tag:blogger.com,1999:blog-22317382193365707382024-03-05T02:16:10.353-08:00Simply LivingInitially intended as a way to share my personal journey as a Jesuit Volunteer in Gresham, Oregon, this space has continued to follow my evolution through my time as an AmeriCorps Volunteer in Seattle, and now to follow my personal and professional transformation as I muddle my way through the four years (or more) of medical school.Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.comBlogger71125tag:blogger.com,1999:blog-2231738219336570738.post-87038358159277805872012-08-05T09:59:00.000-07:002012-08-05T09:59:05.072-07:00Pachamanca<br />
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<span class="Apple-style-span" style="font-size: small;">You know how they say a dog often looks like it's owner? well I think that for my friends Amy, Natasha and I, we look like our home stay moms. Well, maybe not look like, but we definitely have parallel personalities. I was able to see this more closely at our Pachamanca a few weeks ago.</span></div>
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<span class="Apple-style-span" style="font-size: small;">So this was similar to the Watia(Huatia) that I explained before. A tower of rocks were heated to cookable temperature, then collapsed and layered with potatoes, oca (another tuber), sweet potatoes, fava beans, and <i>bananas</i>! BUT THEN you throw slabs of chicken, pork, and lamb drenched in green "condimento" on the piping hot rocks. Cover it all with the remaining stones so and paper so that the alphalpha and dirt that THEN went on top didn't get in the food. </span></div>
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<span class="Apple-style-span" style="font-size: small;">We let it sit for about an hour while we prepared sauces and cut heads off the baked cuy (apparently it doesn't taste as good in the Pachamanca). Then it was ready! everyone got a plate with a bit of everything. The table was pretty much quiet as we ate... Diving into the mountain of food with our hands and pulling apart ever delicious piece until it was gone. To help digest all that food, shots of pisco are passed around the table as you finish. Followed by a glass of sweet rose wine. And then the beer flows.</span><br />
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<span class="Apple-style-span" style="font-size: small;">My friends here Amy and Natasha and I have host parents that are all cousins, so we go to experience this together. As the beer continued to flow, the conversation took off. We sat around with our host mothers animatedly conversing for hours and hours. My host mom Ana just kept opening bottles of beer and placing them in front of us. It was funny to see how Natasha was just as sweet and cute as her adorable host grandmother, Amy was just as dramatic and funny as Maria, and I like to think that Ana and I are both pretty strong and opinionated women. </span></div>
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<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEikrliAuhiXCriq67HEwXFRGqkKVzK9RYJWYk3g0bFqquR2Qrsi21MEy2AADv2MUheHe5sKFyPP3ej_xb2EEK5qjxjFgi8USsgTYQBZoOcFw8GmpVbIcVDyCZ_oLvz77Ja78RECg4OzHrk2/s1600/IMG_1736.JPG" imageanchor="1" style="clear: left; float: left; margin-bottom: 1em; margin-right: 1em;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEikrliAuhiXCriq67HEwXFRGqkKVzK9RYJWYk3g0bFqquR2Qrsi21MEy2AADv2MUheHe5sKFyPP3ej_xb2EEK5qjxjFgi8USsgTYQBZoOcFw8GmpVbIcVDyCZ_oLvz77Ja78RECg4OzHrk2/s320/IMG_1736.JPG" width="320" /></a><span class="Apple-style-span" style="font-size: small;">This was probably my best night in Peru so far. Part of the conversation was spent trying to convince me not to leave, or discussing how I should come back after my trip to Nicaragua, or even after going back to the states. </span></div>
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<span class="Apple-style-span" style="font-size: small;">This is what I love about latin america. Animated conversation and these beautifully emotional relationships between people. It will be hard to leave the people who have become my family for the summer.</span><br />
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</div>Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-47178519139881346842012-08-05T09:53:00.001-07:002012-08-05T09:53:51.951-07:00Food Round 2<br />
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<span class="Apple-style-span" style="font-size: small;">I think I had the weirdest combination of foods at lunch yesterday: frozen/dehydrated potatoes that were rehydrated/steamed, covered in squeekie cheese, accompanied by Lengua de Paula - cow tongue. The potatoes had the texture (and flavor) of strange squishy dirt. The cheese made an actual audible squeak when I chewed, and the cow's tongue was actually quite tasty and tender. It was melt in your mouth tender, which should be awesome, until you thinking about eating tongue with your tongue and then you just feel weird... </span></div>
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<span class="Apple-style-span" style="font-size: small;">This was the first time I really haven't liked the food here. Not gonna make that one at home...</span></div>Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-34123733792185647822012-07-17T10:32:00.000-07:002012-07-17T10:32:13.703-07:00Ausangate<div class="separator" style="clear: both; text-align: center;">
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<span class="Apple-style-span" style="font-size: small;">Ausangate. Holy Smokes. This was the most epic and gorgeous trip I have ever taken. On a whim and invitation by my group of volunteer friends in Ollanta - and with generous donations of warm clothing, sleeping bag, and sleeping mat from others here so I wouldn't die - I decided to join in on this adventure. We took off on a Wednesday afternoon to hit up the Urubumba market, then headed to Cuzco for the evening to repack and get ready. Thursday morning, we found down the bus that drove us three hours to Tinke to meet our trustee guide and horses. We were hiking at around 15,000 to 16,000 every day, crossed three passes - the tallest of which was 17,200, and got caught in two snow storms. It was so incredible I'll try and let he picture speak for themselves since words won't do it justice. Well... with a little comentary of course.</span></div>
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<tr><td class="tr-caption" style="text-align: center;">Here's the group on the morning of the second day. We finally go to see the mountain that was covered in clouds the whole way to our first campsite.</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">My tent in front of Ausangate. Campsite #1.</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">We walked through endless fields of Llamas and Alpacas all trip long. They're so cute!</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Day 2: Mountian lakes and glacier on the west side of the mountain.</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">This was my low point at the top of the first pass day 2. We kept thinking the snow storm would pass... but it didn't. I didn't have my warm hat or my raincoat handy, so just after this picture was taken, our guide Miguel gave me an awesome woven blanket to wrap over my head and shoulders until we found our campsite. I had images of getting lost on Mount Everest and my parents never knowing what happened to me. Again. This was definitely my lowest point.</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Morning day 3. Appropriately clothed and ready to take on snowy pass #2 - 17, 200 ft!</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Our second campsite. Morning after storm number one.</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg06oLeUot5KiXW2hV2ptyJQezwHn8Y06bG8OZg5PIXGGdt2HTITxWimt3lN1a3wjBrObUfajSbDT2XhWp57qid1byHeIsNrOpJ3G6tCX9yTaeOjbuYEwhzOoSow3DNYBq_kgKas0Z_JzRm/s1600/IMG_3175.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEg06oLeUot5KiXW2hV2ptyJQezwHn8Y06bG8OZg5PIXGGdt2HTITxWimt3lN1a3wjBrObUfajSbDT2XhWp57qid1byHeIsNrOpJ3G6tCX9yTaeOjbuYEwhzOoSow3DNYBq_kgKas0Z_JzRm/s320/IMG_3175.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">The ladies celebrating reaching 17,200 ft with star jumps on day 3!</td></tr>
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<tr><td style="text-align: center;"><a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhCwlU_MQh15kg75tYxrK_P-61WJyMRt-EyyPmXvAke8QUNQH5lrAhgcFUFK6Un_t6mA4OZtSvM2d6hfD9n61Da4mdxK2ScC7YHmU-SfvCTNhwIDSOc1HgFMWiCJjk1IQpm5kWI4C61HVzR/s1600/SAM_4002.JPG" imageanchor="1" style="margin-left: auto; margin-right: auto;"><img border="0" height="240" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhCwlU_MQh15kg75tYxrK_P-61WJyMRt-EyyPmXvAke8QUNQH5lrAhgcFUFK6Un_t6mA4OZtSvM2d6hfD9n61Da4mdxK2ScC7YHmU-SfvCTNhwIDSOc1HgFMWiCJjk1IQpm5kWI4C61HVzR/s320/SAM_4002.JPG" width="320" /></a></td></tr>
