Today was our first day at the clinic. Dr. Aguirre, our leader here, came to pick us up this morning and introduce us to the head doctors at the clinics. Melissa and I were at one clinic and Emily and Cristina were at another. We will switch each day. The first two weeks we will be in Duran and the last week we will be in Guayaquil. Two of the clinics in Duran are primary care and the other is an emergency room and delivery room.
The clinic we were at today is primary care. It´s a free clinic. They have 2 general med doctors. These doctors just graduated medical school last year and then have to serve in government hospitals and clinics for the year. They will finish their term in August. They don´t have anything like a residency for general medicine. There is also an OB at the hospital too. Here the OB doesn´t need a medical degree, I think they´re kind of like a nurse midwife. She did general exams and family planning. The government pays for all contraception here, but abortion is illegal (though of course it is still practiced). There was a dentist at the clinic too.
So far, the people at the clinics trust us to do more than we´re qualified to do. Today 3 of us got to take stitches out of a c-section. They were teaching Melissa and I how to give intradermal injections to infants. We also were asked to do a vaginal exam and listen to people´s lungs. I listened, but I don´t really know normal from abnormal yet. There was nothing crazy going on so I said it´s normal, but I also explained that we didn´t know what we were doing. The doctor came to get us when we were in with the OB to listen to two kids who were asthmatic to see the difference. They all are so nice and really want us to learn, and aren´t afraid to teach us something new.
The general medicine doctors were kind of like a prescription mill. A person would come in with a cough for 2 days and they would get a prescription for an antibiotic, antiinflammatory and vitamins, without even a real checkup. Some of the people waited hours for this exact treatment. Vitamins are a funny thing here. All the moms say their child isn´t gaining weight. The children look completely healthy to me and their charts say they are growing and gaining weight like normal. To make them feel better they are given vitamins for the kids. It was the same idea in Guatemala. In this culture, vitamins make you grow. :)
The government is very concerned about TB here. Everyone is vaccinated when they´re young, but anyone with a cough lasting for more than 2 weeks is tested for TB. The treatments for TB are given at the clinic, so they can make sure they are taken and controlled. There is a 6 month treatment and an 8 month treatment so the people have to go to the clinic Monday to Friday for 50 days and then every other day for the rest of the treatment. It seemed weird to me that they´re so concerned about it, but it´s good to keep the contact low I guess.
The scariest part of today was the cleanliness, or lack thereof. Gloves were only used for a few procedures and the doctors never washed their hands (except for after the TB patient). There wasn´t any paper on top of the tables and they were never wiped. I think this is partially because they´re not as germophobic as we are, but also because they don´t have the funds for things like paper and soap or sanitizer.
I think those are all my observations of the day. We´re going to stick around here this weekend and explore Guayaquil, which is the more metropolitan city close by. I´ll try to post more pictures next week! Have a great weekend everyone!
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