Libby: The Clinic/ a typical day

First, the clinic:

The clinic is called FIMRC (Foundation for International Medical Relief of Children). I think there are multiple clinics around the world with the same name, but this one is located in a small "suburb" of San Jose called Alejuelita. I call it a "suburb" because the area was described to us as one part of the "ring of poverty" that surrounds the city of San Jose. Each area is full of immigrants, mostly from Nicuragua at the moment. The immigrants come to Costa Rica for safety and because there is more money here. They think they will be able to get jobs near the capital, and therefore, there are many poor immigrant areas near San Jose.

So- the goal of the clinic is to meet the medical needs of the children from 3 neighborhoods in the area, as Jonathan described earlier. These kids aren't covered under the national health system because they are not citizens. The clinic was set-up by a doctor and a health educator. They are both single guys in their 30's with a lot of enthusiasm as well as compassion for the children they work with.

A typical day:

Leave for the clinic at 7:30, arrive at 8. Have Spanish class from 8-10 with Tatiana, the most amazing language teacher I have ever encountered! (and the clinic psychologist)

10-12: Each day we are assigned to a different part of the clinic:

The waiting room:

All three kids in this family are showing off their new clothes :)

the exam room: 3 students and one doctor sit in the exam room and see one family of children at a time. The doctor and students as questions, and then one student and the doctor exam one patient at a time. It is good for us to practice our clinical exam skills and medical Spanish!

(minus the laptop on the exam table, of course!)

the medicine room, the group that goes out to make home visits, and a few other tasks to help around the clinic (like updating charts and painting some furniture)

12-1 or 2: Lunch! We get chastized for eating so quickly . . . and I am learning to enjoy a prolonged lunch 'hour.'

Two afternoons each week, we go out into the community, either to a nearby soup kitchen or one of the neighborhoods where the kids live. We do skits and teach the kids some basic health lessons. Last week, the theme was nutrition and we taught them about good foods and bad foods, vitamins and the food pyramid, via skits, of course.

We also get one or two lectures each week about the 'theme' of the week. These are given by one of the doctors or the health educator or the psychologist. Last week, we got lectures on nutrition for babies and normal pediatric growth from the Family Medicine doc, Dr. Nancy Struthers. Today, we got a lecture from Tatiana about her work with the children and a bit about childhood and infant psychology.

More to come soon! Hope you are well.

libby

Jonathan: La clinica

So, today was the first day at the clinic. We didn't actually see any patients or anything, but we spent the whole day there... The morning was spent taking a tour of the barrios (neighborhoods/slums) where the patients live. That was quite an experience. A good one, though. Most of their houses were made out of corrugated metal and jam-packed together. Apparently each house normally has somewhere between 5 and 10 kids. We saw lots and lots of kids on the tour. Very few parents, though. Since Libby got to put all the pictures in the last entry, I beat her to it this time.

There were just a ton of little houses crammed together on this huge hill. The sanitation was terrible, there was only semi-pirated electricity, and apparently crime was rampant. Before going on the walking tour, they instructed us to take nothing with us but our clothes. We almost didn’t even take cameras... and when we did, we were instructed to keep them mostly out-of-sight and hold them close. One thing they told us that I found interesting (though sad, I suppose) is that a fairly common thing in one area we saw was to have little houses that were like bars, only instead of alcohol, people bought and did drugs there. Oh, and there was litter everywhere. Lots of places where they were burning their trash. I suppose if no one’s going to pick it up for you, and you don’t have any transportation, you have to do something with it.

Another interesting thing was the divisions within the barrio. There were little paths and roads that, as we were told, very clearly divided different areas - safe ones from dangerous ones, poor ones from even more poor ones, ones with water to ones without. They all looked pretty much the same to me. So, I suppose you have to be quite familiar with the place in order to not get yourself into trouble by going into the wrong place.

We spent the afternoon at the clinic itself...

We unpacked most of the donations that we had brought, but ran out of time before the day was up. We've got a lot of work to to, organizing things and such... Some classmates even want to convert a semi-open room in the back of the building to a fully-furnished exam room. We'll see if we have the time and resources for that.

Libby and I wandered when we got home. Had a little adventure with conversions. It wasn't until after our first trip to the ATM (and then two stores) that we remembered that $40=20,000 colones, not the 2,000 that we got the first time around. Oops.

I'd better finish for now so that we can eat dinner before a group meeting tonight at our house to discuss weekend plans...

Jonathan

Jonathan: El Principio

January 20, 2008
So, we arrived in San Jose yesterday. That was an adventure. Thankfully, it wasn’t much of an adventure getting our 350lbs of medical supplies through customs. The biggest part of the adventure was cramming that, along with 9 people and their luggage into a van and then driving to the FIMRC clinic. We only had to stop once on the way to make sure nothing had fallen off!