<tr><td class="tr-caption" style="text-align: center;">On the other side second pass. More high desert headed towards pass number three.</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">These alpacas were dressed up all fancy!<br /></td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Campsite number three. The snow stopped just as we set up camp. but then started again in the middle of the night along with raging winds.... But beautiful, no?</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Day 4: Here's hoping storm number three doesn't hit before we get over the last pass</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">The Promised Land! No more snow!</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Celebrating surviving the worst of it in some hot springs at the end of day 4</td></tr>
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<tr><td class="tr-caption" style="text-align: center;">Day 5: Back in Tinke waiting for the bus back to Cuzco after 5 days of awesomeness. Our guide Miguel and his son helped send us off.<br /><br /><h3 style="text-align: left;">
<span class="Apple-style-span" style="font-family: Arial, Helvetica, sans-serif; font-size: small; font-weight: normal;">So these are only a few of the amazing photos and stories I have. But this is all that trying to upload pictures 5 days in a row using Peruvian internet will allow</span>.</h3>
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Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-35869374120998017012012-07-14T12:26:00.001-07:002012-07-14T12:26:21.159-07:00Sunrise at Macchu Picchu<br />
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<span class="Apple-style-span" style="font-size: small;">Two weeks ago, my classmates who are working in Lima this summer made it out to the Sacred Valley to visit me. When I met them in Ollanta's Plaza de Armas, Ben's first words to me were "Josh's eyes are going to get tired this weekend from him rolling them at you. This place is rediculous." Ridiculously AWESOME. I know. I'm so so grateful that I get to spend my summer in Ollanta and pretty happy that I got to share it with some friends. So our main agenda for the Sacred Valley weekend was to visit Macchu Picchu. I've done it once before when I was here 5 years ago with my mom, but the boys wanted to do it "right": at sunrise. After a little tour of town, and introduction to the host family and host animals, including family cow Chiara, we grabbed a drink then hopped on the train to Aguas Calientes for a few hours of sleep before our epic sunrise adventure. </span></div>
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<span class="Apple-style-span" style="font-size: small;">It was incredible. I'll let some of the photos speak for themselves, but it was so sureal to see the ancient city take on a whole new life after the tranguility of the dark and cool morning. Once the sun hit we climed Huaynapicchu for yet another view of the ruins. We took our time on the top for a mid morning snack and nap on what felt like the top of the world. Then ventured down and across to the other side of the citadel to the Sungate, where the Inca Trail enters Macchu Picchu. Gorgeous.</span></div>
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<span class="Apple-style-span" style="font-size: small;">Exhausted by 1 after being up since 4:45, we trained back to Ollanta, grabbed dinner with my volunteer friends, and took some Cuzqueña beers to the ruins for some star gazing to finish off the night... or so we thought. The small Ollanta disco tec still doesn't know what hit it.</span></div>Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-27370594925985255962012-07-13T12:41:00.000-07:002012-07-13T12:41:03.608-07:00I Love Food<br />
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<span class="Apple-style-span" style="font-size: small;">As you all know I love food. Which is great because my host mom is a great cook and loves to talk about food. Food words are often the hardest - so I only know what ingredients she's using half the time, but I'm learning. She also has wonderful herb garden that she harvests. She walked me through it the other day pointing out different things she's used to cook and having me smell them. Here's some of the stuff I've gotten to eat:</span></div>
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<span class="Apple-style-span" style="font-size: small;"><i>Watia - </i>For father's day we make a traditional Andean meal called Watia or Pachamanka depending on what you're cooking. It's essentially the creation of an stone/earth oven by building a dome of stones over a fire. You heat the stones for an hour or so until they're good and hot, then you throw potatoes inside and slowly collaps the stones, adding food layered as you go. Then the whole thing is covered with Paja - or straw, then a sheet of plastic, then covered in dirt. It sits there for another half an hour to an hour, then the whole thing is covered, the food removed, and you eat (you always peal the potatoes by hand after they cook). Best sweet potatoes I've ever had. For us it was served with Cuy - stuffed with something essentially like spinach. along with a sauce called aji. It was incredible!!!</span></div>
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<span class="Apple-style-span" style="font-size: small;"><i>Palta -</i> So much Avocado. I'm in heaven</span></div>
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<span class="Apple-style-span" style="font-size: small;"><i>Patita de Paula - </i>Paula is my family's old cow. I ate her feet - or hooves I guess. Some piece still had hair on them. It was weird, but hey - I'll try anything once. I know Lengua de Paula is gonna show up sometime…</span></div>
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<span class="Apple-style-span" style="font-size: small;"><i>Mazamora - </i>Often for dinner I get essentially rice pudding. Sometimes it's made with ground corn and it is SOOO GOOD. But it's like dessert for dinner. And I can't say no when they ask if I want more. So I might have diabetes when I get home. Holy Carbohydrates!</span></div>
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<span class="Apple-style-span" style="font-size: small;"><i>Grenadilla</i> - this is a strange fruit that has a hard shell you have to hit agains the table or something hard to crack, then pick it away piece by piece. then you see the fruit inside that looks kind of like frog eggs. And you slurp out these little juice packets and their seeds to eat them. So sweet and tasty.</span></div>
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<span class="Apple-style-span" style="font-size: small;"><i>Vicera de Cuy - </i> yup. Guinnea pig innards: heart, liver, intestines, the whole gammet. Fried up and served withe peas, carrots, fava beans, corn, and french fries on rice. Awesom</span></div>
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<span class="Apple-style-span" style="font-size: small;"><i>Boiled Banana - </i> has a special name that I forget already. But really sweet and yummy. Bananas will never be the same in the states</span></div>
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<span class="Apple-style-span" style="font-size: small;"><i>Jugo - </i>I recently discovered the juice lady in the market. For 4 soles (less than $2) you get a small pitcher of any juice combination you want. Today: beets, carrots, orange and ginger; then round two was beets, carrots, pinneapple, papaya, orange, banana and ALOE. Not to mention the fresh orange, banana, and papaya juice my host mom makes for breakfast almost every day...</span></div>
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<span class="Apple-style-span" style="font-size: small;">I'm hoping to bring some of these recipes home (except all things cuy related) for whoever wants to try them ...</span></div>Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-2096593331912659522012-06-27T14:04:00.000-07:002012-06-27T14:04:49.957-07:00Just another day at "work"...<br />
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<span class="Apple-style-span" style="font-size: small;">Monday I went to Huilloc to do a formal door-to-door community needs assessment. Unfortunately I had decided not to bring my camera, which is a shame because there were so many surreal and beautiful moments as I wandered through this rural community.</span></div>
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<span class="Apple-style-span" style="font-size: small;">Amy, a Sacred Valley Health volunteer, and I were tasked by Leticia, the SVH nurse, to climb up the hill (mountain rather) that this community sits on to find the promotora named Teresa to help us do the questionaire and serve as our Quechua interpreter. As we started our journey up the steep hilside, we asked whoever we could find where Teresa Echami lived. They would just chuckle a little at the out of breath Gringas and point up the mountain and say "Arrrrrriba arriba" - waaaaay up there. So we kept on trucking. We would be stopped occassionally by the few other people traveling along the foot path who wanted to figure out what we were doing up in the mountains. One man was clearly drunk or high on cocoa leaves and was making no sense at all. Amy and I chuckled to ourselves as we tried to make sense of his incomplete Spanish/Quechua questions.</span></div>
