan seems to be going out to music and then dinner. After a cold shower.
Dr. Carol Kimball, PINCC volunteer in Leon
Monday:
If you don't understand a word Carol says, you understand that everything is ok. So we learned that we could not work in the Clinic where we had originally planned to work, but we understood we had a place that maybe would have one or two rooms to work in. While the week before they were short of providers, this week we have five plus our Medical Director, Dr. Ilana Addis.
So Monday comes and we walk a block from Hotel Real to Asociación Mary Barreda, an NGO where the focus is on working with victims of violence and preventing violence against women and children. There is an ante room, then a step into the back area. Like most buildings in Leon, it has the idea of an inner courtyard that is open to the air. Each room is off that courtyard.
We walk into a room that is perhaps 11 x 20 and thankfully has a small wall air conditioner unit and two fans. This turns out to be our cryotherapy room and command center. We do the teaching, the computer entry, storage of bags and general planning in this room. There is a rope with a sheet to divide it into an exam room as well.
There is a small exam room that Dr. Alborz uses and this is also the LEEP room. Then an open kitchen like area that is divided into two exam areas, in the open air half is the sterilization area.
The first day we see nine patients--thanks to Carol wanting to make sure the day went smoothly. It really did go smoothly.
In addition to the usual teaching activities, Dr. Alborz Alali gave a lecture to the four OB/GYN residents who came, and it was well received. Dr. Eduardo Zapata interpreted for him.
Tuesday:
Original Plan Dr. Alborz gives lecture at 7am or 8am to students and faculty about cervical cancer, but Monday night in an attempt to learn the real time, we find it was moved to Friday. This morning starts, only two nurse trainees are here before 9. We get a call at 8:30am asking where Alborz is--there are 70 people waiting to hear his talk....
Breath... The lecture went well.
Ended seeing 14 patients in the morning and at least one in the afternoon. Three cyros and one LEEP were done. Teaching of three OB/GYN residents and three nurses and one general physician in two groups for the afternoon
Evening plan seems to be going out to music and then dinner. After a cold shower.
Dr. Carol Kimball, PINCC volunteer in Leon
Tuesday, June 23, 2015
Totuguero: friends, memories, dreams
Tortuguero
by Barbra Lanier
 |
| saddles for sale in Totuguero |
A place
I’d never heard of. Yet, I now have friends, memories, dreams of
Tortuguero.
 |
| rubber riding boots with spurs |
Tortuguero is like a town
out of a western movie. There are horses everywhere. The streets
are composed of packed dirt and country music can be heard blending with a kind
of salsa. Saddles, cowboy boots and riding gear are for sale at the
market on Main Street. It takes four and a half hours to reach Tortuguero
by boat, and eight by car (when the dirt road is passable in dry
weather). The weather in June is hot and humid, so most days are spent
dripping wet. There is running water, but it only runs cold, not
hot. There is electricity...most of the time.
 |
| Juliana with patient |
 |
| Team resting on the porch |
But one thing Tortuguero
does have is a hospital, run by a wonderful woman, Dr. Violetta Torres, and
staffed by four fine doctors and four caring nurses who learned much from the
PINCC team about examining for the HPV virus and treating women who had it so
they would not die of cervical cancer. That’s why I went to Tortuguero
and that’s why I took my 15-year old grand daughter, Juliana, on this
trip. And that’s why I now have friends, memories and dreams of
Tortuguero.
Monday, June 22, 2015
Friday, June 19, 2015
Classroom in Tortuguero Nicaragua
Classroom exercise
Tortuguero
on Atlantic Coast of Nicaragua.
Photographs by Madelene Todel.
Teaching in Kukrahill
Dr. Virginia Hanson, Medical Director, teaching in Kukrahill, Nicaragua.
Posters made by Emiko Omori on the walls.
Photographs by Madelene Todel.
Meet Doña Maria Bravo
If you are very lucky, there will be one person at the clinic who knows where everything is, where everyone is(!). We were so lucky in Tortuguero. Meet Doña Maria Bravo, protector and caretaker of the PINCC team in Tortuguero.
Muy intelligente, resourceful, compassionate and funny. No matter the question, the answer was "ask Maria Bravo." On the first day, she was the first person to sign up to be examined so she could be a proud example for the more timid women in the clinic waiting room.
