Tuesday, February 19, 2013

El Centro de Salud

19 febrero, parte 2

It just didn't feel right to write about the lake and my clinic work on the same page because no segue came to mind.

I started volunteering yesterday morning at El Centro de Salud, which is essentially Xela's health department.   I am working in what I understand is the city's only STD clinic with Dr. Gonzales, who I call Javier.

Javier is a middle aged guy with 3 kids who used to be the only doctor in a hospital in which he treated all the patients medically and performed appendectomies, hysterectomies, and hernia repairs.  He lived and worked as a physical therapist in California for 7 years so he likes to practice his English with me and with a top 40 Chicago radio station that he listens to online.  Generally, I speak to him in Spanish and he responds in English.  I really appreciate that he likes to eat as much as I do.  Each morning, we take a break and get a snack of tacos or a mini sandwich or chile relleno that a lady sells outside the building or that a couple sells out of the back of their station wagon.

Javier began working at El Centro de Salud relatively recently.  He sees all-comers with concerns of STDs and having very frequent check-in appointments with the city's sex workers.  The female patients work in "bars" and each day in the clinic is assigned a particular bar's workers.  The women come every 15 days for a brief check, every 3 months for a more detailed interview, every 6 months for an HIV test, and every 12 months for a pap smear.  In general.  There is a lot of variation depending on her complaints/symptoms, if any, and the availability of pap smear supplies and personnel in the lab.   In general, we see 12-20 patients in a morning, which for me is 8-12.  This morning was interesting because we also had 2 male patients, who were more of diagnostic challenges than the women are.  We also had one pregnant patient.  If women have symptoms, Javier prescribes syndromic treatment, which essentially means covering for the major STDs with a combination of 3 or 4 antibiotics.

I'm definitely getting more comfortable doing the patients' exams and speaking in Spanish about their symptoms or lack thereof.  Yesterday was a bit awkward as I got used to the phrases and the invasive exams but the women are really friendly and made it less so.  At one point, I found myself being asked to be in a picture with three women from the same bar and at once felt touched and also very tall.  It's a strange feeling to be memorable here, after spending the last several years mostly in clinical situations where I am one of so many trainees.

Anyways, my days are a bit busier now, with clinic all morning, lunch afterwards, classes from 2-5, and often yoga until dinnertime.  I did, however, find time to go by the Mennonite bakery again today immediately after clinic....talk about a strange transition.

Thanks, as always for all the e-love.

Rachel

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