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<span class="Apple-style-span" style="font-size: small;">We got to the top of one hill to discover a makeshift soccerfield in the middle of the mountain, set just in front of another dauntly steep slope with even more houses nestled on top. Asking again, people pointed to a house at the top of this peak to indicate where we should go. So we trecked on. Finally, huffing and puffing, we made it to the top. As we paused to catch our breath, we turned around and were in awe at the way Huilloc layed out below us. Our magical and literally breathtakingly difficult 1.5 hour climb allowed us an incredible view of the slowly climbing valley and distant glaciers. <i>If only I had remembered my camera....</i></span></div>
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<span class="Apple-style-span" style="font-size: small;">We turned around to find two darling little girls gawking at us. We asked if they knew where Teresa lived, and the just looked at us saying the two Quechua works I know "ari" - yes, and "mana" - no. We wandered a little further only to stumble upon a group of women sitting amidst piles of "Paja" - hay, and "papas" - potatoes - layed out on blankets. A beautiful image of how these women spend their days. They confirmed that the two little girls belonged to Teresa, but that she was infact off with her "burro" - donkey - for the day.</span></div>
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<span class="Apple-style-span" style="font-size: small;">So we tried to take advantage of what time we had left to talk to these people so high up in the Huilloc community. We interviewed some of these women in broken Spanish on both ends. Then continued around the slope to find a few more hidden houses. We walked up to each yelling "Compañera?" until someone would emerge to talk to us. A cute 17 year old girl helped us ask her mom questions, then accompanied us to two of her neighbor's houses to interpret for us. At one house, we were invited into the field outside their house. The woman of the house layed down a blanket for us to sit on while we chatted, which I was grateful for since the "yard" was essentially a field filled with pellets of goat poop. Her husband was clearly drunk (confirmed by his wife), and was super funny and very adamantly told us that he was very healthy and has no health problems when we asked about what health concerns affect men in the community.</span></div>
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<span class="Apple-style-span" style="font-size: small;">We bid our young friend/interpreter goodbye and started down the mountain taking in the sites and pickin up an interview or two on the way. As we went down, it realized how incredibly high we were. When we headed the slope below the soccer field, we had to stop for a pack of llamas and alpacas heading up the hill at us. Gorgeous. We made it down and met up with leticia and headed back to town, to compile the data we collected, but the incredible day and intimate look into the lives of the people in Huilloc stuck with me.</span></div>
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<br /></div>Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-10785106634329605822012-06-22T14:53:00.002-07:002012-06-26T13:06:11.875-07:00Medical Campaign<br />
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<span class="Apple-style-span" style="font-size: small;">Last Thursday through Saturday I was able to tag along on a medical brigade with the NGO I'm working with, which took me into the super isolated communities in this mountains. It took 3 hours by Combi (van turned into a little bus) to get to some of these places that are towns of no more than 70 to 100 people. They mostly speak Quechua - very few people speak Spanish. They have no way to get anywhere besides walking (which they will, for endless hours to get to town), live off of what they grow themselves (which is primarily potatoes), and have virtually no access to health care of any kind. They are beautiful people and live in the gorgeous puna (dry high hills). These communities are at 13,000 feet or higher. We would set up our make shift clinic in the school and my job was mostly to take social histories and chief complaint information. It was incredible to hear these people’s stories. Most of the ailments were backaches from hard labor either working in the fields or as porters on the inca trail (the trail tourists can hike fro three days to get up to Macchu Picchu), dental pain, headaches, and “la gripe” – which is anything from a head cold to the flu. In one community we saw quite a bit of alcohol use on the part of the men, and unfortunately that seemed to coinced with a lot of domestic violence. One woman was even suffering from epilepsy, which may have been related to many things – being beaten by her drunk husband, syphilis, cycsticercosis, something related to her drastically low blood pressure – but she had no money to go into town to get a full work up, so there wasn’t really much we could do for her.</span></div>
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<span class="Apple-style-span" style="font-size: small;">But it wasn’t all sad. I took a break when we were in a community called Kelccanka to play soccer with some little boys, but I tried for all of 5 minutes and thought my lungs were going to explode. Damn altitude. Another time, we pulled our two combis over on the side of the road to serve some people working in the fields that couldn’t make it down to the school. The people generously offered us Watia – potatoes cooked in the ground with hot stones – which is their only source of income. It was incredibly generous of them to offer the only thing they had as a thank you for our services. Not to mention how awesome it was to set up a clinic out of two Combis on the side of a mountain. </span></div>
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<span class="Apple-style-span" style="font-size: small;">The campaign was a great introduction to the way the way of life in the Sacred Valley, but also a bit heart breaking. We just kept uncovering more and more problems that need solutions much bigger than I could ever solve and need a lot more buy in from the government, whose support is virtually absent in these communities. Coincidentally I’m reading “Healing of America” which is an exploration of different health systems around the world and how they came to be. It makes me think not only about what would be required to get health care coverage and services to the people out in small communities like Yanamayo compared to what it would take for the United States to finally change to a health care system that also cared for those who don't have access to health care. </span></div>
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<i>Yanamayo</i></div>
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<i>Yanamayo</i></div>
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<i>Little girls in Yanamayo</i></div>
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<i>The Puna on our way to Kelccanka</i></div>
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<i>Watia in Kelccanka</i></div>
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<i>Kelccanka </i></div>
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<br /></div>Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-90020836627289548752012-06-18T10:51:00.002-07:002012-06-18T10:51:51.293-07:00Sitting on Chicken Crates in Open Top Cargo TrucksI've spent the last four days exploring the smaller communities high in the Andes.<br />
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Wednesday I me the spanish/quechua speaking nurse that works with Sacred Valley Health (the non-profit I'm partnering with here in Ollanta) named Leticia. We were supposed to go up to a village called Huilloc about 45 minutes up the mountain by car to talk with the president of the community and the two elected promotas to get an interview and ask about their take on the health status of their community. We tried to find a Combi - essentially a mini van converted into a little bus - but they usually leave around 7:30 am and we didn't get our butts in gear until 9:30.<br />