She and I shared speculum washing duty on the outdoor back patio. Rain or shine, we would laugh and talk while we washed the tools of our trade. Then she started dancing just a little bit. And I showed her a salsa step I had just learned-and we were off. Dancing and washing speculums with the rain pouring around us. Well, why not?
Jan Lecklikner, PINCC volunteer in Tortuguero and Kukrahill, RAAS, Nicaragua
 |
| Jan Lecklikner with Doña Maria Bravo |
Thursday, June 18, 2015
Volunteers Venture...
Nicaragua, June 2015
(posted to PINCC facebook 6/18/2015)
PINCC volunteers venture out into communities
that tourists don't easily get to. We flew from Managua to Bluefields on
the Nicaraguan Atlantic Coast and the next day took a four and a half
hour ride to Tortuguero, a remote primarily agricultural community on
the Atlantic coast. Tortuguero is accessible by boat and, in the dry
season, by road west to Managua.
Tortuguero is a small hamlet without paved roads. One sees horses, pigs, chickens and dogs on the streets. On market day men and women came to town on horseback and many of the women we examined road up to 12 hours on horse back in order to be seen.
Our first week included eleven PINCC volunteers ranging in age from fifteen to - seventy years & eight Nicaraguan doctors and nurses. The medical staff in Tortuguero included a number of Nicaraguan physicians trained in Cuba.
By Madelene Todel, CNMTortuguero is a small hamlet without paved roads. One sees horses, pigs, chickens and dogs on the streets. On market day men and women came to town on horseback and many of the women we examined road up to 12 hours on horse back in order to be seen.
Our first week included eleven PINCC volunteers ranging in age from fifteen to - seventy years & eight Nicaraguan doctors and nurses. The medical staff in Tortuguero included a number of Nicaraguan physicians trained in Cuba.
(posted to PINCC facebook 6/18/2015)
Kukra Hill, Nicaragua
Kukra Hill, Nicaragua June 2015
Written by Jan Lecklikner
The women came to the clinic in Tortuguero on horseback, by panga (boat) in Kukra Hill. The reality of all season roads does not exist in this part of Nicaragua. Instead, we have hospitals several hours away by boat. And time begins to slow to "panga" time. In Tortuguero, we said "of course" when our exit panga was needed in an emergency for a woman with a preeclampsia pregnancy. Five of our team members missed their flight from Bluefields as a result. That is life in Nicaragua. When our panga broke down between Pearl Lagoon and Kukrahill, people "loaned" us their panga to get home.
Yesterday, I interviewed a woman who had had a successful LEEP procedure on the last PINCC visit to Kukra Hill in November. Carol handed me the interview form and said this woman was saved by PINCC. And, indeed she was. We may be treating one woman at a time but each woman is a mother, daughter, neighbor, friend. She is a part of the fabric of her community and her unnecessary suffering and death from cervical cancer would rip that fabric for generations. Every trainee becomes a trainer and the knowledge and skill moves out into these remote and rural communities to save women's lives.
I am not a doctor or a nurse. But I can wash speculums and make sure the rooms are stocked and clean. I get to be a thread in the fabric which keeps us all together. For that, I am grateful to be here. Jan
Written by Jan Lecklikner
The women came to the clinic in Tortuguero on horseback, by panga (boat) in Kukra Hill. The reality of all season roads does not exist in this part of Nicaragua. Instead, we have hospitals several hours away by boat. And time begins to slow to "panga" time. In Tortuguero, we said "of course" when our exit panga was needed in an emergency for a woman with a preeclampsia pregnancy. Five of our team members missed their flight from Bluefields as a result. That is life in Nicaragua. When our panga broke down between Pearl Lagoon and Kukrahill, people "loaned" us their panga to get home.
Yesterday, I interviewed a woman who had had a successful LEEP procedure on the last PINCC visit to Kukra Hill in November. Carol handed me the interview form and said this woman was saved by PINCC. And, indeed she was. We may be treating one woman at a time but each woman is a mother, daughter, neighbor, friend. She is a part of the fabric of her community and her unnecessary suffering and death from cervical cancer would rip that fabric for generations. Every trainee becomes a trainer and the knowledge and skill moves out into these remote and rural communities to save women's lives.
I am not a doctor or a nurse. But I can wash speculums and make sure the rooms are stocked and clean. I get to be a thread in the fabric which keeps us all together. For that, I am grateful to be here. Jan
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