We had a little orientation last night before meeting our host families and settling in. We had a wonderful dinner that they prepared for us: arroz con pollo, frijoles negros, melon. If all the food is as good as that, we’ll be gaining some weight unless we run quite a bit.

We unpacked after dinner and then went to bed, pretty thoroughly exhausted after a long day of traveling. Apparently some of our classmates were a little more energetic and went to a local bar. So, it was no surprise when they did not meet us, as planned, in the morning at the local fruit market (la feria).

They had tons of interesting fruits and vegetables. The family bought some stuff, including something called guanacanama or something like that. All I could think of was the Muppets song, Mahna Mahna. Anyways, we tried it at breakfast and it may very well have been the most delicious fruit I’ve ever had. So rich and sweet, with a nice texture. Mmmmm...

We also had pupusas. They reminded me a lot of gorditas in Mexico. Dough with beans and lemon and chicharones stuffed inside before grilling them. Those were good, too.

It’s been interesting getting a peak into family life here. There are definitely some stereotypes/machismo in action. The mother of the family we’re staying with seems to do all of the housework (at least from what I can tell), yet defers to her husband to explain anything to me (use of the keys, how the shower works, etc.). Also, whenever something needs to be explained, they don’t ever talk to both Libby and myself, but single me out as the one to receive the instructions. I think it’s because of my gender, rather than my language abilities, but I’m not sure...

Speaking of the shower, that was interesting, too. The set up is that the houses here only have cold water, but the shower head is electric. It has what basically amounts to an electric stove burner inside that heats the water as it passes through. Not the most effective, but it’s apparently cheaper.

I am a bit thankful, though, that our host family’s toilet/plumbing can handle toilet paper. Apparently that’s quite a rarity here. Normally, they just have a little wastebasket next to the toilet for you to put used toilet paper in. I haven’t actually encountered that, yet, though.

It’s been kind of fun staying with a family with kids. It makes me look ahead to what it might be like for Libby and me some day. Some day. The younger of the two, Fabian (almost 3) is a handful. He keeps wandering into our room and trying to take off his pants. Not exactly sure why, though.

That reminds me of another adjustment that has been a bit difficult. Not majorly so, but a little disconcerting. You see, the host family we’re staying with has a mother and father, both in their 30s or so, and two kids. The disconcerting piece is that the father tends to lounge around wearing nothing but boxers. I personally don’t care, but I don’t want my wife to be seeing such things. Inappropriate. But I suppose it’s probably culturally acceptable with all the machismo and such.

Jonathan

Libby: Arrival in Costa Rica

As we made our initial decent into San Jose, Costa Rica, I had a moment of panic as I realized I had never had a travel experience like this before . . . 6 weeks in a country where I don't really know the language, nor am accustomed to the poverty or the myriad of bugs and other creatures. What did I get myself into this time and why didn't I pay more attention in Spanish class? For the first time in my life, my first thought upon seeing a new country wasn't pure excitement, but a mix of excitement and anxious anticipation of what the following 6 weeks would hold. For once, I am content enough with where I am that I don't need the excitement and adventures of travel. But it is because of Jonathan that I am content with our home in Michigan, and he is here- my Spanish-speaking knight in shining armor- and it will be great!

The scenery flying into San Jose was beautiful. There are mountains/ hills that surround the city, greenery and low hanging clouds covering the tops of some of the mountains- a stark contrast to the flat, bleak brown of Michigan. As we hit the runway, we could see tons of people lined up outside the gate of the airport- waiting for passengers, or simply watching planes- we weren't entirely sure.

We made it through immigration and customs with no problems at all- a small miracle since we have 7 crates full of medicines and other supplies we are taking down to the clinic. When we left customs, we faced an overwhelming amount of people, mostly with signs, waiting to pick people up. (See picture below)

Many men were calling to us, asking if we needed a taxi. Others were asking where we were going. We had not been told ahead of time who would be meeting us at the airport, and when we saw all of the people waiting to greet us, this small oversight became a little more overwhelming. When we finally found the FIMRC guy, I then became worried we would never fit in the van he had brought. With 9 students, each with their own checked bag and carry on, AND 7 tubs, I was pretty convinced we wouldn't all fit in the minivan that came to pick us up . . . until they started piling tubs and suitcases on the roof rack. Fitting everything in one vehicle was quite a feat! (See pic below)
Our host family came to pick us up after a short orientation to the area. Ivonne? and Oscar and their two small children, Baleria (5) and Fabian (will be 3 next Saturday). We have our own room that is separate from their house. We will be eating breakfast and dinner with them, and they will pack lunches for us during the week. They have been very welcoming and very patient with my broken Spanish. They keep saying "this is your house."

We went to the market this morning and saw all kinds of fresh fruits and vegetables as well as meat and fish . . . and SUN! We are definitely enjoying the weather here and are thankful we are not in the 8 degree weather of Michigan :)

So- we are enjoying life in Costa Rica thus far! Hope this finds you well.

Libby