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Because we had missed all the Combis, we decided to wait and see who was driving up the mountain that day. After about an hour, we were at the point of giving up and walked back down the road, but Leticia flagged down a big open back truck to ask where they were headed. Before I knew it I was climbing a ladder into the back of this HUGE cargo truck full of produce, crates, and people headed up the hill to sell what they had harvested that day. After a few minutes I realized that the crate I had perched myself on was chirping and the one next to me was oinking. The folks in the back of the truck just kept smiling at the two Gringa's who'd just joined their party (me and Amy, another SVH volunteer) and telling Amy - who has golden blond hair - that they wanted their son to marry her. Men were sitting on the top of the wooden walls keeping us all contained and had to duck occasionally for tree branches, and two babies just laid sprawled on the sacks of produce. We arrived at Huilloc only to find that the two promoters were working in the Chakra (fields), but were able to talk to the nurse at the seldom used Posta (government clinic), and we tracked down the community president. With no phones and only the radio to commentate, it's pretty difficult to connect with people. I think this is the community I'll be doing my project in so I'm excited to go back. Just hopefully with a real seat and a roof over my head...<br />
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.Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-6613581656902318642012-06-11T16:23:00.000-07:002012-06-11T16:23:04.166-07:00oh.my.goodness.so.beautiful<br />
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I've arrived safely in Ollantaytumbo, and this might possibly be the most beautiful place I've ever been. It's nestled in the valley between the jagged hills of the Andes looking out at distant snow capped peaks. These are not like our northwest mountains. They are much more steep and threatening. I'm living at about 9,000 feet which feels better compared to how winded I was getting off the plane in Cuzco at about 12,000. The hour and a half drive to Ollanta was one of the most breathtaking car rides I've taken. But also the scariest - winding down narrow switchbacks and passing cars at 80 miles an hour...</div>
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The town itself is darling with narrow cobblestone streets, and plenty of quaint restaurants for the tourists surrounding a darling little central plaza. School must have just gotten out when I arrived because there were tons of kids running around in uniforms and backpacks. There are two different Incan ruins on the west side of town up in the steep hills that I can hike to once I walk past the edge of town. </div>
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My homestay is going to be interesting. Thankfully I have a nice room all to myself with a little desk complete with Justin Beiber poster among the Incan/Peruvian/Religious paraphernalia. It's a cute little family. Ana Maria and Margarita (mom and adult daughter) picked me up from the Awamaki office (the non-profit I'm partnering with). The three of us and all my stuff smashed in a little moto-taxi to get home then Ana Maria and made a late lunch as her son and Margarita's husband came home. Ana Maria made Lomo a la Plancha (kind of like carne asada) from the meat that was sitting in a plastic bag on the table, rice that had been in a rice cooker for who knows how long, and "ensalada rusa" - russian salad which is carrots, onions and beats, hopefully cooked but at least pealed - as the flies whirled around us. The kitchen itself is super rustic. They heat the water over an open fire in the corner and there's a hole in the roof for the smoke. Dirt floors. Cats, dogs and rooster running in and out. The Goat bleating outside. Most things are covered with plates or plastic to keep clean and no refrigeration. The food and cocoa leaf tea were really quite good, but I'm crossing my fingers that I don't have diarrhea tomorrow. I also tried a new fruit that is SUPER tasty... you just pull it apart and it has really sweet white flesh and big black seeds in each of the little fleshy sections. But I can't remember what they called it...</div>
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So I'm truly living in the Campo for the next 7 weeks. Not quite what I expected, but it's pretty awesome. I meet with the health non-profit people tomorrow to talk more about how my project is going to take shape. Here I go!!</div>Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-37596096073473992742012-06-10T21:47:00.000-07:002012-06-10T21:47:08.289-07:00Lima Mini-Vacation<br />
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I know it's only been 5 days, but I'm heading to Cuzco/Ollantaytumbo tomorrow and thought I'd post a little update since I'm not sure what internet will be like once I get there. Lima is super dirty and gross. Some of it's neighborhoods are alright, but I'm glad I was only here for four days. Every day has been gray and gloomy. I'm excited to get out to the Campo and breath some fresh air and see some blue sky again. </div>
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<b>Lima Highlights</b></div>
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Quincha House:</div>
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I've been staying at this super strange hostel in town. No one is ever here. The guy who showed me my room at 6:30 am on Thursday morning looks very much like a SoCal surfer beach bum: Tan, bleach blond hair, only wears board shorts, probably late 20's early 30's. I expected him to speak to me in English, but nope, he's definitely Peruvian. I think his mom might live in the basement? It's been nice and very relaxed and safe, but just a little strange.</div>
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Random Old People:</div>
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Friday I had to spend on my own while my friends from school who are in Lima finished up work, so I walked to some pre-Incan ruins in town. While there I met this super friendly old Peruvian man who mistook me for a Brazilian woman - I have no idea how or why, but I'll take the compliment. He was there with some french friends and they invited me to lunch for authentic Peruvian food and beer after the tour. I had nothing better to do so I went. The french people were super into natural medicine and it came up that I was a medical student, so they talked my ear off about Shakras, and Auras, and Reincarnation and the Curandero (natural healer) that the French man worked with in Ecuador - all in broken french/spanish and some translation through our peruvian friend. I just sat there laughing to myself most of the time because it was so random.</div>
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Teenage Cover bands:</div>
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In an attempt to like Lima more, my two friends from WWAMI land (the Pullman first year site) wandered all over the city exploring the cooler neighborhoods of Lima. There's not a lot to do here in Miraflores where I've been staying. We ended up in the Barranco neighborhood which we discovered has all the bars and discos. We wandered into a sketchy looking bar that had live music, grabbed some Cuzqueño beers a took a seat in the dark and creepy looking balcony. It must have been some kind of open mic or local band night because we were the only white people there and the band was REALLY bad. Some kind of peruvian grunge. I'm pretty sure everyone in the audience was friends and family of the band members. But THEN these teenagers who couldn't be older than 14 came on and were doing covers of the Red Hot Chili Peppers, Elvis, Cold Play, Green Day and some Spanish pop. It was AWESOME! </div>
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But now my mini vacation is over. Time to head to the Valley and start thinking about my project. Hopefully I'll find some fun locals or expats to have some adventures with!</div>Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-64095676077068403982012-06-06T18:03:00.000-07:002012-06-06T18:03:24.612-07:00Reflections of a Rising MS2<!--[if gte mso 9]><xml>
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<b style="mso-bidi-font-weight: normal;">Reflections of a Rising MS2<o:p></o:p></b></div>
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<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">Erin Cooley, MS1 (MS2 now I
suppose), WAFP Student Trustee <o:p></o:p></i></b></div>
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<b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;"><br /></i></b></div>
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My first year of medical school year is over! For all you
physicians for whom med school is a distant memory, this is indeed big deal. It
marks the consummation of years of arduous academic work, rigorous health
volunteer experiences, and serious introspection on my part.<span style="mso-spacerun: yes;"> </span>It signals the achievement of a goal I
had pursued long and hard.<span style="mso-spacerun: yes;"> </span>Of
course, I thought the hard part was over when I received the phone call letting
me know I’d been accepted to the University of Washington School of Medicine.
