Day 5

Blog Entry 5: 09/24/08

I woke up at 6:30 A.M. because my tour of the clinics started at 7:15 today, too early!! Dr. Tenorio showed my group locations of Centro de Salud, Hospital Civil, and C.R.I.T.. Centro de Salud is a primary care clinic focused on providing healthcare to underserved communities within Oaxaca city and the outskirts. We saw about 4 different Centro de Saluds. A big problem with Oaxaca city is that it's growing without city planning, due to people arriving (mostly in the hills) from other parts of the state, and trying to live anywhere they can find space. This makes it hard for the government to provide services because it cannot anticipate the immigration of these people, and therefore provide a proper infrastructure for sanitation and health. Dr. Tenorio pointed out that these people, who've usually arrived from the countryside, live in close proximity to their animals which brings up a variety of other health issues in that community. I found it interesting that in Mexico it's actually the poor that live in these extremely beautiful hills, and the rich that live in the downtown. This is due to the fact that the city itself is too expensive for the poor to move into, so they colonize the hills and areas outside the city, which as I've mentioned before is unregulated by the government in terms of infrastructure. Dr. De La Torre, brought up another interesting point that when it rains in Oaxaca city the runoff from hills can act as a vector for the spread of disease because the dirt and areas of the hills are generally covered with waste from these poor hillside communities that lack proper waste management, and this then floods into the city itself. I found this to be particularly scary being that it's been raining for the past two days now!!! Also, dengue fever is a problem in these communities because the poor never throw away their stuff, instead they collect it, and their stuff becomes a breeding ground for mosquitos. Centro de Salud offers educational programs for local communities explaining the causes of dengue fever and spread of disease due to local living conditions. I really want to get involved with that because it would give me a great opportunity to learn about epidemiology and to teach as well.
On an interesting side note, the Centro de Salud Volcanes, which is my first rotation, has focused on dealing with the prevalence of obesity and diabetes within the Mexican community. Dr. Tenorio explained to us that Mexicans are more prone to diabetes due to their genetics and diet (i.e. Tacos, Tortillas etc.) It was interesting to find out that Mexican women suffer from obesity more then men. Also, Dr. De La Torre said that recently Mexican women have acquired all the same health risk factors (that relate to chronic diseases) as Mexican men, due to the movement of women into careers and lifestyles similar to men. Really interesting stuff.
We were also shown a separate, and large, daycare facility that was provided and fully paid for by Hospital Isste. It kind of bothered me to think that if a country with an economy such as Mexico can provide these free services for hospital employees, why doesn't the U.S. do it, especially considering our country's relative affluence?
We visited C.R.I.T. last. C.R.I.T. is a very well-funded and maintained facility dedicated to the rehabilitation of children. This facility was so modern, large, and maintained, that it makes me wonder again why the U.S. lacks facilities of such calibre, with it's relative affluence. One thing I've noticed in Mexico is that there is a real commitment to providing health care to it's population, even with limited resources, which is something that I have not seen in the U.S.. Anyways, returning to the topic... C.R.I.T is divided up into four divisions, a church, physical rehabilitation center, medical services, and psychological services. If families couldn't afford the fees for their kids, the facility took care of it for them. I really found C.R.I.T. amazing, it was really centered around helping these kids, which direly need it. When I was walking through the facility, I was extremely sad. I was literally horrified at some of the faces I saw on the kids. One kid, you could tell just by looking at his expression, he had given up on life, and this bothered me because he's a KID, not an ADULT. In my entire life, I've only seen kids with hopes and dreams, with brightness on their face, full of innocence and joy. Today, I can't even explain it, for the first I saw a kid as young as 8 literally in depression. This kid communicated his entire condition without words. I can't tell you how much I wanted to help him, how much it hurt me in every way.
Yet, C.R.I.T. is great because they showed us many kids who've received rehabilitation and how much it's improved their lives. There was one kid who was maybe 5 or 6, and he was SO cheerful and friendly. He lost both of his arms, but through rehab, he was able to use his feet, with great skill, to put on his socks and use them to play board games, it was amazing. They also showed us a video of a girl who only had one leg, C.R.I.T. provided her with a prosthetic leg that fits on her leg stub, and taught her how to walk with in their therapy division. They really have helped children here, I was definitely impressed.
After CRIT, we took the bus back home, it takes about 45min. At Bercari, Mi Mama (home-stay mom) gave a presentation on the traditions of Oaxaca to the class, it was pretty interesting. At home, she also noticed that my Spanish proficiency was higher, which made me pretty happy. All in all a good day, can't wait for my official rotations to start. Oh and I was able to sign-up for surgery observation (Hospital Carmen) for tommorow, I'll fill you in manana. Salamz.