Ha! This year made it clear I was taking only the first step of a whole new
phase of achieving and striving. But with MS 1 behind me, I feel I'm on my way.
<o:p></o:p></div>
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For those of you may not remember your first medical school
year, let me remind you a little of the whirlwind MS 1 journey. Our year was
jumpstarted with gross anatomy “boot camp” that bonded our class unlike any
other experience. I struggled with seeing my first dead body in the form of my
cadaver and being confronted with the reality of life and death while
simultaneously in awe of the intricacies of the biological mechanisms that
allow us to exist.<span style="mso-spacerun: yes;"> </span>The macroscopic
gross anatomy was juxtaposed with the microscopic in histology and
biochemistry.<span style="mso-spacerun: yes;"> </span>Winter quarter
we returned to our cadavers for musculoskeletal anatomy and cell physiology. I
was enthralled by all the minuscule innervations and origins and insertion that
work together and allow me to walk to my self-assigned seat in the lecture
hall. In the spring, neuroscience and microbiology were woven together to give
us an understanding of the command center of the body and it’s tenuous relationship
with microbes housed both within and outside of ourselves.<span style="mso-spacerun: yes;"> </span>Ever time I studied for a final exam I
was astounded by the sheer quantity of facts I had mastered, or fit in my brain
long enough to pass the exam. I cross my fingers that it’s true when they say
all the important things will be repeated over and over and over. Because as
fascinating as I found most of the material, I’ll be honest, I barely remember
what ventral tegmental area does, or what the tendons that make up the “snuff
box” in the wrist are.<span style="mso-spacerun: yes;"> </span><o:p></o:p></div>
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I found the MS1 year difficult for many reasons.<span style="mso-spacerun: yes;"> </span>The transition back to the classroom
was more challenging than expected after two years of working side by side with
patients and providers in clinics.<span style="mso-spacerun: yes;">
</span>Not only that, I had to learn to balance my new friends and future
colleagues—the people who will truly understand the what the transformation
into becoming a doctor entails—with my community and family within Seattle who
knew my pre-medical school self to the core.<span style="mso-spacerun: yes;"> </span>Then there was the challenge of trying to maintain the
“person” parts of me—my interests and passions outside of medicine—while
managing to pass my classes and feel confident that I am learning the facts and
skills that will make me a good doctor. Thankfully mentors abound in my new environment
and they consistently remind me of what I am working towards as well as
modeling well-rounded and healthy lives outside of clinic. They remind me of The
Big Picture and that keeps me going.<span style="mso-spacerun: yes;">
</span><o:p></o:p></div>
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The Big Picture for me continues to come back to my passion
for the underserved and for rectifying the unfortunate realities of our
difficult medical system. This passion continued to grow with the stories and
experiences my fellow classmates shared with me as well as the patient’s
stories I listened to in the hospitals and at my preceptorship. I am grateful
for the physicians in the community who have modeled for me the kind of
clinical and advocacy and work that I hope to continue in my career as a
physician.<o:p></o:p></div>
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The other picture that keeps me motivated is a global one
that I hope to recapture as I now head off to South America for my “last summer
of freedom.”<span style="mso-spacerun: yes;"> </span>Based on a community
needs assessment, I will develop a project specifically designed to serve rural
communities outside of Cuzco, Peru. The time I spent in this area five years
ago is what first inspired me to become active for health and social justice as
a physician.<span style="mso-spacerun: yes;"> </span>I hope to reconnect
to my inspiration as well as gain a better understanding of what health care
means in a worldwide context. The program that I'll work under is called the
Global Health Immersion Program. Interestingly, it underwent an intentional
name change from Int<a href="" name="_GoBack"></a>ernational Health Opportunity
Program. The reason for this is that health issues are not international in the
sense that we can draw a line between heath concerns in our country and health
concerns in other countries. The health concerns plaguing those in Africa or
Asia or Latin America all find their way to our back yard.<span style="mso-spacerun: yes;"> </span>We cannot separate ourselves from our
neighbors. <o:p></o:p></div>
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This fall, as I enter what they say will be the hardest
quarter of my undergraduate medical education, I hope that my experiences this
summer, and the awe that I felt this first year of classes, will continue to
forge me into a truly compassionate and competent physician. I want to be able
to hold on to the faces of the people I meet in the rural Andean villages in my
head as I memorize the intricate workings of the cardiovascular or reproductive
systems.<span style="mso-spacerun: yes;"> </span>They will keep me
grounded on those late nights of studying. <o:p></o:p></div>
<!--EndFragment-->Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-67870038679502998892011-07-28T22:58:00.001-07:002011-08-16T23:35:53.374-07:00June: Changed for the Better<div>As the year comes to and end, I’m starting to process what I will take away from this experience. One of the most valuable parts of this program is my team. Partly because we support each other as we learn and grow and struggle; trying to understand the role of a community health center, how to provide quality care, and define what “quality care” really means. But also for the amazing experiences and interests we are able to share with each other as our relationships have developed, as well as learning from each other in the more formal setting of member lead trainings and individual service projects. </div><div>
<br /></div><div>I thought this year would simply be a continuation of what I had done previously – working in community health serving the Latino population. But this year I have developed a much greater understanding of the bigger issues, how those are manifested on an individual scale, and I have grown in compassion towards populations I had previously harbored prejudice towards or simply did not recognize, and can now validate the struggles different populations endure.</div><div>
<br /></div><div>Member lead trainings on LGBT health disparities made me realize how uncomfortable and unwelcoming something as seemingly small as the way bathrooms are set up in clinics can be, and how simple changes can break down this barrier. It also made me think hard about the needs of this community as it ages and finding safe and appropriate facilities to care for their health. The mental health training made me recognize my own misunderstandings around mental health issues , and tendency to see the disease, and not the person. Another member’s discussion of her time with the People’s Harm Reduction Alliance and the challenges and condescension IV drug users encounter in the medical system made me want my practice to be a safe place for people to receive the medical attention they need and be treated with dignity and respect.</div><div>
<br /></div><div>This experience has not just been my own. My time in clinic has helped me value one-on-one interactions and the importance of listening, and my outreach work has awoken my passion for teaching, but the stories of my teammates have made this year that much richer and that much deeper than I ever could have anticipated. I have allowed myself to be challenged and to grow with the support of those around me and I am coming out a more aware and compassionate person on the other end. I am immensely grateful for the people who chose to challenge themselves this year, and walk with me through our struggles to not just serve those in need, but to make greater changes so that those services aren't a necessary fabric of society.</div>Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-73631053575388360392011-07-28T22:57:00.001-07:002011-08-16T23:28:50.309-07:00May: Early Disadvantage<div>Among the various and invaluable services Sea Mar offers are yearly physicals for high school students of migrant families. As part of the outreach team, I went and gave presentations during the Proyecto Saber class while students were pulled for exams. This class in and of itself is a pretty upstream model of education. It provides support for minority students especially in a predominantly white high school, and is also a way for these students get credit retrieval for classes they may have failed and receive enough credits to successfully graduate. Additionally, it offers an opportunity for students to learn more about their native culture. It places value on where these students have come from in a way that is lacking in today’s public school curriculum.</div><div>
<br /></div><div>Our outreach team gave each class an option of what topic they wanted to learn about – chronic diseases, nutrition, mental health, tobacco, or sexually transmitted diseases. Each class period felt more like a conversation with peers than a presentation and reminded me that I am not as far removed from my own high school experience as I may have thought. It also made me recognize a little of my own ageist tendencies. These kids are smart! And many of them have experienced more in their 16 years than I have in my 23.</div><div>
<br /></div><div>I had one conversation in particular with a student who made me realize how difficult being a teen can be, especially in a migrant family. The icebreaker for the mental heath presentation requires that everyone to share something that causes them stress. This droopy eyed student shared that family problems on top of balancing work and school were stressful. After the presentation he came up to me, asking about the consequences of drinking a lot of energy drinks. As we talked about sugar content, and the trouble with using energy drinks as a supplement or actual sleep, he revealed to me that his dad was recently injured and he was taking over his father’s night shift to support his family. He would go to work around 11pm, work all night long, come home at 7 or 7:30 and sleep for an hour or so, wake up and come to school. He was failing classes, having anger management issues, and only had one friend who helped keep him awake during class, but no one knew the whole story. “I’m a private person, I don’t want people to finding out about this and start talking about me” he told me, reminding me of how vicious rumors can spread in high school.</div><div>
<br /></div><div>I talked with him about some of his options – make sure his teachers were on the same page and working with him to accommodate a schedule that allowed him to sleep and do school work, and to make sure to be in touch with the school counselor about his anxiety and anger issues. But I couldn’t help but feel slightly helpless. His family relied on him for survival. He was carrying way more responsibility at 17 than I ever have. And there wasn’t really any way around it. Who else could work? Who could take care of his siblings if his parents were to take a different job? How else could they make money? Who was going to pay the medical bills? These burdens were falling on his shoulders impacting his mental and physical health as well as his social health – the quality of his education and future prospects for job development and breaking the cycle of poverty his family is in. </div><div>
<br /></div><div>I am grateful for Proyecto Saber that offers support, the free physicals that Sea Mar provides during school hours, and the school psychologist, but this student’s story exemplifies heartbreaking effects of social determinants of health that inhibit people from being truly and wholly healthy.</div>Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-37332091585295018562011-07-28T22:56:00.001-07:002011-08-16T23:24:33.092-07:00May: Culture Shock<div>A Laotian man sat down at my desk yesterday seeking medication assistance. He is a refugee. He has been living in the United States for about a year, and three months ago "moved" to the South Park neighborhood. I say "moved" because he doesn't really have a home. He has no money and no house, just a friend who would let him stay on his couch, but occasionally will change his mind and throw him out. </div><div>
<br /></div><div>He has no money and is trying to manage hypertension and cholesterol. Fortunately his medications are available on the $4 list for some generics, but he can't even afford that. He is plugged in with an Asian Resource Center, but he cannot find work until his health is better. He speaks in a hoarse whisper and doesn't know why he can't speak louder. </div><div>
<br /></div><div>As we talked about his inconsistent housing situation, and difficult financial circumstances, he started to talk about life in the United States:</div><div>
<br /></div><div>"I am a refugee form Laos. I love America. I am proud to be in America, But in America, you are all by yourself. At 18, you move out of your families house, you are expected to pay for things on your own. You are responsible for yourself. Its different here when you have to pay for things, how you have to pay for things, and who has to pay for them. I'm proud to be an American, but it is a hard life here."</div><div>
<br /></div><div>This makes me call into question the individualistic nature of our American culture. We strive for independence from our families, from each other, to make our own story and our own lives. There is social support, but it is created by individuals or some families, not necessarily supported by our societal or governmental structure. Social support and a willingness to help people outside of yourself are values that can be easily lost. </div><div>
<br /></div><div>Hearing the story of someone who is deeply struggling to get by shows me how painful this isolation and individualism can be. It helps me better understand the value of community - how it can provide not just social support but can be a tangible resource, a source of sanity, and a vehicle for positive change that everyone deserves be a part of.</div>Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-864074805248017812011-07-28T22:55:00.001-07:002011-08-16T23:17:33.102-07:00April: Community Through Soccer<div>The charter of the first Community Health Center describes its purpose as serving the not just the medical, dental, and mental health care needs, but providing the social support specific to the needs the community to which it belongs. It is a beautiful model of holistic care that considers not just the individual, but the neighborhood, environment, and society the belong to. Sea Mar has done a great job of doing so in the various communities it is a part of and the many varied services we offer. But I would not have guessed that a soccer team would be considered one of those many services we provide.</div><div>
<br /></div><div>Sea Mar's U8 (mostly second grade) soccer team is about to wrap up its first-ever season. The team was birthed from the Childhood Obesity Interest Group and our frustration with the lack of access of low income communities to organized sports. But the goal was not just to make kids run around to shed some pounds. A sports team is more than just physical activity. A sports team helps instill a sense of belonging, teamwork, and personal responsibility. As a coach, I have the opportunity to build relationships with these budding athletes and can help instill in them a value of active living, teaching them responsibility, conflict resolution and how to listen. </div><div>
<br /></div><div>This team is not only a positive force for the team members, but also their families. Many parents are getting outside and being active along with their kids. Three Latina mothers have started walking laps around the field together as they watch their kids practice. On game days, we see parents bringing out video cameras and cheering for their child’s team. Families are also learning the value of active living, and are able to support their children and share in this part of their development.</div><div>
<br /></div><div>Hopefully these values will continue to grow with the support of the community, and these families will help make this soccer team a sustainable project that can continue to benefiting our South Park neighborhood.</div><div>
<br /></div>Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-186945446975391232011-07-28T22:54:00.000-07:002011-08-16T23:15:01.750-07:00March: More Positivity than I Could Muster<div>I tend to think of myself as a pretty joyful and optimistic person, but if I had to deal with the mountain of challenges my patients face daily to be healthy, find food, buy medication, and pay rent and bills while unemployed or underemployed - I'm not sure I could maintain my optimism.</div><div>
<br /></div><div>The Basic Health plan of Washington state was severely affected by the state budget deficit. More and more patients have been coming to me for help finding affordable medications because they were dropped from Basic Health and can no longer have prescription coverage. As I worked with Diabetic patient and her doctor to find programs that would help her get her insulin, she expressed immense gratitude for the work I was doing on her behalf. She shared that she knew her situation was hard. She has a innumerable worries and challenges. In her own home she lets herself get down about these things and feel the weight of her burdens, but as soon as she steps out her front door she puts on a smile. She has seen how people can carry their negativity and hardships into their interactions with others - being snappy or reclusive - and she won't let herself do that. She knows that life is hard, but she will try and move forward. She will treat people with kindness despite how tired or worried she is. </div><div>
<br /></div><div>"Negativity won't get you anywhere. You have to smile." She said.</div><div>
<br /></div><div>She inspires me to put my own challenges in perspective, and start each day with a smile.</div>Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-54593064215024665382011-07-28T22:53:00.000-07:002011-08-16T23:12:31.763-07:00February: GraduationMy first patient graduated from the Hypertension Case Management program! This program is set up so that patients can take their blood pressure regularly, and try start to seeing relationships between their exercise, stress level, what they eat and drink and how it has an effect on their blood pressure. Simultaneously we set goals together and I call monthly to follow up.
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<br />Mariposa has lowered her blood pressure significantly, and has been able to maintain a healthy 123/80 for a few months now. I've discussed with her in previous follow ups that it was time to start thinking about exiting the program. This would mean that she would need to return the loaned blood pressure cuff to clinic. Though possible, she asked that I give her more warning before she exited so that she could save up for a few months in order to buy her own blood pressure monitor. Her doctor had told her to check her pressure every day. Her heart is her life and she wants to take care of it. She was proud of her progress and insistent on still being able to take her blood pressure so that she could keep it in control and stay healthy. I asked my supervisor if we could make an exception for Mariposa. She couldn't really afford a blood pressure monitor, but was willing to try and make this financial sacrifice in order to take care of her health. Inspired by her motivation, I was allowed to let her keep the monitor. When I called Mariposa to let her know that I would no longer be making follow up calls, but she was able to keep her monitor - with the one condition that she must return it if she ever stops using it - she was immensely grateful and assured me that the monitor would continue to be put to good use.
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<br />People no longer will no longer "exit" the Hypertension Case Management Program as I had previously thought. They will "graduate" having learned the value of taking care of your heart.
<br />Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-44583620718134245302011-07-27T10:09:00.000-07:002011-08-16T23:10:01.569-07:00February: "Quiero compartir una estadistica contigo"<div>"I'd like to share a statistic with you" Is frequently the introduction to many of the outreach team's presentations. "Immigrants arrive in the United States with the best health in the nation, but in just 5 years, they come to have the poorest health in the nation. How could that be?"
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<br />I sat down with a patient today to talk about participating in our upcoming diabetes group classes entitled Tomando Control de su Diabetes, or Taking Control of your Diabetes. During our conversation, It became clear that diabetes was the least of her struggles. She was nervous of finding the location - which is two blocks from our clinic. She told me about a time when she had an appoinment in a new clinic and would wander the same city blocks over and over looking for the building, scared to stop. Nervous and frustrated, she eventually took a turn off the main road and hunched down in the ally way and sobbed. She would hear people approach and be overcome with fear that they would harm her. All she could do was pray. Pray and cry. Eventually she calmed her self and just went home. But now she only goes to the places she already knows, using bus routs she is familiar with, and will spend hours in our clinic trying to get all of her needs so she doesn't need to go elsewhere. To try and make it to the Diabetes group visits was too much to handle.
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<br />The anxiety and fear of living in a new and foreign place is overwhelming. Leaving her home out of financial necessity to live in a place that has no feeling of home or community has allowed terror to permeated her life. It has worsened her physical an mental health and stunted her social interactions. Its no wonder that immigrants, who may have come to the US happy and healthy, are stripped of their health within only a few years.</div>Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-74595329156210926102011-07-27T09:19:00.000-07:002011-07-27T10:00:20.538-07:00December: The Power of LaughterSexual Health, albeit important, is not the easiest thing to talk about. Especially with a room full people who don’t know each other, aren't familiar you, and come from a culture that historically doesn't talk very openly about this subject. This made our health outreach team more than a little apprehensive about giving the presentation that the Mexican Consulate staff specifically asked us to give on Sexual Health around the holidays. We were very mindful about the how we presented this information and trying to create a light hearted and open environment so that people would be comfortable and receptive to the information we presented.<br /><br />We started with an ice breaker: We handed out cups filled with little pieces of paper - mostly white, but a few cups were full of yellow, red, or orange paper - and had everyone stand up. The group was asked to talk with at least three other people and ask a simple question: "What's your name?" "Where are you from?" "How long did you have to travel to get to the consulate today?" As each questions was asked, the pair exchanged a bit of paper from each of their cups. The outreach team participated to try and break down the barriers between the three "Gringas" presenting and the other participants. Once we explained that this was a model of the transmission of sexually transmitted infections, the room erupted with laughter and pointing of fingers, a few red faces, and a lot of surprise - mostly for us who were not expecting the metaphor to be so well received. We asked how people felt who had started with only white paper and then by the end had a mixture of colors - indicating they had received an STI, as well as those who had started with colored paper (STIs) and didn't know they'd had an infection. The participants openly talked about their feelings of dissapointment and being tricked.<br /><br />After allowing everyone to laugh and relax, the group was primed to pay attention to the information we had to offer. When our presentations were done and the team was packing up, the consulate staff said they'd never heard so much laughter and participation during a presentation about STIs. Our team really had a way with breaking down barriers and helping people be involved in the learning and teaching process. This was not only a testament to our enthusiasm as presenters, but to the people we are presenting to. They key is being able to connect. Something about our outgoing demeanor and smiling faces made the participants more comfortable. Taking any opportunity to make them laugh and let them breath a little easier made them much more receptive to the information we had to offer, and hopefully made them think seriously about their personal sexual health. Healthier individuals make a healthier community, and a little laughter can go a long way in helping that happen.Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-528836887768562382011-07-27T09:12:00.000-07:002011-07-27T09:19:12.826-07:00December: Face to FaceIt is not always easy to connect with the patients participating in my hypertension case management project. I am supposed to call with patients who have been lent home blood pressure monitors each month to follow-up on their blood pressure readings and self management goals. Surprisingly I have a found that more than a few of the nine patients participating prefer to make the extra trip into clinic and do our check-in face to face. I had been playing phone tag with one patient in particular for a few weeks. He happened to come into clinic one day for a follow up with his primary care doctor, and wandered up to my desk as he was waiting to be registered. “Are you Erin?” he asked tentatively. Recognizing his voice form our previous phone conversations I said “Why yes I am, and you must be Ron.* Its so nice to put a face to a name.” He was just as pleased to match a face to the voice that left him messages each month. I asked if he had time to check in after his appointment with the doctor, and he returned a while later ready to talk. He had a complicated medical case and was not keeping good track of his hypertension due to other worries and problems. Throughout our conversation I tried hard to pick out the things he was really concerned about that may be a good place to start. He was not really willing to pick one goal to work on, but was recognizing that there were many things that could change. I empathized with his complicated situation and encouraging him to take things one step at a time. We were able to make one goal that he would be willing to revisit when we checked in January after he’d had some testing done for his other health concerns. We had a wonderful conversation and he felt very comfortable sharing his worries with me. I knew he would respond well with a little more encouragement and could handle a little more push to make some small lifestyle changes the next time we talked. As he stood up to leave my desk, we talked about our next check in. He said “you know, I’d really prefer to come in and talk with you in person if that’s possible. It really was a pleasure meeting you.” I guess a little personal connection can go a long way.<br /><br />*Name changed to protect patient confidentialityErinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-24043219218380033942011-07-27T08:28:00.000-07:002011-07-27T09:11:00.553-07:00November: Patient AdvocacyMy identity as a patient advocate and future physician go hand in hand, but I have had some interactions with doctors in my clinic that contradict that ideal.<br /><br />A patient came in needing help with Labor and Industry paperwork that required a letter from the doctor stating her treatment plan in order for her to continue getting her payments. The paperwork had been faxed to the provider a week or so previously and the patient asked the doctor about it during her visit, but she was sent to the "social worker" to have this paperwork filled out. The paperwork explicitly required information directly from the doctor, and was not information that any other clinic staff could fill out. The patient was very distressed. She was frustrated with the quality of care she was receiving as well as very concerned about being able to pay her bills.<br /><br />As I worked with medical assistant to make sure the doctor wrote the letter, she explained that he often tries to have other clinic staff do this kind of work. He doesn't like to be bogged down with paperwork and simply passes it off. How frustrating that a physician who's entire job is to care for his patients would stop so short of providing complete and quality care!<br /><br />I expected to be allies with providers to make sure patients had everything they needed. I did not expect to have to advocate for my patients so much within my own clinic.Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-45361724318823407882011-07-19T11:42:00.000-07:002011-07-19T11:59:31.051-07:00November - Pride: one of the few things left to hold ontoOne patient who I see on a regular basis has really made Sea Mar his home. This is in part because he has been coming here so long that the clinic staff treats him more like that quirky uncle than a patient, and in part because he is homeless and really has no place else to go in South Park. I am like the gatekeeper of his home. He will walk in the door, raise a hand and shout "How's it <span id="SPELLING_ERROR_0" class="blsp-spelling-error">goin</span>, Miss Erin?" then continue forward seating himself in the chair in front of my desk and hand over one of the many tattered business cards of social support services that are the thread holding the remaining fabric of his life together.<br /><br />His situation broke my heart a little further right before Thanksgiving. As temperatures dropped, he came in each day with a new layer of clothes and with a little less excitement in his greeting. His usual smile started to droop and the glimmer in eye grew dimmer and dimmer. I searched for housing downtown, but without a guarantee that he would have a place to sleep, he didn't want to make the trek to the city.<br /><br />One day it was finally dropping below zero and emergency shelters in the city center were opening up. I urged him to go to City Hall, but he pushed back, not wanting to have to wait in line for hours just to be kicked out early in the morning. "But it's a warm bed" I pleaded with him. He replied "Its not a bed. Its a cot on the floor." I had no response. He was desperately trying to hang onto his last shreds of dignity. He would rather sleep with blankets under the bridge than wait in line to be packed into a dirty, smelly room with other people without homes hoping for a few hours of warmth on the City Hall floor.<br /><br />There was nothing I could say to convince him to go. I can make the resources known, but protecting your pride when you have nothing else is sometimes a bigger priority.Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-2800628486991289272011-07-12T09:45:00.000-07:002011-07-12T10:43:02.013-07:00October - First Presentation at the ConsulateWe were full of nerves and excitement at our first presentation at the Mexican Consulate. The Health Education team nervously practiced our parts in Spanish, hoping to sound natural and fluid as we tried to get the important information we wanted to share across to the room of people anxiously waiting for their documents.<br /><br />There were a few bumps in the road as other groups showed up scheduled to present, but we rolled with the punches and waited our turn. Finally it was time to go. The audience started out fairly quiet and hesitant o participate, with the exception of one woman. She sat in the front row with her husband with her eyes wide and eager to contribute to the conversation about Diabetes, Hypertension and High Blood Pressure. She was the first to volunteer when we offered free testing for those three conditions with our nurse. On the other hand, there was a man who sat in the back with a sly smile who just kept quiet, not quite buying what we were talking about. Throughout the presentation, he became a little more vocal. He asked questions, participated in a demonstration, but still did not want to get tested. As our Diabetic Educator spoke about Diabetes, our Champion poked her bright eyes around the corner of the testing room and displayed her bandaged finger for all to see, proud of getting her blood sugar checked and encouraging others to do the same.<br /><br />As the discussion wound down, and we asked the last time for people interested in getting their blood sugar, blood pressure, and cholesterol checked, our quiet friend and his sly smile reluctantly shook his head and raised his hand. Empowered not only by the knowledge we imparted, but by the actions and advocacy of his peers, he checked his sugar, which was high, and was referred to out clinic for follow up - something so simple that will help him live a longer and healthier life.Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0tag:blogger.com,1999:blog-2231738219336570738.post-20418518794511770582011-07-05T13:48:00.000-07:002011-07-05T13:55:08.592-07:00October - Hypertension Case ManagementToday I enrolled my first patient in our hypertension case management pilot program.<br /><br />As she sat down at my desk, wide-eyed and overwhelmed by her disease, I could see her pressure rising along with her anxiety. She recently buried her son, and has had over 5 family members die due to high blood pressure. I asked what she knew about the disease, and she said not much. She was told she had it about 6 years ago, but felt fine so didn't worry about it. I could see her putting pieces together as I gave simple explanation of what blood pressure is, and what having high blood pressure for a long time can do to your body. As she began to comprehend the risks of uncontrolled high blood pressure, she was more and more willing to take charge of her disease. With the support of her daughter she was ready to make a change. When I asked about what has inspired her to change and how I could best support her, the tears started to well up in her eyes. Still struggling with the recent death of her son, and the social isolation of living with an absent niece, she was grateful just to have someone who would walk with her through her struggle to survive this disease. With support and knowledge she was encouraged and empowered to manage her blood pressure. The silent yet heartfelt thank you spoken through tear-filled eyes reminds me why I have chosen to serve others and inspires me to continue to walk along side my patients in their struggles to lead healthy lives.Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com1tag:blogger.com,1999:blog-2231738219336570738.post-77237940375742479502011-07-05T11:28:00.001-07:002011-07-05T12:17:28.386-07:00Another Year GoneMy year of service with <span id="SPELLING_ERROR_0" class="blsp-spelling-error"><span id="SPELLING_ERROR_0" class="blsp-spelling-error">AmeriCorps</span>/<span id="SPELLING_ERROR_1" class="blsp-spelling-error">HealthCorps</span> </span>is almost over and I haven't written a word since <span id="SPELLING_ERROR_1" class="blsp-spelling-corrected">orientation</span> last September... <span id="SPELLING_ERROR_2" class="blsp-spelling-error"><span id="SPELLING_ERROR_2" class="blsp-spelling-error">WOOPSIES</span></span>!<br /><br />This year has been full of growth to say the least, and I truly do want to share my journey with you all. As I start to get everything ready for the new Patient Navigator in my last four weeks with Sea Mar Community Health Centers, I'm starting to reflect on what this year has meant to me and what I will take away from this experience.<br /><br />But before I process too much, I wanted to share some of the things I've done. Throughout the year we are required to report "Great Stories" each month showing the work we've done and what we've learned. These are <span id="SPELLING_ERROR_3" class="blsp-spelling-corrected">ultimately</span> used as a promotional tool for our program, but as I weed through them I thought I'd post a few so people can have a better sense of the things I've done this year.<br /><br />So keep your eye out - the next few posts will be a few of my "Great Stories" from this year.<br /><br />Enjoy!Erinhttp://www.blogger.com/profile/18214737113194997294noreply@blogger.com0